Insight is a useful construct in clinical assessments if used wisely

Medical ethicist, Guidry-Grimes has critically reviewed the concept of insight, voicing concerns that it lacks consensus as to its components and that it undermines patient perspectives. We respond by briefly summarising research over the last 30 years that she overlooks which has helped establish the clinical validity of the construct. This includes the adoption of standardised assessment tools—at least in research—and longitudinal and cross-sectional studies quantifying associations with psychopathological, clinical and cognitive measures. We also make the distinction between the current standards for assessing decision-making capacity leading to, where appropriate, involuntary treatment in clinical and medico-legal settings which in most legislations do not include insight assessments, and anecdotal reports of the use and misuse of ‘lack of insight’ as a proxy for more comprehensive evaluation. We conclude by encouraging a broader view of insight akin to self-knowledge.

You Are the Perfect Age: An Inquiry into Surgical Ethics during the Arc of a Career

There is an old saying that history only makes sense in retrospect. I am sure that I am as susceptible to this adage as any other person. However, I will tell the story of my long history as an amateur medical ethicist, which is, to this day, how I would describe myself. My interest in the ethics of medicine, particularly as these ethical principles apply to interventions or procedures, started at a young age, fairly frequently going to the hospital with my father, a General and Thoracic Surgeon. I think that I found myself agreeing to accompany him, when invited, presuming that doing so would be a chance to spend some time with my dad, who was, throughout my childhood, either a surgical resident or a busy practicing surgeon. I will admit that I probably also figured that, at least late at night on the way home, we would stop by some establishment where we could get burgers and fries. However, I will start my reminiscences and reflections on these issues with a more recent story, as it prompted me to think back on my perceptions of those experiences of my youth.

7. Establishing fair procedure

No healthcare system in the world has sufficient money to provide the best possible treatment for all patients in all situations. When is the extra benefit of a new, better, and expensive treatment worth the extra cost? ‘Establishing fair procedure’ explains that medical ethics can provide practical support to assist policy-makers in the allocation of healthcare resources. The medical ethicist acts as the architect of a process of fair and accountable decision-making, and also facilitates discussion about, and judges between, those ethical values that have been identified for application within this process. The rule of rescue principle is discussed along with thought experiments that support or go against it.

What Is Medical Ethics Consultation?

As everybody knows, advances in medicine and medical technology have brought enormous benefits to, and created vexing choices for, us all – choices that can, and occasionally do, test the very limits of thinking itself. As everyone also knows, we live in the age of consultants, i.e., of professional experts who are ready, willing, and able to give us advice on any and every conceivable question. One such consultant is the medical ethics consultant, or the medical ethicist who consults.Medical ethics consultants involve themselves in just about every aspect of health care decision making. They help legislators and judges determine law, hospitals formulate policies, medical schools develop curricula, etc. In addition to educating physicians, nurses, and lawyers, amongst others, including medical, nursing, and law students, they participate in clinical decision making at the bedside.