Committees established by professional societies, health facilities, or other institutions to consider decisions that have bioethical implications. The role of these committees may include consultation, education, mediation, and/or review of policies and practices. Committees that consider the ethical dimensions of patient care are ETHICS COMMITTEES, CLINICAL; committees established to protect the welfare of research subjects are ETHICS COMMITTEES, RESEARCH.
The philosophy or code pertaining to what is ideal in human character and conduct. Also, the field of study dealing with the principles of morality.
The moral obligations governing the conduct of research. Used for discussions of research ethics as a general topic.
Services provided by an individual ethicist (ETHICISTS) or an ethics team or committee (ETHICS COMMITTEES, CLINICAL) to address the ethical issues involved in a specific clinical case. The central purpose is to improve the process and outcomes of patients' care by helping to identify, analyze, and resolve ethical problems.
The identification, analysis, and resolution of moral problems that arise in the care of patients. (Bioethics Thesaurus)
Ethics Committees, Research
Hospital or other institutional committees established to protect the welfare of research subjects. Federal regulations (the "Common Rule" (45 CFR 46)) mandate the use of these committees to monitor federally-funded biomedical and behavioral research involving human subjects.
Ethics Committees, Clinical
Hospital or other institutional ethics committees established to consider the ethical dimensions of patient care. Distinguish from ETHICS COMMITTEES, RESEARCH, which are established to monitor the welfare of patients or healthy volunteers participating in research studies.
An approach to ethics that focuses on theories of the importance of general principles such as respect for autonomy, beneficence/nonmaleficence, and justice.
A philosophically coherent set of propositions (for example, utilitarianism) which attempts to provide general norms for the guidance and evaluation of moral conduct. (from Beauchamp and Childress, Principles of Biomedical Ethics, 4th ed)
Clusters of topics that fall within the domain of BIOETHICS, the field of study concerned with value questions that arise in biomedicine and health care delivery.
The use of systematic methods of ethical examination, such as CASUISTRY or ETHICAL THEORY, in reasoning about moral problems.
A formal process of examination of patient care or research proposals for conformity with ethical standards. The review is usually conducted by an organized clinical or research ethics committee (CLINICAL ETHICS COMMITTEES or RESEARCH ETHICS COMMITTEES), sometimes by a subset of such a committee, an ad hoc group, or an individual ethicist (ETHICISTS).
Duties that are based in ETHICS, rather than in law.
The state or quality of being kind, charitable, or beneficial. (from American Heritage Dictionary of the English Language, 4th ed). The ethical principle of BENEFICENCE requires producing net benefit over harm. (Bioethics Thesaurus)
Character traits that are considered to be morally praiseworthy. (Bioethics Thesaurus)
Voluntary authorization, by a patient or research subject, with full comprehension of the risks involved, for diagnostic or investigative procedures, and for medical and surgical treatment.
Abstract standards or empirical variables in social life which are believed to be important and/or desirable.
Interference with the FREEDOM or PERSONAL AUTONOMY of another person, with justifications referring to the promotion of the person's good or the prevention of harm to the person. (from Cambridge Dictionary of Philosophy, 1995); more generally, not allowing a person to make decisions on his or her own behalf.
The state or condition of being a human individual accorded moral and/or legal rights. Criteria to be used to determine this status are subject to debate, and range from the requirement of simply being a human organism to such requirements as that the individual be self-aware and capable of rational thought and moral agency.
Fundamental claims of patients, as expressed in statutes, declarations, or generally accepted moral principles. (Bioethics Thesaurus) The term is used for discussions of patient rights as a group of many rights, as in a hospital's posting of a list of patient rights.
The philosophical view that conceptions of truth and moral values are not absolute but are relative to the persons or groups holding them. (from American Heritage Dictionary of the English Language, 4th ed)
The science or philosophy of law. Also, the application of the principles of law and justice to health and medicine.
The privacy of information and its protection against unauthorized disclosure.
Value of Life
The intrinsic moral worth ascribed to a living being. (Bioethics Thesaurus)
The branch of philosophy that treats of first principles, including ontology (the nature of existence or being) and cosmology (the origin and structure of the universe). (From Random House Unabridged Dictionary, 2d ed)
Conflict of Interest
A situation in which an individual might benefit personally from official or professional actions. It includes a conflict between a person's private interests and official responsibilities in a position of trust. The term is not restricted to government officials. The concept refers both to actual conflict of interest and the appearance or perception of conflict.
