This short work examines what the Hippocratic Oath said to Greek physicians 2400 years ago and reflects on its relevance to medical ethics today. Drawing on the writings of ancient physicians, Greek playwrights, and modern scholars, each chapter explores one passage of the Oath and concludes with a modern case discussion. This book is for anyone who loves medicine and is concerned about the ethics and history of the profession.

Kaci Hickox was a nurse who worked with persons who were infected with Ebola in West Africa. When she returned to the United States, the governors of New Jersey and Maine intervened to confine her to inpatient quarantine despite the fact that she was asymptomatic and had no serological evidence of infection. She defied the quarantine which resulted in enormous public attention and discussion of quarantine and public fear. This article summarizes the case discussing the history of the case, the (...) government actions, and the final legal rulings. (shrink)

First published in 2005. Routledge is an imprint of Taylor & Francis, an informa company.

In lieu of an abstract, here is a brief excerpt of the content:...

The controversy over abusive interrogations of prisoners during the war against terrorism spotlights the need for clear ethics norms requiring physicians and other clinicians to prevent the mistreatment of prisoners. Although policies and general descriptions pertaining to clinical oversight of interrogations in United States' war on terror prisons have come to light, there are few public records detailing the clinical oversight of an interrogation. A complaint by the Federal Bureau of Investigation (FBI) led to an Army investigation of an interrogation (...) at the United States prison at Guantanamo Bay. The declassified Army investigation and the corresponding interrogation log show clinical supervision, monitoring and treatment during an interrogation that employed dogs, prolonged sleep deprivation, humiliation, restraint, hypothermia and compulsory intravenous infusions. The interrogation and the involvement of a psychologist, physician and medics violate international and medical norms for the treatment of prisoners. (shrink)

The standard approach to the ethics of reproductive technologies starts and ends with the parents’ procreative liberty. There's much more to think about. We should start with the relationship between parents and children.

"First Published in 1990, Routledge is an imprint of Taylor & Francis, an informa company.".

Objects of Hope brings ranging scholarship and refreshing candor to bear on the knotty issue of what can and cannot be achieved in the course of psychoanalytic therapy. It will be valued not only as an exemplary exercise in comparative psychoanaly.

Medical ethicists have assumed a role in justifying public voyeurism of human "curiosities." This role has precedent in how scientists and natural philosophers once legitimized the marketing of museums of "human curiosities." At the beginning of the twentieth century, physicians dissociated themselves from entrepreneurial displays of persons with anomalies, and such commercial exhibits went into decline. Today, news media, principally on television, promote news features about persons that closely resemble the nineteenth century exhibits of human curiosities. Reporters solicit medical ethicists (...) for soundbites to affirm the newsworthiness and propriety of public voyeurism of these medical stories. Ethicists' soundbites are usually ambiguous or self-evident and rarely enable viewers to morally engage the issues. The precedent of early twentieth century physicians disengaging from such exploitive public shows is a useful example for medical ethics. (shrink)

In _The Analyst’s Experience of the Depressive Position: The Melancholic Errand of Psychoanalysis_, Steven Cooper explores a subject matter previously applied more exclusively to patients, but rarely to psychoanalysts. Cooper probes the analyst’s experience of the depressive position in the analytic situation. These experiences include the pleasures and warmth of helping patients to bear what appears unbearable as well as the poignant experiences of, limitation, incompleteness, repetition and disappointment as a vital part of clinical work. He describes a seam (...) in clinical work in which the analyst is always trying to find and refind a position from which he can help patients to work with these experiences. The Analyst’s Experience of the Depressive Position includes: An exploration of the analyst’s participation and resistance to helping patients hold some of the most unsettling parts of their experience. Cooper draws some analogies between elements of theory about aesthetic experience in terms of how we bear new and old experience. An examination of the patient as an artist of sorts and the analyst as a form of psychic boundary artist: just as the creative act of art involves the capacity to transform pain and ruin into the depressive position, so does the co-creation of how we understand the patient’s mind through the mind of the analyst. Clinical chapters which focus on helping patients move from paranoid to depressive positions, with an emphasis on the analyst’s personal participation in that process. The Analyst’s Experience of the Depressive Position explores a rich, provocative and long overdue topic relevant to psychoanalysts, psychodynamically oriented psychotherapists, as well as students and teachers of both psychoanalysis and psychodynamic psychotherapy. (shrink)

The Medical Practitioner Tribunal Service in the United Kingdom recently revoked a physician's license for failing to report treating a man who had been tortured and for failing to safeguard vulner...

