We write in response to the original article by Rennie and Rudland published in the April 2003 edition of this journal.1 Current and former Dundee Medical School students are concerned at the media misinterpretation of the study and the consequences that this branding of “dishonesty” will have on Dundee Medical School’s reputation and also on individuals embarking on their ….

This code of practice for health professionals was prepared by a multi-professional group and reflects good clinical practice in encouraging dialogue about individuals' wishes concerning their future treatment. It has a broad practical approach, considers a range of advance statements, advises of dangers and benefits of making treatment decisions in advance and combines annotated code of practice with a quick pull out guide for easy reference.

This article presents an analysis of contractual relations in sport from the standpoint of the Croatian legislative system. Due to the complexity of the subject matter, the author considers only a small fragment of it - the significance and the role of sport in Croatian society and the law of contracts „as a cornerstone on which „sports law“ has been built and which is of primary importance in most areas where there is an interface between sport and the law, irrespective (...) of whether the sport is being played at an elite level or at a more humble one“. Bearing in mind the limited extent of this article, the autor tries to provide some clarifications and some guidance on how to deal with the designation and the determination of the applicable law for contracts in the sporting context. Considering that there are different legal regimes which may come into play with regard to the designation of the law applicable to contracts in the sporting context, the author first presents the determination of the applicable law according to the Rome I Regulation and then according to the Croatian Arbitration Act, Swiss Private International Law Act and the CAS Code of Sports-related Arbitration, as the most common in sports practice. Then, the author deals with contracts concluded with minor athletes and the determination of the law applicable to some preliminary questions. Finally, the author presents her perception of the problems encountered and some suggestions for the improvement of the existing legal framework. (shrink)

In this essay I argue that the integration of the humanities into “medical humanities” has implicitly medicalized the humanities. This medicalization of the humanities suppresses those dimensions of the humanities that can most significantly contribute to medicine. I present my argument by studying the critical and crucial gap between the humanities as they are presented and taught in the context of medical schools, often as a set of skills, sensitivities, and competencies, and the humanities as they are experienced and lived (...) in the humanities—as an ideological-ethical calling, which saturates and infuses daily life with an ethicizing, politicizing, and ideological critique. It is this core essence of the humanities that is abrogated and annulled in medical humanities. After presenting my argument, I exemplify some of the ways in which my colleagues and I attempt to imbue medical students with the critical and ethicizing outlook and calling of the humanities. (shrink)

Summary Principles Timely support for patients and people close to them, and effective, sensitive communication are essential. Decisions must be based on the individual patient's circumstances and reviewed regularly. Sensitive advance discussion should always be encouraged, but not forced. Information about CPR and the chances of a successful outcome needs to be realistic. Practical matters Information about CPR policies should be displayed for patients and staff. Leaflets should be available for patients and people close to them explaining about CPR, how (...) decisions are made and their involvement in decisions. Decisions about attempting CPR must be communicated effectively to relevant health professionals. In emergencies If no advance decision has been made or is known, CPR should be attempted unless: the patient has refused CPR; the patient is clearly in the terminal phase of illness; or the burdens of the treatment outweigh the benefits. Advance decision making Competent patients should be involved in discussions about attempting CPR unless they indicate that they do not want to be. Where patients lack competence to participate, people close to them can be helpful in reflecting their views. Legal issues Patients' rights under the Human Rights Act must be taken into account in decision making. Neither patients nor relatives can demand treatment which the health care team judges to be inappropriate, but all efforts will be made to accommodate wishes and preferences. In England, Wales and Northern Ireland relatives and people close to the patient are not entitled in law to take health care decisions for the patient. In Scotland, adults may appoint a health care proxy to give consent to medical treatment. Health professionals need to be aware of the law in relation to decision making for children and young people.IntroductionWhy policies are neededCardiopulmonary resuscitation can be attempted on any person whose cardiac or respiratory functions cease. Failure of these functions is part of dying and thus …. (shrink)

Medicalization appears to be an issue that is both ubiquitous and unquestionably problematic as it seems to signal at once a social and existential threat. This perception of medicalization, however, is nothing new. Since the first main writings in the 1960s and 1970s, it has consistently been used to describe inappropriate or abusive instances of medical authority. Yet, while this standard approach claims that medicalization is a growing problem, it assumes that there is simply one “medical model” and that the (...) expanding realm of “the medical” can be more or less clearly delineated. Moreover, while intended to establish the reality of this growing threat, this research often requires making arbitrary or unjustified distinctions between different practices. To better clarify the concept of medicalization, I will focus more on capturing the variety of medical practices than on the sociological aspects of medical discourse. In doing so, I will explore the distinction between medicalization and pathologization, a distinction that is often overlooked and that brings with it many conceptual and practical implications. After defining these terms, I will use some examples to show that while pathologizing is closely tied to medicalizing, both can occur independently. I will then further develop this distinction in terms of the different individual and social effects of these practices. (shrink)

