Chapter 45: Ethical Issues in Digital Health Information

Introduction Digital communication through e-mail, the Internet, and social media are becoming increasingly common in medicine, as in other areas of life. In addition, the US government is urging the adopting of electronic health records (EHRs). These digital technologies present the promise of more efficient and higher quality health care. However, digital health information presents […]

Chapter 44: Ethical Issues in Cross-Cultural Care

Introduction The cultural backgrounds of US patients are becoming increasingly diverse. By 2050, non-Hispanic Caucasians will no longer be a majority of the population. Furthermore, immigrants are settling in new areas of the country. Thus, physicians across the country will care for patients from many cultural heritages, which will change over their careers. Previous chapters […]

Chapter 43: Ethical Issues in Public Health Emergencies

Introduction In recent years, public health emergencies have required physicians, the public, and public health officials to consider how the doctor–patient relationship may change during a public health emergency. In 2001, the bombing of the World Trade Center and outbreaks of inhalation anthrax raised concerns about bioterrorism. In 2003, severe acute respiratory distress syndrome (SARS) […]

Chapter 42: Ethical Issues in Genomic Medicine

Introduction Since the sequencing of the entire human genome in 2002, DNA-based tests have become increasingly available for such conditions as cystic fibrosis (CF), familial colon and breast cancer, hemochromatosis, and polycystic kidney disease. Current high-throughput genotyping allows researchers to assay 500,000 single nucleotide polymorphisms (SNPs) and carry out genomewide association studies for common polygenic […]

Chapter 41: Ethical Issues in Organ Transplantation

Introduction After receiving a kidney, liver, heart, or lung transplant, many patients with end-stage disease can return to active lives. Organ donors undergo interventions to benefit the recipient. The ethical concern is that the donor’s well-being might be compromised to benefit someone else. Thus, consent for donation and minimizing harm to donors are essential to […]

Chapter 40: Ethical Issues in Psychiatry

Introduction Some patients have such severe psychiatric illness that they might seriously harm themselves and others. Treating their psychiatric illness might restore their decision-making capacity and their control over their actions. To protect them from the grave consequences of nonautonomous decisions and actions, physicians might need to restrict their freedom temporarily. Involuntary court-ordered interventions raise […]

Chapter 39: Ethical Issues in Obstetrics and Gynecology

Introduction Ethical dilemmas in obstetrics and gynecology are particularly difficult because care for a pregnant woman and care for her fetus are inextricably linked. Furthermore, decisions about reproduction and sexuality involve intimate and private topics, such as sexuality, reproduction, and childrearing, which are often socially contested. How Are Ethical Issues in Ob-Gyn Different? Third Parties […]

Chapter 38: Ethical Issues in Surgery

Introduction Surgery differs from other specialties in clinically significant ways. First, surgeons intentionally cause short-term injury to achieve long-term therapeutic goals. Patients undergo operative risks, experience pain, and emerge with scars. Although all medical interventions involve risk, many surgical adverse effects are certain, rather than possible, and occur before any benefit can be realized. Second, […]

Chapter 37: Ethical Issues in Pediatrics

Introduction Children are immature and depend on their parents or guardians emotionally and financially. They cannot make informed decisions about their care. Children must be protected from the consequences of unwise decisions that they or others make. It is tragic if a child dies or suffers serious harm because a simple, effective medical treatment was […]

Chapter 36: Ethical Dilemmas Students and House Staff Face

Introduction Every clinician in training has performed a procedure knowing that someone else could do it more skillfully. Case 36.1. Performing an invasive procedure Obviously tired after a 9-hour wait in the emergency room, a woman with an asthma exacerbation is finally admitted to her room. “Oh no, not another needlestick!” she groans, as a […]