BACKGROUND Physicians face ethical difficulties daily, yet they seek ethics consultation infrequently. To date, no systematic data have been collected on the strategies they use to resolve such difficulties when they do so without the help of ethics consultation. Thus, our understanding of ethical decision making in day to day medical practice is poor. We report findings from the qualitative an...

This article considers the ethical guidelines concerning autonomy, negotiated consent and transparency in relation to an ethnography of psychiatry. It suggests that the complexities and unequal power distribution of the psychiatric consultation make these guidelines difficult to apply. Rather an attempt is made to develop an ethics of patient acknowledgement even where this presents ethical mis...

A prenatal diagnosis of ductal-dependent, complex congenital heart disease was made in a fetus with trisomy 18. The parents requested that the genetic diagnosis be excluded from all medical and surgical decision-making and that all life-prolonging therapies be made available to their infant. There was conflict among the medical team about what threshold of neonatal benefit could outweigh matern...

BACKGROUND The growing prevalence of health care ethics consultation (HCEC) services in the U.S. has been accompanied by an increase in calls for accountability and quality assurance, and for the debates surrounding why and how HCEC is evaluated. The objective of this study was to evaluate the effectiveness of HCEC as indicated by several novel outcome measurements in East Asian medical encount...

Living with a life-threatening illness is extraordinarily challenging. This challenge intensifies when patients struggle to weigh personal and familial interests when facing difficult medical decisions. When patients are unduly pressured by their families to make medical decisions that are not in line with previously held values, beliefs, or perspectives, autonomy is compromised. A case example...