It is common wisdom that today’s medicine focuses too much on treating those who are sick and too little on preventing the sickness in the first place. This essay proposes that Jesus’ teaching in the Sermon on the Mount challenges that assumption and the preventive medicine to which it has given rise. In light of Jesus’ teaching, the essay identifies four apparent problems with much of preventive medicine. It then offers four heuristics that might form a basic Christian logic for (...) medicalizing risk—for discerning when and why it would be fitting, wise, and faithful for Christians to make use of medicine to avoid future illness and death. (shrink)

1. Aim of the guidelines2. Principles of good practice3. Circumcision for medical purposes4. Non-therapeutic circumcision 4.1. The law 4.1.1. Summary: the law 4.2. Consent and refusal 4.2.1. Children’s own consent 4.2.2. Parents’ consent 4.2.3. Summary: consent and refusal 4.3. Best interests 4.3.1. Summary: best interests 4.4. Health issues 4.5. Standards 4.6. Facilities 4.7. Charging patients 4.8. Conscientious objection5. Useful addresses.

The popularity of surgical modifications of race-typical features among Asian women has generated debates on the ethical implications of the practice. Focusing on blepharoplasty as a representative racial surgery, this article frames the ethical discussion by viewing Asian cosmetic surgery as an example of medicalization, which can be interpreted in two forms: treatment versus enhancement. In the treatment form, medicalization occurs by considering cosmetic surgery as remedy for pathologized Asian features; the pathologization usually occurs in reference to western features as (...) the norm. In the enhancement form, medicalization occurs by using medical means to improve physical features to achieve a certain type of beauty or physical appearance. Each type of medicalization raises slightly different ethical concerns. The problem with treatment medicalization lies in the pathologization of Asian features, which is oppressive as it continues to reinforce racial norms of appearance and negative stereotypes. Enhancement medicalization is ethically problematic because cosmetic surgery tends to conflate beauty and health as medical goals of surgery, overemphasizing the value of appearance that can further displace women’s control over their own bodies. I conclude that in both forms of medicalization, cosmetic surgery seems to narrowly frame a complex psychosocial issue involving physical appearance as a matter that can be simply solved through surgical means. (shrink)

While the COVID-19 pandemic riveted public attention on questions regarding how to respond reasonably to risk of illness, everyday medical care involves more mundane forms of pharmaceutical risk management for conditions like high blood pressure, prediabetes, or high cholesterol. This essay, and the collection it introduces, explore medicalization of risk as a theological problem, drawing on resources such as the Sermon on the Mount that caution us about the potential dangers of risk management to Christian discipleship. Medicalization of risk threatens (...) to become an idol that promises immanent security at the cost of one’s relationship with God and others. It misleads contemporary society as to the true human end and medicine’s own capabilities to provide temporal salvation. The essays in this special issue illustrate these problems with respect to pharmaceutical risk management. (shrink)

Assisted suicide, many argue, honors self‐determination in returning control of their dying to patients themselves. But physician assistance and measures proposed to safeguard patients from coercion in fact return ultimate authority over this “private and deeply personal” decision to medicine and society.

The BiDil controversy in America coincides with a renewed interest in the linkages between race and therapeutics, whether in the medical history of the United States itself, or in the colonial world. During the colonial era in South Asia, many anthropological and medical researchers conducted research which compared the European and “colonial” body, contrasting everything from blood composition to brain weight between the races of the Indian Empire. This, as Mark Harrison has shown, was fundamentally a phenomenon of the 19th (...) century, arguing that “[i]t was only after 1800 that racial identities came to be fixed and that India was viewed with terror, as a reservoir of filth and disease.” Racist attitudes in British Indian colonial medicine are not hard to discover. They underpinned, for instance, campaigns to improve the appallingly high maternal and infant mortality rates in which the blame was placed squarely upon the women and the indigenous midwives who delivered them rather than the poverty in which they lived. As such, Peers Dimmock, a professor of gynecology and obstetrics at the Calcutta Medical School, opened his address to the First Indian Medical Congress in 1894 with a diatribe against “the unclean and repulsive traditionary [sic] methods of the native midwives.”. (shrink)