In lieu of an abstract, here is a brief excerpt of the content:Delatores And The Tradition Of Violence In Roman OratorySteven H. RutledgeTwo very prominent scholars have asserted that oratory became more violent and aggressive during the early Principate, as delatores (professional accusers and informants) came to dominate the genre. 1 This assumption has a place in a number of studies on Roman history, culture, and literature which accept their premise. 2 However, such an assumption, before it is accepted, needs (...) to be set in the larger context of Roman oratory over the period from the Republic to the Empire. It is my object here to do just that, for I propose that the new style—one which is generally perceived as more violent—represents not so much a change as a continuity in Roman rhetorical practice, and that the perceived transformation is more a product of how our sources represent orators in the first century c.e. rather than oratory’s metamorphosis into something with a perceptibly more violent style. To that end my argument has two parts. First, we need to put professional accusers into their republican as well as imperial context. Professional accusers in [End Page 555] particular were by no means exclusive to the Empire, and even in Cicero’s time they were associated with a more violent style. 3 After we set them in their larger historical context, we may then set them in their rhetorical context: Roman rhetorical theorists expected prosecution, in which delatores specialized, to be more violent by its very nature—something generally overlooked by scholars. All of this is not to deny that rhetoric underwent a fundamental change between the Republic and Empire; that is indisputable. Rather, I suggest that given the nature of what delatores did, in and of itself, and given our sources, it is very difficult to conclude that the style of delatores was essentially more “savage and aggressive” than that of their predecessors under the Republic. It was the inherent nature of Roman oratory and the ever-competitive milieu of Roman politics—during both the Republic and the Empire—which worked in unison to create such continuity. It is the nature of our sources under the Empire, on the other hand, which has led scholars to a distorted impression of oratory in the first century c.e.Let us turn first to accusatio under the Republic. Accusation appears to have always been a morally dubious undertaking, and the revulsion felt by Tacitus and Pliny under the Empire at those who pursued it professionally was by no means unique to their age. Cicero, our main source for this activity during the late Republic, by all indica-tions felt accusation generally unethical and something to be avoided, for while he noted that it could indeed make a reputation, he also remarked that prosecution ought to be undertaken only in certain circumstances. 4 Pursuit of such activity, if it turned into a habit, could become [End Page 556] an embarrassment for the accuser’s family, as Cicero indicates it was for M. Brutus’: Isdem temporibus M. Brutus, in quo magnum fuit, Brute, dedecus generi vestro, qui, cum tanto nomine esset patremque optimum virum habuisset et iuris peritissimum, accusationem factitaverit (Brut. 130). But even if it was not the habit of an individual to accuse, it was necessary to justify at length the acceptance of a case for the prosecution, as Cicero illustrates in his apology, in Divinatio in Caecilium (passim), for taking up the accusation against Verres. That prosecution was an ethically questionable activity is by no means in doubt; we see an inherent bias against prosecution in Rome in Cicero’s day, one which was carried over into the Empire and which left its mark on our sources. 5This did not prevent orators, however, from habitually undertaking prosecutions. One of the initial indications that orators had started to specialize in accusation is found in Cicero’s Pro S. Roscio Amerino (89–90), where he notes that the dominatio of Cinna and Sulla served as impetus for such activity: 6Verum ego forsitan propter multitudinem patronorum in grege adnumerer, te pugna Cannensis accusatorem sat bonum fecit. Multos caesos non ad Trasumenum lacum, sed ad Servilium vidimus. Quis ibi non... (shrink)

The field, as Steven Cooper describes it, is comprised of the inextricably related worlds of internalized object relations and interpersonal interaction. Furthermore, the analytic dyad is neither static nor smooth sailing. Eventually, the rigorous work of psychoanalysis will offer a fraught opportunity to work through the most disturbing elements of a patient's inner life as expressed and experienced by the analyst - indeed, a disturbance in the field. How best to proceed when such tricky yet altogether common therapeutic situations (...) arise, and what aspects of transference/countertransference should be explored in the service of continued, productive analysis? These are two of the questions that Steven Cooper explores in this far-ranging collection of essays on potentially thorny areas of the craft. His essays try to locate some of the most ineffable types of situations for the analyst to take up with patients, such as the underlying grandiosity of self-criticism; the problems of too much congruence between what patients fantasize about and analysts wish to provide; and the importance of analyzing hostile and aggressive aspects of erotic transference. He also tries to turn inside-out the complexity of hostile transference and countertransference phenomena to find out more about what our patients are looking for and repudiating. Finally, Cooper raises questions about some of our conventional definitions of what constitutes the psychoanalytic process. Provocatively, he takes up the analyst's countertransference to the psychoanalytic method itself, including his responsibility and sources of gratification in the work. It is at once a deeply clinical book and one that takes a post-tribal approach to psychoanalytic theory - relational, contemporary Kleinian, and contemporary Freudian analysts alike will find much to think about and debate here. (shrink)

Nursing homes' ethics committees play a role in designing policies to assure ethical care. The administrative structure of nursing homes is not as large as that of hospitals. Nursing home staff and administration can respond to medical accidents in a way that treats family unethically and does serious harm to the facility. This paper describes incidents in which nursing homes attempted to conceal accidental deaths. It describes how such incidents are discovered, and the consequences of such efforts, and suggests ways (...) to prevent such incidents.This paper presents a retrospective review of a convenience sample of eight cases in which it was discovered that a nursing home attempted to conceal an accidental death. The effort to conceal an accidental death requires a coordinated effort to: [1] limit dissemination of information about the accident by staff and records, [2] decrease suspicion about the death, and [3] decrease the likelihood that an inquiry, if launched, will succeed. This effort begins as a reflexive, emotional and defensive response to the accident and consolidates as an institutional strategy to conceal both the accident and the concealment. The effort is coordinated by administrators who coerce cooperation from front line staff, alter medical records, and fail to follow reporting procedures. The attempt to conceal a lethal accident adversely affects the facility and the healthcare system. Ethics committees should work with professional organizations and administrator to assure proper management and disclosure of harmful accidents. (shrink)

The case of Helga Wanglie involved a conflict between the medical team, which concluded that a respirator was providing no medical benefit to the 87-year-old woman and should therefore be discontinued, and Ms. Wanglie's family who did not want the respirator removed. Most published commentary on the case has analyzed the medical team's conclusion. In contrast, this article examines the impact of the conflict on the conduct of the clinical case, and on the relationships among the various parties involved.