The act or practice of killing or allowing death from natural causes, for reasons of mercy, i.e., in order to release a person from incurable disease, intolerable suffering, or undignified death. (from Beauchamp and Walters, Contemporary Issues in Bioethics, 5th ed)
Dissent and Disputes
An international agreement of the World Medical Association which offers guidelines for conducting experiments using human subjects. It was adopted in 1962 and revised by the 18th World Medical Assembly at Helsinki, Finland in 1964. Subsequent revisions were made in 1975, 1983, 1989, and 1996. (From Encyclopedia of Bioethics, rev ed, 1995)
Withholding or withdrawal of a particular treatment or treatments, often (but not necessarily) life-prolonging treatment, from a patient or from a research subject as part of a research protocol. The concept is differentiated from REFUSAL TO TREAT, where the emphasis is on the health professional's or health facility's refusal to treat a patient or group of patients when the patient or the patient's representative requests treatment. Withholding of life-prolonging treatment is usually indexed only with EUTHANASIA, PASSIVE, unless the distinction between withholding and withdrawing treatment, or the issue of withholding palliative rather than curative treatment, is discussed.
Nontherapeutic Human Experimentation
Human experimentation that is not intended to benefit the subjects on whom it is performed. Phase I drug studies (CLINICAL TRIALS, PHASE I AS TOPIC) and research involving healthy volunteers are examples of nontherapeutic human experimentation.
Members of a religious denomination founded in the United States during the late 19th century in which active evangelism is practiced, the imminent approach of the millennium is preached, and war and organized government authority in matters of conscience are strongly opposed (from American Heritage Dictionary of the English Language, 4th ed). Jehovah's Witnesses generally refuse blood transfusions and other blood-based treatments based on religious belief.
Therapeutic Human Experimentation
The reporting of observed or suspected PROFESSIONAL MISCONDUCT or incompetence to appropriate authorities or to the public.
A person who has not attained the age at which full civil rights are accorded.
Interaction between research personnel and research subjects.
A school of thought and set of moral, ethical, and political teachings usually considered to be founded by Confucius in 6th-5th century B.C. China. (from Cambridge Dictionary of Philosophy, 1995)
Communication, in the sense of cross-fertilization of ideas, involving two or more academic disciplines (such as the disciplines that comprise the cross-disciplinary field of bioethics, including the health and biological sciences, the humanities, and the social sciences and law). Also includes problems in communication stemming from differences in patterns of language usage in different academic or medical disciplines.
The act or practice of killing for reasons of mercy, i.e., in order to release a person or animal from incurable disease, intolerable suffering, or undignified death. (from Beauchamp and Walters, Contemporary Issues in Bioethics, 5th ed)
Those individuals engaged in research.
The absence of a useful purpose or useful result in a diagnostic procedure or therapeutic intervention. The situation of a patient whose condition will not be improved by treatment or instances in which treatment preserves permanent unconsciousness or cannot end dependence on intensive medical care. (From Ann Intern Med 1990 Jun 15;112(12):949)
An ethical system which emphasizes human values and the personal worth of each individual, as well as concern for the dignity and freedom of humankind.
Informed consent given by someone other than the patient or research subject.
Legal guarantee protecting the individual from attack on personal liberties, right to fair trial, right to vote, and freedom from discrimination on the basis of race, color, religion, sex, age, disability, or national origin. (from http://www.usccr.gov/ accessed 1/31/2003)
Beginning of Human Life
The point at which religious ensoulment or PERSONHOOD is considered to begin.
Double Effect Principle
Guideline for determining when it is morally permissible to perform an action to pursue a good end with knowledge that the action will also bring about bad results. It generally states that, in cases where a contemplated action has such double effect, the action is permissible only if: it is not wrong in itself; the bad result is not intended; the good result is not a direct causal result of the bad result; and the good result is "proportionate to" the bad result. (from Solomon, "Double Effect," in Becker, The Encyclopedia of Ethics, 1992)
One of the principal schools of medical philosophy in ancient Greece and Rome. It developed in Alexandria between 270 and 220 B.C., the only one to have any success in reviving the essentials of the Hippocratic concept. The Empiricists declared that the search for ultimate causes of phenomena was vain, but they were active in endeavoring to discover immediate causes. The "tripod of the Empirics" was their own chance observations (experience), learning obtained from contemporaries and predecessors (experience of others), and, in the case of new diseases, the formation of conclusions from other diseases which they resembled (analogy). Empiricism enjoyed sporadic continuing popularity in later centuries up to the nineteenth. (From Castiglioni, A History of Medicine, 2d ed, p186; Dr. James H. Cassedy, NLM History of Medicine Division)
The science concerned with problems of radiation protection relevant to reducing or preventing radiation exposure, and the effects of ionizing radiation on humans and their environment.
The intentional infliction of physical or mental suffering upon an individual or individuals, including the torture of animals.
Manipulation of the behavior of persons or animals by biomedical, physical, psychological, or social means, including for nontherapeutic reasons.
Clinical Trials Data Monitoring Committees
Committees established to review interim data and efficacy outcomes in clinical trials. The findings of these committees are used in deciding whether a trial should be continued as designed, changed, or terminated. Government regulations regarding federally-funded research involving human subjects (the "Common Rule") require (45 CFR 46.111) that research ethics committees reviewing large-scale clinical trials monitor the data collected using a mechanism such as a data monitoring committee. FDA regulations (21 CFR 50.24) require that such committees be established to monitor studies conducted in emergency settings.
Life Support Care
Care provided patients requiring extraordinary therapeutic measures in order to sustain and prolong life.
Guidelines as Topic
A systematic statement of policy rules or principles. Guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by convening expert panels. The text may be cursive or in outline form but is generally a comprehensive guide to problems and approaches in any field of activity. For guidelines in the field of health care and clinical medicine, PRACTICE GUIDELINES AS TOPIC is available.
The state that distinguishes organisms from inorganic matter, manifested by growth, metabolism, reproduction, and adaptation. It includes the course of existence, the sum of experiences, the mode of existing, or the fact of being. Over the centuries inquiries into the nature of life have crossed the boundaries from philosophy to biology, forensic medicine, anthropology, etc., in creative as well as scientific literature. (Random House Unabridged Dictionary, 2d ed; Dr. James H. Cassedy, NLM History of Medicine Division)
Education, Medical, Undergraduate
The period of medical education in a medical school. In the United States it follows the baccalaureate degree and precedes the granting of the M.D.
Truthful revelation of information, specifically when the information disclosed is likely to be psychologically painful ("bad news") to the recipient (e.g., revelation to a patient or a patient's family of the patient's DIAGNOSIS or PROGNOSIS) or embarrassing to the teller (e.g., revelation of medical errors).
Experimentation on, or using the organs or tissues from, a human or other mammalian conceptus during the prenatal stage of development that is characterized by rapid morphological changes and the differentiation of basic structures. In humans, this includes the period from the time of fertilization to the end of the eighth week after fertilization.
A method of ETHICAL ANALYSIS that emphasizes practical problem solving through examining individual cases that are considered to be representative; sometimes used to denote specious argument or rationalization. Differentiate from casuistics, which is the recording and study of cases and disease.
The process by which a person or group of persons comes to be regarded or treated as lacking in human qualities.
The bestowing of tangible or intangible benefits, voluntarily and usually without expectation of anything in return. However, gift giving may be motivated by feelings of ALTRUISM or gratitude, by a sense of obligation, or by the hope of receiving something in return.
The science that investigates the principles governing correct or reliable inference and deals with the canons and criteria of validity in thought and demonstration. This system of reasoning is applicable to any branch of knowledge or study. (Random House Unabridged Dictionary, 2d ed & Sippl, Computer Dictionary, 4th ed)
Tissue and Organ Procurement
The administrative procedures involved with acquiring TISSUES or organs for TRANSPLANTATION through various programs, systems, or organizations. These procedures include obtaining consent from TISSUE DONORS and arranging for transportation of donated tissues and organs, after TISSUE HARVESTING, to HOSPITALS for processing and transplantation.
Critical and exhaustive investigation or experimentation, having for its aim the discovery of new facts and their correct interpretation, the revision of accepted conclusions, theories, or laws in the light of newly discovered facts, or the practical application of such new or revised conclusions, theories, or laws. (Webster, 3d ed)
A late 20th-century philosophical approach or style of cultural analysis that seeks to reveal the cultural or social construction of concepts conventionally assumed to be natural or universal. (from E.R. DuBose, The Illusion of Trust: Toward a Medical Theological Ethics in the Postmodern Age, Kluwer, 1995)
A historical and cultural entity dispersed across the wide geographical area of Europe, as opposed to the East, Asia, and Africa. The term was used by scholars through the late medieval period. Thereafter, with the impact of colonialism and the transmission of cultures, Western World was sometimes expanded to include the Americas. (Dr. James H. Cassedy, NLM History of Medicine Division)
Research that involves the application of the behavioral and social sciences to the study of the actions or reactions of persons or animals in response to external or internal stimuli. (from American Heritage Dictionary, 4th ed)
Attitude of Health Personnel
The doctrines and policies of the Nazis or the National Social German Workers party, which ruled Germany under Adolf Hitler from 1933-1945. These doctrines and policies included racist nationalism, expansionism, and state control of the economy. (from Columbia Encyclopedia, 6th ed. and American Heritage College Dictionary, 3d ed.)
Clinical Trials as Topic
Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries.
Persons as individuals (e.g., ABORTION APPLICANTS) or as members of a group (e.g., HISPANIC AMERICANS). It is not used for members of the various professions (e.g., PHYSICIANS) or occupations (e.g., LIBRARIANS) for which OCCUPATIONAL GROUPS is available.
Health Care Rationing
Peer Review, Research
The evaluation by experts of the quality and pertinence of research or research proposals of other experts in the same field. Peer review is used by editors in deciding which submissions warrant publication, by granting agencies to determine which proposals should be funded, and by academic institutions in tenure decisions.
A course or method of action selected, usually by an organization, institution, university, society, etc., from among alternatives to guide and determine present and future decisions and positions on matters of public interest or social concern. It does not include internal policy relating to organization and administration within the corporate body, for which ORGANIZATION AND ADMINISTRATION is available.
The attempt to improve the PHENOTYPES of future generations of the human population by fostering the reproduction of those with favorable phenotypes and GENOTYPES and hampering or preventing BREEDING by those with "undesirable" phenotypes and genotypes. The concept is largely discredited. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed)
The state of being free from intrusion or disturbance in one's private life or affairs. (Random House Unabridged Dictionary, 2d ed, 1993)
The internal individual struggle resulting from incompatible or opposing needs, drives, or external and internal demands. In group interactions, competitive or opposing action of incompatibles: antagonistic state or action (as of divergent ideas, interests, or persons). (from Merriam-Webster's Collegiate Dictionary, 10th ed)
"The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing.
Right to Die
A collective expression for all behavior patterns acquired and socially transmitted through symbols. Culture includes customs, traditions, and language.
Decision Making, Organizational
A social science dealing with group relationships, patterns of collective behavior, and social organization.
Duty to Warn
A health professional's obligation to breach patient CONFIDENTIALITY to warn third parties of the danger of their being assaulted or of contracting a serious infection.
Research Support as Topic
Financial support of research activities.
Refusal to Treat
Refusal of the health professional to initiate or continue treatment of a patient or group of patients. The refusal can be based on any reason. The concept is differentiated from PATIENT REFUSAL OF TREATMENT see TREATMENT REFUSAL which originates with the patient and not the health professional.
Groups of persons whose range of options is severely limited, who are frequently subjected to COERCION in their DECISION MAKING, or who may be compromised in their ability to give INFORMED CONSENT.
Societies whose membership is limited to physicians.
Medicine in Literature
Attitude to Death
An organized procedure carried out by a select committee of professionals in evaluating the performance of other professionals in meeting the standards of their specialty. Review by peers is used by editors in the evaluation of articles and other papers submitted for publication. Peer review is used also in the evaluation of grant applications. It is applied also in evaluating the quality of health care provided to patients.
Expectation of real uncertainty on the part of the investigator regarding the comparative therapeutic merits of each arm in a trial.
The human being as a non-anatomical and non-zoological entity. The emphasis is on the philosophical or artistic treatment of the human being, and includes lay and social attitudes toward the body in history. (From J. Cassedy, NLM History of Medicine Division)
The Christian faith, practice, or system of the Catholic Church, specifically the Roman Catholic, the Christian church that is characterized by a hierarchic structure of bishops and priests in which doctrinal and disciplinary authority are dependent upon apostolic succession, with the pope as head of the episcopal college. (From Webster, 3d ed; American Heritage Dictionary, 2d college ed)
Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols.
The interchange of goods or commodities, especially on a large scale, between different countries or between populations within the same country. It includes trade (the buying, selling, or exchanging of commodities, whether wholesale or retail) and business (the purchase and sale of goods to make a profit). (From Random House Unabridged Dictionary, 2d ed, p411, p2005 & p283)