Ethical Analysis of Clinical Medicine:
A Guide to Self-Evaluation

Glenn C. Graber, PhD; Alfred D. Beasley, MD; John A. Eaddy, MD

(Baltimore & Munich: Urban & Schwarzenberg, 1985)

Foreword
Preface
Sources and Permissions

GBE0.pdf

Chapter One: Physician-Patient Relationships
1 . General Features
1.1 Fantasies: A Thought Experiment
1.2 Expectations
1.3 Conclusion

GBE1a.pdf

2. Information Exchange
2.1 Relationships
2.2 Obligations
2.3 Fulfilling These Obligations
2.4 Placebos and the Placebo Effect
2.5 Conclusions

GBE1b.pdf

3. Informed Consent
3.1 The Legal and Moral Requirement of Informed Consent
3.2 Practical Applications
3.3 The Paradox of Autonomy
3.4 Mental Competence
3.5 Manipulation

GBE1c.pdf

4. Confidentiality
4.1 The Importance of Confidentiality
4.2 The Need for Confidentiality in Medicine
4.3 Confidentiality in Medicine
4.4 Confidentiality and the Law
4.5 Cases
4.6 President's Commission Recommendations
4.7 Review Exercises
5. Conclusion
References
Further Reading

GBE1d.pdf

Chapter Two: Professional Codes and Ethical Theories
1. Professional Codes
1. 1 The Hippocratic Oath
1.2 AMA Principles of Medical Ethics
1.3 American College of Physicians Ethics Manual
1.4 Limitations of Professional Codes
2. Fundamentals of Ethical Theory
2.1 Ethical Judgments
2.2 Some Points About Ethical Theory
2.3 Key Concepts
3. Review Exercise
3.1 Instructions
3.2 Case: "To Make the Parents Happy
3.3 Questions
3.4 Options for Action
3.5 Additional Questions
References
Further Reading

GBE2.pdf

Chapter Three: The Scope of Professional Responsibility
1 . The Scope of Medical Service
1.1 Case: Joyce and Brent Blackspott
1.2 Analysis: Physician Responsibility for Health and Disease
2. The "Moral Center" of Medicine
2.1 Content of the Moral Center
2.2 Importance of the Moral Center
2.3 The Blackspotts and the Moral Center
2.4 Additional Cases
3. Beyond the Moral Center
3.1 Research
3.2 Other Potential Conflicts of Loyalties
3.3 Conflicts of Loyalties: Toward a Policy Solution
3.4 Family Medicine
3.5 Team Care
3.6 Institutional Delivery of Health Care
4. Expansions of the Scope of Responsibility
4.1 Beyond Treatment
4.2 Beyond the Clinic
4.3 Beyond Illness or Injury
4.4 Palliation, Comforting, and Strengthening Coping Skills
4.5 Conclusion
References
Further Reading

GBE3.pdf

Chapter Four: Life and Death
1 . Determination of Death
1. 1 "Irreversible
1.2 "Vital Functions"
1.3 Statutory Definitions of Death
1.4 "Pronouncing" Death
2. Other Limits to Treatment
2.1 AMA Policy Statements
2.2 Limits Set by Patients
2.3 Dealing with Families' Decisions

GBE4a.pdf

2.4 Other Dimensions of Limits to Treatment
3. Seriously III Newborns
3.1 Issues
3.2 Conclusions
4. Abortion
5. Reproductive Technologies
References
Further Reading

GBE4b.pdf

Chapter Five: Who Gets What?
1 . Allocation of Resources
1.1 Life and Death Resources
1.2 Principles of Allocation
1.3 Case: Who Gets the Protection?
1.4 Triage
1.5 Patient Loyalties and Demands of Justice
1.6 Office Scheduling as an Allocation Problem

GBE5a.pdf

2. Allocation on the Social Scale
2.1 Access to Health Care Services
2.2 The Monetarization of Medicine
2.3 Cost Control
3. Reviewing Your Expectations
Sources of Items in Exercise, Section 2.2.3
References
Further Reading

GBE5b.pdf

Appendix 1:More About Ethical Theories
1. Utilitarianism and Other Goal-Based Theories
1.1 Teleologism, the Goal-Based Approach
1.2 The Moral Reference Group
1.3 Theories of Value
1.4 Act vs. Rule Approach
1.5 Applying Goal-Based Theories
1.6 Review Exercise: Goal-Based Theories
2. Deontological Theories
2.1 Duty-Based Theories
2.2 Kant's Deontological Theory
2.3 Ross' List of Prima Facie Duties
2.4 Review Exercise: Deontological Theories
2.5 Conclusion
References
Further Reading

GBEa1.pdf

Appendix II: Summaries of Reports of the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research
1. Making Health Care Decisions
2. Deciding to Forego Life-Sustaining Treatment
3. Securing Access to Health Care

GBEa2.pdf

Appendix III: American College of Physicians Ethics Manual:
Excerpts

GBEa3.pdf

link to 5th edition of American Collge of Physicians ETHICS MANUAL

Table of Cases
Index

GBEindex.pdf