The neurocentric worldview that identifies the essence of the human being with the material brain has become a central paradigm in current academic discourse. Israeli researchers also seek to understand educational principles and processes via neuroscientific models. On this background, the article uncovers the central role that visual brain images play in the learning-disabilities field in Israel. It examines the place brain images have in the professional imagination of didactic-diagnosticians as well as their influence on the diagnosticians' clinical attitudes. It (...) relies on two theoretical fields: sociology and anthropology of the body and sociology of neuromedical knowledge. The research consists of three methodologies: ethnographic observations, in-depth interviews, and rhetorical analysis of visual and verbal texts. It uncovers the various rhetorical and ideological functions of brain images in the field. It also charts the repertoire of rhetorical devices which are utilized to strengthen the neuroreducionist messages contained in the images. (shrink)

Now I know why so many stories have been written with the theme: “everything changed in one moment.” More than 1,000 days have come and gone, and I still remember one Sunday morning and still follow and feel the effects of one decision.

The social relationships between humans and our closest nonhuman species (e.g., dogs, cats, and horses) are complex and subject to change. This complexity contradicts the popular phenomenon of using these animals in medical interventions for mental health (i.e., animal assisted therapy). This article uses anthropological research and ethnographic examples from the Central Coast, Australia, to exemplify the conflicts, contradictions, and realities of our companion animals’ relationship to human mental health. Using a phenomenological perspective, the article examines the complex realities in (...) which companion animals (being living, fluctuating, mortal creatures) experience trauma, respond to human behaviors, and ultimately change throughout their lives, making them less “manageable” as mental health support while still valuable as a longer-term relationship. Companion animals maintain an extremely important position in the emotional lives of their human companions. However, their position in human worlds has purpose beyond therapeutic utility. Future research and use of companion animals for mental health purposes should carefully reconsider the implications of using living creatures in medical models and instead seek to better understand how our companion animals allow humans to access alternate ways of thinking throughout their lives. (shrink)

The Patient Protection and Affordable Care Act, passed in 2010, is considered by many to be the most significant healthcare overhaul since the 1960s, but part of its promise — improvement of population health through requirements for non-profit hospitals to provide “community benefit” — has not been met. This paper examines the history of community benefit legislation, how community benefit dollars are allocated, and innovative practices by a few hospitals and communities that are addressing primarily non-medical factors that influence health (...) such as social disadvantage, attitudes, beliefs, risk exposure, and social inequalities. (shrink)

Participation in research is supposed to be voluntary and informed. Yet it is difficult to ensure people are adequately informed about the potential uses of their biological materials when they donate samples for future research. We propose a novel consent framework which we call “demonstrated consent” that leverages blockchain technology and generative AI to address this problem. In a demonstrated consent model, each donated sample is associated with a unique non-fungible token (NFT) on a blockchain, which records in its metadata (...) information about the planned and past uses of the sample in research, and is updated with each use of the sample. This information is accessible to a large language model (LLM) customized to present this information in an understandable and interactive manner. Thus, our model uses blockchain and generative AI technologies to track, make available, and explain information regarding planned and past uses of donated samples. (shrink)

*The views expressed are the author's own. This article should not be construed as representing policies of the American Medical Association.

Bowman-Smart et al. (2023) argue for a framework to examine the ethical issues associated with genetic screening for non-medical traits in the context of noninvasive prenatal testing (NIPT). Such s...

Volume 25, Issue 2, February 2025, Page 61-64.

The Council on Ethical and Judicial Affairs of the American Medical Association examines physicians’ professional ethical responsibility in the event that the security of patients’ electronic records is breached.

Volume 25, Issue 2, February 2025, Page 85-87.

*Disclaimer: The views expressed are the author's and should not be ascribed to the American Medical Association.

Volume 24, Issue 8, August 2024, Page 109-111.

Volume 25, Issue 2, February 2025, Page 1-2.

Volume 25, Issue 2, February 2025, Page 23-25.

Volume 24, Issue 10, October 2024, Page 80-82.

