Table of Contents

Cases Preface Acknowledgments Introduction: A Revolution in Learning 1: Ethics Matters: Doing Ethically Sound Medicine I. Ethical Reasoning and Principles in Medicine II. Three Ethical Principles and Questions III. "Resolving" Ethical Dilemmas IV. "Doing Right": A Decision-Making Procedure for Clinical Ethics V. Applying the Ethics Decision Making Procedure 2: The Almost Revolution: Autonomy and Patient-Based Care I. The Autonomy Principle II. The Case of Mrs Malette and Dr Shulman III. Choices: The Good, the Bad, and the Ugly IV. Reduced Autonomy 3: No Man an Island: Confidentiality and Trust I. Rights of Privacy, Confidential Duties II. Professional Regulations III. Limits to Confidentiality IV. Duty to Warn and Protect V. The Digital Age 4: The Power to Heal: Truth and Deception in Clinical Practice I. On Not Telling the Truth II. The Truthtelling Task III. Modern Law and the Profession IV. The Changing Practice of Medicine V. Truthtelling's Exceptions 5: The Power to Choose: Due Care and Informed Consent I. The Essence of Informed Consent II. Ethical Consent III. The Doctor Who Didn't: The Case of Mr Reibl v Dr Hughes IV. The Essential Elements of Consent: When, Who, What, How V. Exceptions to Consent 6: The Waning and Waxing Self: Capacity and Incapacity in Medical Care I. Attending to and Assessing Capacity II. Substitute Decision-Makers (SDM) III. Treatment of the Vulnerable IV. When Not to Rescue V. Failure to Care for Self VI. Cases Involving Minors 7: Helping and Not Harming: Beneficence and Non-maleficence I. The Principles of Beneficence and Non-maleficence II. The "Duty to Rescue" the Patient III. Endangering One's Self IV. In the Best Interests of Minors V. Parental Requests for Treatment 8: Conduct Becoming: Medical Professionalism and Managing Error I. Professionalism in Healthcare II. Professionals and the Drug Industry III. Boundaries and Crossings IV. The Error of Our Ways 9: Beyond the Patient: Doing Justice to Justice I. Justice in Everyday Medicine II. Distributive Justice III. Medically Necessary Treatment IV. The Role of Practice Guidelines V. The Health Professional's Master 10: Labour Pains: Ethics and New Life I. Birthing and Reproductive Choice II. In the Interest of the Child: Being Born and Living Life III. The New Age of Reproduction IV. Desperately Seeking Stem Cells 11: A Dark Wood: End-of-Life Decisions I. Allowing Death: Refusals by the Patient II. Advance Directives III. Who is the Patient? IV. Lost Souls V. Physician-Accelerated Death (PAD) 12: Questions of Culture, Genetics, and Science I. Cultural Connections II. All in the Genome? III. Ethical Regulation of Research IV. Some Questions and Answers Regarding Research Conclusion: Going from Here Notes Index

About the Author

Philip C. Hebert graduated from the University of Toronto medical school in 1984 and completed a Ph.D. in philosophy at York University in 1983. He is emeritus professor of family medicine in the Department of Family and Community Medicine at the University of Toronto, and chair of the research ethics board at Sunnybrook Health Sciences Centre. For twenty years he was a family physician at Sunnybrook & Women's College Health Sciences Centre, retiring from active clinical practice in 2010. He remains on staff there as a consultant. He has an interest in many areas of ethics including disclosure, end-of-life care, consent, medical error, and medical education and teaches widely across Canada. He has published articles in the Canadian Medical Association Journal, New England Journal of Medicine, ICU Management, and the Journal of the American Medical Association. In 2008, he received the second annual William Marsden Award from the CMA for his contribution to ethics teaching in Canada, and in 2011 he was named Academic Family Physician of the Year and received the University of Toronto's Department of Family and Community Medicine Award of Excellence.

Reviews

"Practitioners aren't philosophers-they need to know the why and how of application. There are deliberate, usable, and considered methods throughout this book." --Ken Kirkwood, Western University "The reading style is very engaging and concise - far more palatable than some theoretically dense texts. The liberal use of case studies underscores the relevance to daily practice - something that medical students find very appealing." --Stacy Ackroyd-Stolarz, Dalhousie University