Table of Contents
Preface to the First Edition vii
Preface to the Sixth Edition ix
Section I Fundamentals of Clinical Ethics
1 An Approach to Ethical Dilemmas in Patient Care 3
2 Overview of Ethical Guidelines 13
3 Informed Consent 20
4 Promoting the Patient's Best Interests 33
5 Confidentiality 42
6 Avoiding Deception and Nondisclosure 51
7 Keeping Promises 61
Section II Shared Decision-Making
8 An Approach to Decisions About Clinical Interventions 67
9 Decision-Making Capacity 69
10 Refusal of Treatment by Competent, Informed Patients 77
11 Who Serves as Surrogate When a Patient Lacks Decision-Making Capacity? 81
12 Standards for Decisions When Patients Lack Decision-Making Capacity 87
13 Persistent Disagreements Over Care 100
14 Potentially Inappropriate Interventions 109
Section III Decisions About Life-Sustaining Interventions
15 Confusing Ethical Distinctions 117
16 Ethics Consultations and Ethics Committees 126
17 Do Not Attempt Resuscitation Orders 131
18 Tube and Intravenous Feedings 140
19 Physician-Assisted Suicide and Active Euthanasia 146
20 Unresponsive Wakefulness and the Minimally Conscious State 157
21 Determination of Death 162
22 Legal Rulings on Life-Sustaining Interventions 167
Section IV The Doctor-Patient Relationship
23 Overview of the Doctor-Patient Relationship 175
24 Refusal to Care for Patients 179
25 Gifts from Patients to Physicians 188
26 Sexual Contact Between Physicians and Patients 193
27 Secret Information About Patients 200
28 Clinical Research 203
Section V Conflicts of Interest
29 Overview of Conflicts of Interest 211
30 Health Outcomes, Access, and Cost in the United States 217
31 Payments to Health Care Providers 220
32 Bedside Rationing of Health Care 227
33 Gifts from Drug Companies 234
34 Disclosing Errors 240
35 Impaired Colleagues 248
36 Ethical Dilemmas Students and House Staff Face 254
Section VI Ethical Issues in Clinical Specialties
37 Ethical Issues in Pediatrics 267
38 Ethical Issues in Surgery 276
39 Ethical Issues in Obstetrics and Gynecology 284
40 Ethical Issues in Psychiatry 292
41 Ethical Issues in Organ Transplantation 299
42 Ethical Issues at the Intersection of Public Health and Clinical Medicine 310
43 Ethical Issues in Caring for Diverse Populations 320
44 Ethical Issues with Digital Health Information 330
45 Ethical Issues in Genomic Medicine 338
46 Ethical Issues with Big Data and Artificial Intelligence 348
Cases for Discussion 357
Index 370