1. Copyright © 2012 Pearson Education, Inc. All rights reserved. Ethics: Theory and Practice Jacques P. Thiroux Keith W. Krasemann

2. Copyright © 2012 Pearson Education, Inc. All rights reserved. Chapter Fourteen Bioethics – Ethical Issues in Medicine (selected slides)

3. Copyright © 2012 Pearson Education, Inc. All rights reserved. What Is Bioethics? Bioethics means “life ethics,” or ethics in medicine – What actions might be covered by bioethics?

4. Copyright © 2012 Pearson Education, Inc. All rights reserved. What Is Bioethics? Bioethics means “life ethics,” or ethics in medicine – Bioethics covers the areas of caring for the dying; allowing someone to die, mercy death, and mercy killing; human experimentation and informed consent; genetics, fertilization, and birth; health care and its costs; population and birth control, abortion, and sterilization; allocation of scarce medical resources; and truth telling and confidentiality in medicine

5. Copyright © 2012 Pearson Education, Inc. All rights reserved. Health Care Professionals and Patients and Their Families – Rights and Obligations Paternalism is the position that professionals should take a paternal role toward patients and their families – Laypeople don’t know what’s best for them – They should place themselves totally in the hands of professionals – Patients and their families are like children when it comes to medical matters

6. Copyright © 2012 Pearson Education, Inc. All rights reserved. Paternalism Two Models: – The engineering model, in which the physician tries to be an applied scientist who is value free The problem here is that physicians cannot logically be value free – In the priestly model – which is the opposite extreme – the physician is a new priest The problem is that he or she is still making decisions for the patient

7. Copyright © 2012 Pearson Education, Inc. All rights reserved. Health Care Professionals and Patients and Their Families – Rights and Obligations Radical individualism is the position that patients should have absolute rights over their bodies and lives and may therefore reject doctors’ recommendations – Doctors are just people with special training; they make mistakes – Patients and their families are better qualified to make decisions concerning their own treatment

8. Copyright © 2012 Pearson Education, Inc. All rights reserved. Health Care Professionals and Patients and Their Families – Rights and Obligations The reciprocal model utilizes the team approach, in which patients and their families work with health care personnel to do what is best for patients – Professionals are just people with special training – Many decisions are not strictly medical, so a team approach is needed to make treatment decisions

9. Copyright © 2012 Pearson Education, Inc. All rights reserved. The Reciprocal View Two Models: – The collegial model, in which the physician and patient see themselves as colleagues pursuing a common goal – The contractual model is supposed to permit moral equality between physician and patient, without indulging in any utopian assumptions of collegiality

10. Copyright © 2012 Pearson Education, Inc. All rights reserved. Truth Telling and Informed Consent The main issue is to what extent patients and their families should be told the truth about their medical situations and to what extent they should not Informed consent is a formalized procedure in which patients or their families consent in writing to medical procedures involving some degree of risk to their health or lives

11. Copyright © 2012 Pearson Education, Inc. All rights reserved. Confidentiality Generally, the matter of confidentiality seems fairly clear in that what goes on between doctors and patients should always be confidential At the same time, everything must be done to protect the innocent from contagion

12. Copyright © 2012 Pearson Education, Inc. All rights reserved. Ethical Issues in Medicine Ethics and behavior control is that aspect of bioethics that deals with general questions concerning the extent to which the behavior of human beings should be controlled by the various technologies available to us

13. Copyright © 2012 Pearson Education, Inc. All rights reserved. Behavior Control – How do we determine what constitutes undesirable or socially unacceptable behavior? – Which means of behavior control should be considered ethical? – Who should determine when to control behavior?

14. Copyright © 2012 Pearson Education, Inc. All rights reserved. Human Experimentation Human experimentation is the use of human beings for experimental purposes, either for their own therapy, for the good of humanity, or to advance scientific knowledge

15. Copyright © 2012 Pearson Education, Inc. All rights reserved. Stem Cell Research Stem cells are master cells of the body and can be obtained from both adults and human embryos The moral issue with using embryonic stem cells is that the embryo is destroyed during the procedure