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Informed consent is a key ethical concern when health care providers are consenting to a mandatory vaccination, since autonomous patient choice is not possible where vaccination is a condition of employment.
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Patient safety is at risk if clinicians with undiagnosed conditions causing impairment continue to practice, but colleagues often fail to report the impairment.
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Occasionally, clinicians, patients, or surrogates reject an ethicists advice or recommendations. In this scenario, bioethicists should seek to maintain working relationships and continue dialogue.
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The Affordable Care Act (ACA) will put more emphasis on both comparative effectiveness and cost-effectiveness, and this raises important ethical considerations, according to Gary E. Jones, PhD, JD, professor in the Philosophy Department at University of San Diego (CA).
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Some hospitals are now being required to inform living donors of the risks they face, fully evaluate their medical and psychological suitability, and track their health for years after donation.
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The use of bipolar disorder diagnoses for children whose primary symptoms were manifested by irritability, rather than the traditional cyclical mood symptoms of adult bipolar disorder, has been a major concern in child psychiatry in recent years, says Paul S. Appelbaum, MD, Dollard Professor of Psychiatry, Medicine, and Law and director of the Division of Law, Ethics, and Psychiatry at Columbia University College of Physicians & Surgeons in New York City.
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If a patient finds out her doctor prescribed a medication manufactured by a drug company he happens to have a lucrative consulting contract with, will she view this as an indication that he's prominent in his field or that he has "sold out" to the industry?
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There is still "a good deal of confusion" about what informed consent and shared decision-making really are, according to Howard Brody, MD, PhD, John P. McGovern Centennial Chair in Family Medicine and director of the Institute for the Medical Humanities at the University of Texas Medical Branch at Galveston.
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Both autonomy and the law favor allowing patients access to their medical records, and there are clearly associated benefits, says Gregory R. Moore, MD, MPH, senior director at Stamps Health Services at Georgia Institute of Technology in Atlanta.
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Explantation of battery-operated implants such as pacemakers involves pressing ethical issues but receives little attention, according to Katrina A. Bramstedt, PhD, a clinical ethicist and associate professor at Bond University School of Medicine in Australia, and former faculty in the Department of Bioethics at Cleveland Clinic Foundation, Cleveland, OH.