Background: After over 4 years since medical assistance in dying legalization in Canada, there is still much uncertainty about how this ruling has affected Canadian society. Objective: To describe the positive aspects of medical assistance in dying legalization from the perspectives of hospice palliative care providers engaging in medical assistance in dying. Design: In this qualitative descriptive study, we conducted an inductive thematic analysis of semi-structured interviews with hospice palliative care providers. Participants and setting: Multi-disciplinary hospice palliative care providers in (...) acute, community, residential, and hospice care in Vancouver and Toronto, Canada, who have engaged in end-of-life care planning with patients who have inquired about and/or requested medical assistance in dying. Ethical considerations: The research proposal was approved by University of British Columbia Research Ethics Board in Vancouver and University Health Network in Toronto. Participants were informed regarding the research goals, signed a written consent, and were assigned pseudonyms. Results: The 48 participants included hospice palliative care physicians (n = 22), nurses (n = 15), social workers (n = 7), and allied health providers (n = 4). The average interview length was 50 min. Positive aspects of medical assistance in dying legalization were identified at (1) the individual level: (a) a new end-of-life option, (b) patients’ last chance to express control over their lives, (c) patient and family comfort and relief, and (d) a unique learning experience for hospice palliative care providers; (2) the team level: (a) supportive collegial relationships, (b) broadened discussions about end-of-life and palliative care, and (c) team debriefs provide opportunities for education and support; and (3) the institutional level: (a) improved processes to facilitate the implementation logistics. Conclusion: While being involved in the medical assistance in dying process is complex and challenging, this study sheds light on the positive aspects of medical assistance in dying legalization from the hospice palliative care provider’s perspectives. Medical Assistance in Dying legalization has resulted in improved end-of-life conversations between hospice palliative care providers, patients, and their families. Improved communication leads to a better understanding of patients’ end-of-life care plans and bridges some of the existing gaps between hospice palliative care and medical assistance in dying. (shrink)

Medical Ethics, Law and Communication at a Glance presents a succinct overview of these key areas of the medical curriculum. This new title aims to provide a concise summary of the three core, interlinked topics essential to resolving ethical dilemmas in medicine and avoiding medico-legal action. Divided into two sections; the first examines the ethical and legal principles underpinning each medical topic; while the second focuses on communication skills and the importance of good communication. Medical Ethics, Law and Communication at (...) a Glance offers an accessible introduction to the fundamentals of good medical practice, and will provide indispensable support for undergraduate medical students and nurses, as well as newly qualified healthcare professionals. (shrink)

The Direction of Medical Ethics The direction bioethics, and specifically medical ethics, will take in the next few years will be crucial. It is an emerging specialty that has attempted a great deal, that has many differing agendas, and that has its own identity crisis. Is it a subspecialty of clinical medicine? Is it a medical reform movement? Is it a consumer pro tection movement? Is it a branch of professional ethics? Is it a ra tionale for legal decisions and (...) agency regulations? Is it something physicians and ethical theorists do constructively together? Or is it a morally concentrated attack on high technology, with the prac titioners of scientific medicine and the medical ethicists in an adversarial role? Is it a conservative endeavor, exhibiting a Frankenstein syn drome in Medical Genetics ("this time, they have gone too far"), or a Clockwork Orange syndrome in Psychotherapy ("we have met hods to make you talk-walk-cry-kill")? Or does it suffer the afflic tion of overdependency on the informal fallacy of the Slippery Slope ("one step down this hill and we will never be able to stop") that remains an informal fallacy no matter how frequently it's used? Is it a restricted endeavor of analytic philosophy: what is the meaning of "disease," how is "justice" used in the allocation of medical resources, what constitutes "informed" or "consent?" Is it applied ethics, leading in clinical practice to some recommenda tion for therapeutic or preventive action? This incomplete list of questions indicates just how complex. (shrink)

Medical science is advancing all the time. Researchers are constantly trying to find new ways to help people to have long and healthy lives. Thanks to their work, doctors today can cure diseases, lessen pain, replace unhealthy limbs or organs, and help infertile couples have children. Doctors can even keep seriously ill people alive against all odds. But not everyone is enamored with advances in medicine. They question whether it is appropriate to prolong life in all cases, or believe that (...) certain treatments have been developed unethically. This book looks at how the ways that doctors treat the sick are developed, and examines some of the questions that are raised by advances in medical science. (shrink)

Medical ethics involve more than a prohibition against advertising or solicitation of patients, or a limit on the height of the letters on a doctor's office door. The true ethics of health care are the fundamental values that guide-or should guide-physicians in every aspect of their interaction with patients, their families, and society at large. Professional ethics is a complex and controversial issue, but one that must be dealt with in an era of increasing skepticism about the practice of medicine. (...) Medical Stewardship is a carefully reasoned historical and philosophical inquiry into the origins of our notions of medical ethics, and the ways in which a true sense of the doctor's proper role can be restored. Tracing the development of medical ethics from ancient times to the modern era, Dr. Kepler consides them in relation to the medical profession of today. He considers several areas seldom discussed in works on medical ethics: the exploitation of the patient, preventive versus disease treatment, ethical problems in medical education, drug abuse by physicians, the ethics of organized medicine, and some important but under-utilized roles of the physician. (shrink)