1997
James F. Childress
- Abstract: Managed care organizations can
produce conflicts of obligation and conflicts of interest that may lead
to problems of conscience for health care professionals. This paper
provides a basis for understanding the notions of conscience and
conscientious objection and offers a framework for clinicians to stake
out positions grounded in personal conscience as a way for them to
respond to unacceptable pressures from managers to limit services.
Teresa Stanton Collett
- Introduction: American lawyers have long claimed
the right to select clients in accordance with their conscience. From the
first formulation of an American code of legal ethics to its current
incarnations, members of the legal profession have recognized the tension
arising fromthe duty to assure the availability of legal services to all who
need representation and the right of lawyers to determine whom they
represent. In its earliest formulation this tension was stated as a
matter of conscience. Current lawyer regulations state the problem in
terms of personal integrity. The Preamble to the Model Rules of
Professional Conduct describes the tension in these terms: 'Virtually all
difficult ethical problems arise from conflict between a lawyer's
responsibilities to clients, to the legal system, and to the lawyer's own
interest in remaining an upright person while earning a satisfactory
living." . . .
Daly BJ, Berry D, Fitzpatrick JJ, Drew B, Montgomery K.
Assisted suicide: implications
for nurses and nursing. Nurs Outlook 1997 Sep-Oct;45(5):209-14
PMID: 9364530
Barbara J. Daly, Devon Berry, Joyce J. Fitzpatrick, Barbara Drew,
Kathleen Montgomery,
- The ANA, as well as the AMA and the National Hospice Association, have
issued position statements expressly declaring opposition to nurse or
physician participation in assisted suicide. Nonetheless, the literature
includes numerous reports of the participation of nurses and
physicians in assisted suicide. What are the implications of this issue
for nurses and nursing?
Ellen S. Lazarus
- Abstract: --Ever-increasing technological innovations
surrounding birth are creating new challenges in biomedical ethics in
U.S. obstetrics. The politicization of abortion has augmented these
challenges and led to increased conflict between physicians' personal
morality and professional responsibility. This paper focuses on some of
the problems generated by abortion policies and procedures in an obstetric/
gynecology residency program. Examples of conflicts among residents are
presented to demonstrate the effect of pluralistic moral perspectives. A
system is described where some residents will do abortions and some will
not. Patients seeking abortion are often treated in an unprofessional manner
when it appears that a conflict exists between the values of patients and
those of residents. Unless the socialization of residents includes
ethical training, defined educational policy and institutional direction,
ethical dilemmas will lead to increased resident stress, an inadequate
doctor-patient relationship and a continued shortage of physicians
willing to perform abortions despite new policies called for in graduate
medical education.
Kevin William Wildes
Abstract: Bioethics has focused on the areas of
individual ethical choices--patient care--or public policy and law. There
are, however, important arenas for ethical choices that have been
overlooked. Health care is populated with intermediate arenas such as
hospitals, nursing homes, hospices, and health care systems. This essay
argues that bioethics needs to develop a language and concepts for
institutional ethics. A first step in this direction is to think about
institutional conscience.