Response to: What counts as success in genetic counselling?
(57/930)
Clinical genetics encompasses a wider range of activities than discussion of reproductive risks and options. Hence, it is possible for a clinical geneticist to reduce suffering associated with genetic disease without aiming to reduce the birth incidence of such diseases. Simple cost-benefit analyses of genetic-screening programmes are unacceptable; more sophisticated analyses of this type have been devised but entail internal inconsistencies and do not seem to result in changed clinical practice. The secondary effects of screening programmes must be assessed before they can be properly evaluated, including the inadvertent diagnosis of unsought conditions, and the wider social effects of the programmes on those with mental handicap. This has implications for the range of prenatal tests that should be made available. While autonomy must be fully respected, it cannot itself constitute a goal of clinical genetics. The evaluation of these services requires interdepartmental comparisons of workload, and quality judgements of clients and peers. (+info)
Paternalism versus autonomy: medical opinion and ethical questions in the treatment of defective neonates.(58/930)
This paper considers the justifications for adhering to a principle of confidentiality within medical practice. These are found to derive chiefly from respect for individual autonomy, the doctor/patient contract, and social utility. It is suggested that these will benefit more certainly if secrecy is rejected and the principle of confidentiality is removed from the area of health care. (+info)
The history of confidentiality in medicine: the physician-patient relationship.
(62/930)
The author of this article reviews the history of the confidentiality of medical information relating to patients from its roots in the Hippocratic Oath to the current codes of medical ethics. There has been an important shift in the basis for the demand for confidentiality, from a physician-based commitment to a professional ideal that will improve the physician-patient relationship and thus the physician's therapeutic effectiveness, and replace it with a patientbased right arising from individual autonomy instead of a Hippocratic paternalistic privilege. (+info)
Ethics and family practice: some modern dilemmas.
(63/930)
Ethical dilemmas in family practice have increased in frequency and complexity as both the potential benefit and the potential harm of medical treatments have increased. All physicians must be aware of moral issues relating to medicine. Family physicians commonly face ethical problems concerning the patient with diminished autonomy; the right to refuse treatment; allocation of resources; informed consent; surrogate consent (for children, for the incompetent, and for those with diminished autonomy); and the appropriate level of aggressiveness in treatment. (+info)
Values in preventive medicine: the hidden agenda.
(64/930)
We know how lifestyle affects health, yet concern for preventing illness by promoting healthy lifestyles remains marginal in medical practice. Effective preventive strategies can raise daunting moral and political problems about the extent to which individual freedoms may be infringed, particularly on paternalistic grounds. Evaluative questions also arise about more specific matters, such as identifying risk and causal factors, determining what level of risk is acceptable, and deciding how compelling the evidence must be to take preventive action. (+info)