Methods and principles in biomedical ethics.
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The four principles approach to medical ethics plus specification is used in this paper. Specification is defined as a process of reducing the indeterminateness of general norms to give them increased action guiding capacity, while retaining the moral commitments in the original norm. Since questions of method are central to the symposium, the paper begins with four observations about method in moral reasoning and case analysis. Three of the four scenarios are dealt with. It is concluded in the "standard" Jehovah's Witness case that having autonomously chosen the authority of his religious institution, a Jehovah's Witness has a reasonable basis on which to refuse a recommended blood transfusion. The author's view of the child of a Jehovah's Witness scenario is that it is morally required-not merely permitted-to overrule this parental refusal of treatment. It is argued in the selling kidneys for transplantation scenario that a fair system of regulating and monitoring would be better than the present system which the author believes to be a shameful failure. (+info)
Statistical association criteria in forensic psychiatry-a criminological evaluation of casuistry.
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PURPOSE: Identification of potential shared primary psychoprophylaxis and crime prevention is measured by analyzing the rate of commitments for patients-subjects to forensic examination. MATERIAL AND METHOD: The statistic trial is a retrospective, document-based study. The statistical lot consists of 770 initial examination reports performed and completed during the whole year 2007, primarily analyzed in order to summarize the data within the National Institute of Forensic Medicine, Bucharest, Romania (INML), with one of the group variables being 'particularities of the psychiatric patient history', containing the items 'forensic onset', 'commitments within the last year prior to the examination' and 'absence of commitments within the last year prior to the examination'. The method used was the Kendall bivariate correlation. For this study, the authors separately analyze only the two items regarding commitments by other correlation alternatives and by modern, elaborate statistical analyses, i.e. recording of the standard case study variables, Kendall bivariate correlation, cross tabulation, factor analysis and hierarchical cluster analysis. RESULTS: The results are varied, from theoretically presumed clinical nosography (such as schizophrenia or manic depression), to non-presumed (conduct disorders) or unexpected behavioral acts, and therefore difficult to interpret. CONCLUSIONS: One took into consideration the features of the batch as well as the results of the previous standard correlation of the whole statistical lot. The authors emphasize the role of medical security measures that are actually applied in the therapeutic management in general and in risk and second offence management in particular, as well as the role of forensic psychiatric examinations in the detection of certain aspects related to the monitoring of mental patients. (+info)
Use of the vascularized iliac-crest flap in musculoskeletal lesions.
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Doctors' stories, patients' stories: a narrative approach to teaching medical ethics.
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Many senior doctors have had little in the way of formal ethics training, but express considerable interest in extending their education in this area. This paper is the report of an initiative in continuing medical education in which doctors were introduced to narrative ethics. We review the theoretical basis of narrative ethics, and the structure of and response to the two-day workshop. (+info)
An anthropological exploration of contemporary bioethics: the varieties of common sense.
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Patients and physicians can inhabit distinctive social worlds where they are guided by diverse understandings of moral practice. Despite the contemporary presence of multiple moral traditions, religious communities and ethnic backgrounds, two of the major methodological approaches in bioethics, casuistry and principlism, rely upon the notion of a common morality. However, the heterogeneity of ethnic, moral, and religious traditions raises questions concerning the singularity of common sense. Indeed, it might be more appropriate to consider plural traditions of moral reasoning. This poses a considerable challenge for bioethicists because the existence of plural moral traditions can lead to difficulties regarding "closure" in moral reasoning. The topics of truth-telling, informed consent, euthanasia, and brain death and organ transplantation reveal the presence of different understandings of common sense. With regard to these subjects, plural accounts of "common sense" moral reasoning exist. (+info)