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taking sides


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informed consent in clinical care is essential; promotes good communication and patient autonomy despite obstacles of implementation
informed consent is transitional concept
useful only for moving toward radical framework where physicians/patients are paired on basis of shared deep social, moral, institutional values
Christopher James Ryan
advance directives that refuse active treatment for individuals whose incompetence is reversible should be abolished bcz healthy people are likeley to underestimate their desire for treatment should they become ill.
Steven luttrell/Ann Sommerville
respect for ppl of autonomy requires that individuals be permitted to make risky choices about their own lives; ignoring autonomous choices made by competent adults reinstates the outmoded noton of medical paternalism.
Bernard C. Meyer
physicians must use discretion in communicating bad news to patients. Adherence to a rigid truth-telling formula fails to appreciate differences in patients' readiness to hear and understand the information.
Sissela M. Bok
The harm of disclosing bad news to patients is outweighed by benefits; it give sthe patient the right to choose among treatments.
adolescents with normal cognitive and developmental skills have capacity to make their own h.c. decisions. advance directives can give older pediatric patients a voice in their care.
parents shoudlb e responsible for their childrens' h.c. decisions. Children need to develop virtues - self-control, to enhance long-term autonomy.
since h.c. resources are scarce, people who have lived a full natural life span should be offered care that relieves suffering but not expensive life-prolonging technologies.
amitai etzioni
rationing healthcare for elderly would encourage conflict btwn generations and invite restrictions on h.c. for other groups.
expansion of managed care and imposition of significant cost controls could undermine critical aspects of phys-patient relationship, including freedom of choice, careful assessments of physician competence, time, continuity of care.
physicians must balance the interests and wishes of the patient with the welfare of the h.c. system in which they practice and must stop viewing the case manager as the unavoidable but unwanted child within the family of medicine.
bans on selling organs remove the only hope of the detitute and the dying. arguments against selling organs are weak attempts to justify the reugnance felt by people who are rich or healthy.
trafficking in organs for transplantation is motivated by greed and subverts the ethical principles of the medical profession.
doctors-in=training, like iother workers, should have the right to organize and to bargain collectively for better working conditions in hospitals so that they can provide enhanced care for their patients.
doctors-in-training are primarily students, not employees, and union activities would negatively affect the educational experience.

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