Handbook for health care ethics committees

Abstract

Preface Acknowledgments I. Curriculum for Ethics Committees 1. Ethical Foundations of Clinical Practice The Role of Ethics in Clinical Medicine Ethics Committees in the Health Care Setting Fundamental Ethical Principles Principlism and Alternative Approaches The Role of Culture, Race, and Ethnicity in Health Care Conflicting Obligations and Ethical Dilemmas 2. Decision Making and Decisional Capacity in Adults Health Care Decisions and Decision Making Decision-Making Capacity Assessment and Determination of Capacity Deciding for Patients without Capacity 3. Informed Consent and Refusal Evolution of the Doctrine of Informed Consent Elements of Informed Consent and Refusal The Nature of Informed Consent Exceptions to the Consent Requirement 4. Truth Telling Justifications Disclosure Disclosure of Adverse Outcomes and Medical Error Privacy and Confidentiality Genomic Testing and Control of Information 5. Special Decision-Making Concerns of Minors Decisional Capacity and Minors Consent for and by Minors Confidentiality and Disclosure Special Problems of Functionally Alone Adolescents 6. Ethical Issues in Reproduction The Ethics and Politics of Reproductive Choice Assisted Reproductive Technologies Surrogacy and Gestational Carriers Termination of Pregnancy Maternal-Fetal Issues Prenatal/Newborn Genetic Testing and Genomic Newborn Screening Special Decision-Making Concerns of the Elderly The Other Side of the Mountain Diminishing Autonomy and Decisional Capacity Promise that you won't ever put me in a nursing home Independence, Dependence, and Role Reversals Prior Wishes and Current Needs Intimacy and Security Transition from Hospital to Home or Nursing Home 8. Ethical Issues in the Care of Disabled Persons Disability and Its Place in Bioethics Defining Disability The Medical and Social Models of Disability The Disability Rights Critique of Prenatal Genetic Testing Special Challenges in the Care of Persons with Severe Cognitive Impairment Medical Decision Making and the Disabled 9. End-of-Life Issues Decision Making at the End of Life Defining Death Organ Donation Advance Health Care Planning Honoring Patients' End-of-Life Decisions Goals of Care at the End of Life Forgoing Life-Sustaining Treatment Protecting Patients from Treatment Rejection of Recommended Treatment and Requests to Do Everything Medical Futility 10. Palliation From Caring to Curing and Back Again The Experience of and Response to Pain The Moral Imperative to Relieve Pain Assisted and Permitted Dying Pediatric Palliative Care Palliative Care and Hospice Palliative Care 11. Justice, Health, and Access to Health Care Access to Health Care in the United States Justice and Health Disparities Health Care as a Requirement of Justice Health Care and Health Theories of Justice Rationing Health Care Reform 12. Organizational Ethics From Bioethics to Health Care Organizational Ethics Moral Responsibilities of Health Care Organizations Organizational Ethics and Compliance Ethics and the Allocation of Resources Ethics Committees and Organizational Issues Developing an Organizational Ethics Service II. The Creation, Nature, and Functioning of Ethics Committees 13. Profile of Ethics Committees Origins Committee Functions Membership Expertise in Ethics Leadership Securing a Foothold Clinical Ethics Consultation Overview of Ethics Consultation Three Models of Clinical Ethics Consultation Services Building an Ethics Consultation Service Credentialing and Privileging Clinical Ethics Consultants Analytic Approaches to Clinical Ethics Consultation Selecting the Best Clinical Ethics Consultation Service Model for Your Institution Access to Clinical Ethics Consultation Policies 15. Ethics Education Brown Bag Lunches Journal Clubs Case Conferences Ethics Grand Rounds Ethics Modules in Residency Training and Medical School Programs Ethics Symposia White Papers, Memoranda, Guidelines, and Protocols Additional Education Opportunities 16. Sample Clinical Cases Adolescent Decision Making Advance Directives Autonomy in Tension with Best Interest Confidentiality Decisional Capacity Disclosure and Truth Telling End-of-Life Care Forgoing Life-Sustaining Treatment Goals of Care Informed Consent and Refusal Medical Futility Parental Decision Making Surrogate Decision Making 17. Sample Policies and Procedures III. Organizational Codes of Ethics Regional Medical Center Code of Conduct Metropolitan Medical Center Code of Ethics University Health Network Code of Ethics IV. Key Legal Cases Informed Consent Privacy Confidentiality Health Care Decision Making Medical Decision Making for Minors Reproductive Rights State Action to Protect Public Health State Action to Control What Practitioners Must or Must Not Discuss with Their Patients Health Care Reimbursement V. An Ethics Committee Meeting Index