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17 results

  • 19 - Brain death

  • from 2 - End-of-life issues
  • Edited by Gail A. Van Norman, University of Washington, Stephen Jackson, Stanley H. Rosenbaum, Susan K. Palmer
  • Book:
    Clinical Ethics in Anesthesiology
    Published online:
    05 March 2012
    Print publication:
    28 October 2010, pp 108-113

  • Summary

    Restraint therapy is instituted to prevent injuries to patients or others by restricting a patient's movement. Used appropriately, restraint therapy reduces patient risk and improves outcome. Otherwise, restraint can cause accidental injury or even death. Physicians are ethically obliged to limit the use of restraints to clinically and adequately justified situations so that associated risks can be reduced. Physicians should consider whether the benefits of restraint therapy are worth the harms. This chapter presents two case studies on the appropriate use of restraint therapy. In the first case, the desire for the restraints may have been misguided. The second case exhibits the effects of restraint therapy on the family. The ethical principles of respect for patient self-determination (including informed consent obtained from surrogate decision-makers), beneficence and non-maleficence should weigh heavily in the decision to employ restraint as a mode of treatment.

  • 17 - Withholding and withdrawing life support in the intensive care unit

  • from 2 - End-of-life issues
  • Edited by Gail A. Van Norman, University of Washington, Stephen Jackson, Stanley H. Rosenbaum, Susan K. Palmer
  • Book:
    Clinical Ethics in Anesthesiology
    Published online:
    05 March 2012
    Print publication:
    28 October 2010, pp 97-102

  • Summary

    The principle of respect for patient autonomy supports a pregnant woman's rights to refuse recommended medical treatments, even if such refusal may be detrimental to her or to her fetus. The incidence of cesarean delivery without medical or obstetrical indications is increasing in the US, one component of which is cesarean deliveries at maternal request (CDMR). Principles of beneficence and nonmaleficence are particularly challenging with CDMR, since they must balance benefits and harms for both mother and baby in a situation where there is a lack of reliable authoritative data, physicians' own personal views may vary widely, and there is heated political as well as medical debate. The anesthesiologist probably would not have been directly involved in the patient's and obstetrician's decisions regarding mode of delivery. When patients request unnecessary interventions, additional ethical considerations include issues of distributive justice.

Clinical Ethics in Anesthesiology
  • A Case-Based Textbook
  • Edited by Gail A. Van Norman, Stephen Jackson, Stanley H. Rosenbaum, Susan K. Palmer
  • Published online:
    05 March 2012
    Print publication:
    28 October 2010
  • Ethical issues facing anesthesiologists are more far-reaching than those involving virtually any other medical specialty. In this clinical ethics textbook, authors from across the USA, Canada and Europe draw on ethical principles and practical knowledge to provide a realistic understanding of ethical anesthetic practice. The result is a compilation of expert opinion and international perspectives from clinical leaders in anesthesiology. Building on real-life, case-based problems, each chapter is clinically focused and addresses both practical and theoretical issues. Topics include general operating room care, pediatric and obstetrical patient care, the intensive care unit, pain practice, research and publication, as well as discussions of lethal injection, disclosure of errors, expert witness testimony, triage in disaster and conflicts of interest with industry. An important reference tool for any anesthesiologist, whether clinical or research-oriented, this book is especially valuable for physicians involved in teaching residents and students about the ethical aspects of anesthesia practice.