Post-traumatic stress disorder (PTSD) is a serious mental disorder that develops in some individuals following exposure to severe psychological stressors. In this chapter, we provide an overview of the conceptual issues, specific methods, and practical considerations in evidence-based assessment of PTSD. First, we outline the conceptual issues and practical components of a comprehensive assessment of PTSD. Second, we provide an overview of the most widely used self-rated and clinician-rated measures of trauma exposure and PTSD, comorbid disorders, and response bias. Third, we discuss cultural considerations in assessing PTSD. Fourth, we offer practical guidelines for conducting a clinically sensitive assessment of PTSD, highlighting some of the unique considerations in engaging trauma survivors in the assessment process and optimizing the information obtained. Last, we briefly summarize conceptual considerations and specific measures for other trauma- and stressor-related disorders.

Anaesthesia is possibly the most pharmacology oriented of all clinical medical specialties. What we do every day is, effectively, applied pharmacology. Yet with all this practical experience, some aspects, particularly pharmacokinetics, can appear dauntingly complex. Indeed, mathematical modelling and developing target-controlled infusions is difficult as is the design of modern vaporisers for inhalational drugs but, as an analogy, we don’t need to be able to design a car in order to know how to drive it. However, there are certain basic PK features that will enhance your understanding and improve your ability to use these drugs appropriately.

This chapter provides an ethical framework to guide decision making about periviable birth.

Viability in professional ethics in obstetrics and gynecology is a function of both fetal physiology and available resuscitation and life-sustaining treatment. Viability is therefore the biological capacity of a live-born infant to survive even if full technological support is needed. This is the concept of viability used by the United States Supreme Court in its landmark ruling, Roe v. Wade, in 1973.

This chapter provides an ethical framework for decision making about initiation of pregnancy.

Obstetrician-gynecologists play two important roles in the initiation of pregnancy. The first is the medically assisted initiation of pregnancy, usually to manage infertility in the female patient or her partner or both. The second is preconception counseling to anticipate and prevent ethical challenges in assisted initiation of pregnancy.

This chapter provides guidance on deliberative clinical judgment and decision making about preventing pregnancy in professional ethics in gynecology.

The biologic concept of sex is an essential component of the biologic concept of fertility. It is used to categorize human beings according to reproductive role: only the capacity to produce gametes, or the capacity to produce gametes and initiate a pregnancy. Sex was once thought to be dimorphic, but modern genomics of chromosomes has abandoned dimorphism for a concept of biologic sex as ranging along a continuum between these two productive roles. In other words, like all other human traits, biologic sex displays variation.

This chapter provides an introduction to professional ethics in obstetrics and gynecology based on the ethical concept of medicine as a profession and the ethical concepts of the female patient, pregnant patient, and fetal patient. There is also an introduction to professional ethics in perinatal medicine.

This chapter provides an ethical framework for offering, recommending, performing, and referring for induced abortion and feticide.

Counseling pregnant women about induced abortion and feticide presents the obstetrician with a distinct set of challenges., The American Medical Association and the American College of Obstetricians and Gynecologists have provided general guidance. Based on the ethical principles of beneficence and respect for autonomy in professional ethics in obstetrics and gynecology (see Chapter 2), this chapter provides practical, clinically comprehensive ethical guidance on when to offer, recommend, perform, and refer for abortion and feticide.

This chapter provides an ethical framework to guide decision making about fetal analysis.

The ethical principle of respect for autonomy in professional ethics in obstetrics creates the obstetrician’s prima facie ethical obligation to empower the pregnant patient to make informed and voluntary decisions about obstetric management. This ethical obligation has two components. The first is providing her with clinical information about options for fetal analysis using nomenclature that is precise.

This chapter provides an ethical framework for setting justified limits on life-sustaining treatment.

Sometimes a patient’s condition has deteriorated to such a degree that in deliberative clinical judgment the prediction of imminent death becomes reliable. When death is imminent patients are transferred to a critical care unit in which they receive life-sustaining treatment. Life-sustaining treatment deploys a range of interventions, including physical intervention such as cardiopulmonary resuscitation; intravenous administration of drugs, fluids, and nutrition; and mechanical devices such as circulation devices, extracorporeal membrane oxygenation, dialysis, and ventilators. These interventions are designed to support or replace organ functions in the absence of which the risk of mortality will rapidly approach 100%.

This chapter provides an ethical framework to guide decision making about intrapartum management.

Most women deliver their babies vaginally. Vaginal delivery is clearly safer for the pregnant patient because no invasive clinical management is involved, even when fetal monitoring takes place. This clinical reality makes assisting vaginal delivery the default in clinical judgment, placing the burden of proof on justifying cesarean delivery. As a consequence, in traditional obstetric thinking, cesarean delivery is either indicated – the burden of proof is met – or nonindicated – the burden of proof is not met. When cesarean delivery is indicated, it should be recommended. When cesarean delivery is not indicated, it should not be offered, much less recommended.

This chapter provides an ethical framework for the identification and responsible management of conflicts of interest and conflicts of commitment.

The professionally responsible management of conflicts of interest and conflicts of commitment is essential for sustaining the three commitments of the ethical concept of medicine as a profession (see Chapter 1) and therefore for professional integrity.