摘要:

This paper sets out to discuss what precisely is meant by ‘‘benefit" when we talk of the requirement that the health care system concern itself with health gain or with maximizing beneficial health care. In particular I argue that in discharging the duty to do what is most beneficial we need to choose between rival conceptions of what is meant by beneficial. One is the patient's conception of benefit and the second is the provider's or funder's conception of benefit. I argue that it is the patient's conception of benefit which is paramount and that if this is followed it commits us to a conception of patient care which must be blind to prognosis in so far as prognosis is thought to bear upon issues of prioritisation or resource allocat

ISSN:0269-9702    

DOI:10.1111/1467-8519.00029

出版商:Blackwell Publishers Ltd    

年代:1996

数据来源: WILEY

摘要:

Beyond the well‐known ethical issues involved in medical experimentation on human subjects, experimenting with embryos raises unique and particularly hard problems. Beside the psychological obstacles connected with the fear of ‘‘playing God" and the awe with which we hold the process of the creation of human beings, there are three philosophical problems which are the main subject of the article:1. The logical problem of circularity: the morality of experimenting on embryos is dependent on the status of the embryo, which in turn is partly decided by experimentation.2. The metaphysical problem: experiments are justified by the benefits they bring to human subjects; but it is doubtful whether an early embryo is a ‘‘subject" and whether coming into being is a ‘‘benefit".3. The moral problem: the standard constraint on medical experiments is that they benefit either the individual subject or at least members of a relevantly defined group of patients suffering from the same syndrome. But embryo experimentation is often associated with potential cure to people of a completely different category (like geriatric patients).Finally, the article discusses the limits of the force of philosophical arguments in the formation of actual policies for regulating such practices as experimenting with embryos. The widely‐shared fourteen‐day limit is shown to be a sound practical compromise despite the difficulties in justifying i

ISSN:0269-9702    

DOI:10.1111/1467-8519.00030

出版商:Blackwell Publishers Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACTA clinical scenario is described where an anaesthetist is concerned about the seemingly high risk/benefit ratio relating to laparoscopic versus standard inguinal hernia operations. Some options for further action by the anaesthetist are introduced. The remainder of the paper explores the question of who can legitimately assess the acceptability of risk/benefit ratios, and defends the use of practice guidelines at the expense of so called clinical freedom. It is argued that respect for persons is not breached by limiting the treatment options offered to patients to those therapies which have a‘reasonable’risk/benefit ratio. This‘reasonableness’is context dependent, and should be properly decided by those with expertise in th

ISSN:0269-9702    

DOI:10.1111/j.1467-8519.1996.tb00131.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACTIsobel Ross rightly points out that providing information is not enough to guarantee that patients will choose the best course of action. She argues that to adequately protect patients’interests, we need practice guidelines to‘ensure that dangerous and unnecessarily risky procedures are excluded from practice’. What constitutes an‘unnecessarily risky procedure’is to be determined by a group of reasonable doctors. At one point, Ross suggests that such guidelines are‘presumptive’rather than ‘absolute’. But this is really a concession to patient variability. She intends that certain procedures are ruled out on paternalistic grounds.I will argue that practice guidelines are desirable but should not determine practice. We should not rule out procedures on pate

ISSN:0269-9702    

DOI:10.1111/j.1467-8519.1996.tb00132.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Isobel Ross rightly points out that providing information is not enough to guarantee that patients will choose the best course of action. She argues that to adequately protect patients' interests, we need practice guidelines to ‘ensure that dangerous and unnecessarily risky procedures are excluded from practice’. What constitutes an ‘unnecessarily risky procedure’ is to be determined by a group of reasonable doctors. At one point, Ross suggests that such guidelines are ‘presumptive’ rather than ‘absolute’. But this is really a concession to patient variability. She intends that certain procedures are ruled out on paternalistic grounds.I will argue that practice guidelines are desirable but should not determine practice. We should not rule out procedures on patern

ISSN:0269-9702    

DOI:10.1111/1467-8519.00032

出版商:Blackwell Publishers Ltd    

年代:1996

数据来源: WILEY

ISSN:0269-9702    

DOI:10.1111/j.1467-8519.1996.tb00133.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0269-9702    

DOI:10.1111/j.1467-8519.1996.00034.pp.x

出版商:Blackwell Publishers Ltd    

年代:1996

数据来源: WILEY

摘要:

Book Reviws in this ArticleMeta‐Medical Ethics: The Philosophical Foundations of Bioethics, edited by Michael A. Grodin. Dordrecht: Kluwer Academic Publishers, 1995Autonoaty and Intervention: Parentalism in the Caring Life, by Job Kultgen. New York: Oxford University Press, 1995Long‐Term Care Decisions, Ethical and Conceptual Dimensions, edited by Laurence McCullough and Nancy Wilson. Baltimore; The John Hopkins University Press, 1995Contemplating Suicide: The Language and Ethics of Self Harm by Gavin Fairbairn. Landon and New York: Routledge,

ISSN:0269-9702    

DOI:10.1111/j.1467-8519.1996.tb00135.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0269-9702    

DOI:10.1111/j.1467-8519.1996.tb00136.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0269-9702    

DOI:10.1111/j.1467-8519.1996.tb00137.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY