اخلاق پزشکی

اخلاق پزشکی دانشی میان رشته ای است که موضوع آن مسائل و مباحث اخلاقی در حوزه ی علوم پزشکی است.
این مسائل و مباحث در شاخه های مختلف علوم پزشکی به عنوان حرفه، پژوهشهای پزشکی و سیاستگذاری نظام سلامت مطرح هستند .
محتوای این مباحث از رشته های گوناگون دانش و معرفت بشری به اخلاق پزشکی وارد شده و در شکل گیری این حوزه از دانش دخیل بوده اند. در این میان، فلسفه اخلاق، حقوق، الهیات، فقه، ادبیات، جامعه شناسی، روان شناسی، اقتصاد و تاریخ تاثیر و نقش بیشتریداشته اند.
برخی مسائل و پرسشها در حوزه اخلاق پزشکی سابقه ای دیرینه دارند و در متون کهن پزشکی نیز مورد توجه و بحث قرار گرفته اند مثل سقط جنین و رابطه پزشک و بیمار. برخی دیگر به دنبال پزشکی مدرن پدید آمده اند و از توانایی ها و امکانات بی سابقه ای که دانش و فناوری پزشکی نوین پیش روی بشر قرار داده ناشی می شوند مثل پیوند اعضاء و استفاده از سلولهای بنیادی در معالجه و درمان .
از جمله مباحث اخلاق پزشکی می توان مسائل اخلاقی در بیماران پایان حیات ، اخلاق در پژوهشهای پزشکی، وظایف و مسئولیتهای پزشک، حقوق و نقش بیمار در تصمیم گیریهای پزشکی، فایده رساندن و زیان وارد نکردن، مباحث حقوقی و اخلاقی در پیوند اعضاء، عدالت در توزیع منابع، رضایت آگاهانه، اتانازی، سلامت و بیماری، مفهوم شخص ، شاٌن و کرامت انسانی، شاٌن اخلاقی(Moral status)، مسائل اخلاقی در باروری و ناباروری، کمیته های اخلاق در پژوهش، مرگ مغزی و شاخص های آن، شبیه سازی انسان، اهلیت (Competence) و راه های تعیین آن، رهیافت مبتنی بر اصول، رهیافت مبتنی بر موارد الگو (Casuistry)، رهیافت مبتنی بر نتایج (Consequentialism)، رهیافت مبتنی بر روایت(Narrativism) رهیافت مبتنی بر مراقبت، پژوهش روی حیوانات، رهیافت وظیفه گرا، اخلاق در سیاستگذاری و تخصیص منابع محدود را نام برد.
قس در دانشنانه رشد
مکارم اخلاقی وجه امتیاز و شرافت انسان است. ارزش هر انسان بستگی به انصاف و آراستگی او به سجایا و اخلاق حسنه دارد. هدف و فلسفه بعثت پیامبران الهی نیز تکامل اخلاقی بشری بوده است. حاکمیت اخلاق کریمه در جوامع انسانی نیز نشانه تعالی و تمدن واقعی آن جامعه تلقی می‌شود.

پیشرفتهای علمی بشری زمانی برای نوع بشر مفید و ثمربخش است که از پشتوانه اخلاقی برخوردار باشد. علم و تخصص بدون بهره‌مندی از اخلاقیات پاسخگوی نیازهای فطری بشر نبوده و گاهی نقض غرض است، زیرا هر نوع پیشرفت باید دارای جهت و هدف باشد و اخلاق به پیشرفت علمی جهت و هدف می‌بخشد. پیشرفت علمی عاری از مکارم و سجایای اخلاقی حرکت در تاریکی است. اخلاق چراغ هدایت هر حرکت محسوب می‌شود.
اخلاق در پزشکی
در عرصه پزشکی نیز این حکم صادق است و اساسا حرکت طب بر محور اخلاق بوده و پایه‌های آن بر مبانی اخلاقی استوار است. کوشش برای نجات جان انسانها و اعاده حیات و سلامت به آنان و درمان بیماریها و تشقی و تسکین آلام دردمندان و تلاش در بقای نسل و سالم سازی محیط انسانی خود از ارزشهای اخلاقی است.

اگر تکاپو و مساعی متصدیان امور پزشکی برای دستیابی و نیل به اهداف مقدس فوق باشد، خدمات ارزنده آنان جنبه عبادی به خود می‌گیرد و زیباترین کمالات اخلاقی به منصه ظهور می‌رسد، زیرا عالی‌ترین تظاهر عواطف بشری ، چون تعهد ، علم و تخصص ، فداکاری و ایثار ، نجات ، التیام و آرام بخشی و عشق و دلسوزی در این نوع خدمات پزشکی متبلور است.
جلوه‌گاه اخلاق در منظر پزشکی
جلوه‌گاه این کرامت اخلاقی در دنیای پزشکی در مرحله حساس و سرنوشت‌ساز برخورد پزشک با بیمار است. هر قدر این برخورد انسانی ، اخلاقی ، عاطفی و صمیمانه ، شکوهمند و شرافتمندانه و احترام آمیز باشد، حصول آرمانهای مقدس پزشکی و امنیت روانی و جسمی بیمار و رضایت خاطر او و اطرافیانش قطعی‌تر خواهد بود.
عواقب عدم مراعات جنبه‌های اخلاقی
ممکن است پزشک از دیدگاه علمی و فنی به وظیفه خود عمل و حتی بیمار را معالجه نماید. لیکن عدم مراعات جنبه‌های اخلاقی و انسانی در برخورد با بیمار او را از هدف عالی پزشکی دور کند و کوچکترین غفلت ، مسامحه و لغزش از موازین اخلاقی و وجدانی و بی‌حرمتی نسبت به شخصیت بیمار و اطرافیان او سبب عدم امنیت خاطر ، دل‌شکستگی ، آشفتگی و تکدر روحی بیمار و سلب اعتماد او از پزشک معالج گردد.

به نظر می‌رسد این مهم ، یعنی نحوه برخورد پزشکان با بیماران ، می‌بایست سرلوحه خدمات پزشکی قرار گیرد تا از رهگذر این اصول به اهداف متعالی پزشکی که نجات جان و مداوا و حفظ حیات و سلامت آنان و ایجاد امنیت جسمی و روانی افراد جامعه و جلب رضایت مردم و لازمه رضایت خالق است، محقق گردد.
قس
رده:اخلاق پزشکی
از ویکی‌پدیا، دانشنامهٔ آزاد
زیررده‌ها

این ۳ زیررده در این رده قرار دارند؛ این رده در کل حاوی ۳ زیررده است.

س
[+] سقط جنین‏ (۱ ر، ۶ ص)
م
[+] مرگ خوب‏ (۲ ر، ۲ ص)
ک
[×] کاهش آسیب‏ (۲ ص)
صفحه‌ها

این ۱۳ صفحه در این رده قرار دارند؛ این رده در کل حاوی ۱۳ صفحه است.

آ
آزمایش روی حیوانات
آزمایش میلگرم
آزمایش میکروب سفلیس در گواتمالا
ا
اوتانازی
ب
برنامه تعویض سرنگ
ب (ادامه)
بیماری روانی
بیماری‌های یاتروژنیک
ت
تاگ‌سازی انسان
تخمک مردان
س
سوگند‌نامه بقراط
ش
شبه دارو
ف
فیلوکتتس (سوفوکل)
م
میکرودوزینگ
رده‌های صفحه: پزشکیچالش‌های اخلاقیاخلاق زیستی
قس عربی
أخلاقیات الطب أو آداب الطب جزء من الأخلاقیات یبحث مشکلات تعامل الأطباء مع المرضى ومع زملائهم من الأطباء؛ وهی مجموعة من القوانین واللوائح والأخلاقیات المتعارف علیها طبیا خلال ممارسة مهنة التطبیب وهی أخلاقیات وقیم تم اکتسابها وتبنیها من قبل الهیئات الطبیة على مدار تاریخ الطب واستنادا لقیم دینیة وفلسفیة وأخلاقیة.
[عدل]التاریخ

یمکن تتبع نشأة أخلاقیات الطب إلى العصور القدیمة وذلک إلى أبقراط و ما یعرف بقسم أبقراط، وإلى التعالیم الربانیة النصرانیة القدیمة. وفی العصور الوسطى وبدایة العصر الحدیث فإن الفضل یعود لأطباء مسلمین کإسحاق بن علی الرحاوی فی کتابه (آداب الطبیب)، والطبیب أبو بکر الرازی، ومفکرین یهود کـموسى بن میمون القُرْطُبیّ ، ومفکرین مدرسیین کاثولیکیین کالقدیس توما الأکوینی. والذین ترکوا بصمة واضحة فی تاریخ الطب فی العصور الوسطى والذی نجد له الأثر حتى عصرنا هذا فی أخلاقیات الطب الإسلامیة والیهودیة والکاثولیکیة.
[عدل]القیم فی أخلاقیات الطب

هناک ست قیم یجدر الحدیث عنها؛ وذلک لأنها القیم الأساسیة التی یجب أخذها بعین الاعتبار فی مناقشات القضایا الأخلاقیة الطبیة:
الاستقلال الذاتی– للمریض الحق فی اختیار أو رفض طریقة معالجته. (Voluntas aegroti suprema lex).
المعاملة الحسنة– یجب على صاحب المهنة أن یعامل المریض بکامل الاهتمام.(Salus aegroti suprema lex).
عدم الإیذاء – من اللاتینیة (primum non nocere) وتعنی "بدایةً، لا تؤذِ".
العدالة – الاهتمام بتوزیع مصادر الصحة النادرة، وتقریر من الذی یستحق أخذ علاج ما (الإنصاف والمساواة).
الکرامة – للمریض (ومعالِجِه) الحق فی الکرامة.
الصدق والأمانة – ازدادت أهمیة مصطلح الموافقة المستنیرة بعد محاکمة الأطباء (وهی المحاکمة الأولى لـ12 محاکمة أقامتها الولایات المتحدة لـجرائم الحرب فی نورنبیرغ).

یمکن - فی بعض الحالات - أن تتعارض هذه المبادئ مع بعضها وهو ما قد یشکل معضلة، ویمکن أن لا یوجد حل مثالی لمعضلة من هذا النوع. کما یمکن أن تتعارض هذه القیم عند أناس وآخرین.
هذه بذرة مقالة عن العلوم الطبیة تحتاج للنمو والتحسین، فساهم فی إثرائها بالمشارکة فی تحریرها.
تصنیف: أخلاقیات الطب
قس انگلیسی
Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology.
Contents [show]
[edit]History

Historically, Western medical ethics may be traced to guidelines on the duty of physicians in antiquity, such as the Hippocratic Oath, and early rabbinic and Christian teachings. The first code of medical ethics, Formula Comitis Archiatrorum, was published in the 5th century, during the reign of the Ostrogothic king Theodoric the Great. In the medieval and early modern period, the field is indebted to Muslim medicine such as Ishaq bin Ali Rahawi (who wrote the Conduct of a Physician, the first book dedicated to medical ethics) and Muhammad ibn Zakariya ar-Razi (known as Rhazes in the West), Jewish thinkers such as Maimonides, Roman Catholic scholastic thinkers such as Thomas Aquinas, and the case-oriented analysis (casuistry) of Catholic moral theology. These intellectual traditions continue in Catholic, Islamic and Jewish medical ethics.
By the 18th and 19th centuries, medical ethics emerged as a more self-conscious discourse. For instance, authors such as Thomas Percival wrote about "medical jurisprudence" and reportedly coined the phrase "medical ethics." Percival's guidelines related to physician consultations have been criticized as being excessively protective of the home physician's reputation. Jeffrey Berlant is one such critic who considers Percival's codes of physician consultations as being an early example of the anti-competitive, "guild"-like nature of the physician community.[1][2] In 1847, the American Medical Association adopted its first code of ethics, with this being based in large part upon Percival's work [2]. While the secularized field borrowed largely from Catholic medical ethics, in the 20th century a distinctively liberal Protestant approach was articulated by thinkers such as Joseph Fletcher. In the 1960s and 1970s, building upon liberal theory and procedural justice, much of the discourse of medical ethics went through a dramatic shift and largely reconfigured itself into bioethics.[3]
As a result of the Nuremberg Trials, the Belmont Report was entered into law in the United States.[citation needed] This led to the creation of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research.
Since the 1970s, the growing influence of ethics in contemporary medicine can be seen in the increasing use of Institutional Review Boards to evaluate experiments on human subjects, the establishment of hospital ethics committees, the expansion of the role of clinician ethicists, and the integration of ethics into many medical school curricula.[4]
[edit]Values in medical ethics

Six of the values that commonly apply to medical ethics discussions are:
autonomy - the patient has the right to refuse or choose their treatment. (Voluntas aegroti suprema lex.)
beneficence - a practitioner should act in the best interest of the patient. (Salus aegroti suprema lex.)
non-maleficence - "first, do no harm" (primum non nocere).
justice - concerns the distribution of scarce health resources, and the decision of who gets what treatment (fairness and equality).
respect for persons - the patient (and the person treating the patient) have the right to be treated with dignity.
truthfulness and honesty - the concept of informed consent has increased in importance since the historical events of the Doctors' Trial of the Nuremberg trials and Tuskegee syphilis experiment.
Values such as these do not give answers as to how to handle a particular situation, but provide a useful framework for understanding conflicts.
When moral values are in conflict, the result may be an ethical dilemma or crisis. Sometimes, no good solution to a dilemma in medical ethics exists, and occasionally, the values of the medical community (i.e., the hospital and its staff) conflict with the values of the individual patient, family, or larger non-medical community. Conflicts can also arise between health care providers, or among family members. Some argue for example, that the principles of autonomy and beneficence clash when patients refuse blood transfusions, considering them life-saving; and truth-telling was not emphasized to a large extent before the HIV era.
[edit]Autonomy
The principle of autonomy recognizes the rights of individuals to self-determination. This is rooted in society's respect for individuals' ability to make informed decisions about personal matters. Autonomy has become more important as social values have shifted to define medical quality in terms of outcomes that are important to the patient rather than medical professionals. The increasing importance of autonomy can be seen as a social reaction to a "paternalistic" tradition within healthcare.[citation needed] Some have questioned whether the backlash against historically excessive paternalism in favor of patient autonomy has inhibited the proper use of soft paternalism to the detriment of outcomes for some patients.[5] Respect for autonomy is the basis for informed consent and advance directives.
Autonomy is a general indicator of health. Many diseases are characterised by loss of autonomy, in various manners. This makes autonomy an indicator for both personal well-being, and for the well-being of the profession. This has implications for the consideration of medical ethics: "is the aim of health care to do good, and benefit from it?"; or "is the aim of health care to do good to others, and have them, and society, benefit from this?". (Ethics - by definition - tries to find a beneficial balance between the activities of the individual and its effects on a collective.)
By considering autonomy as a gauge parameter for (self) health care, the medical and ethical perspective both benefit from the implied reference to health.
Psychiatrists and clinical psychologists are often asked to evaluate a patient's capacity for making life-and-death decisions at the end of life. Persons with a psychiatric condition such as delirium or clinical depression may not have the capacity to make end-of-life decisions. Therefore, for these persons, a request to refuse treatment may be taken in consideration of their condition and not followed. Unless there is a clear advance directive to the contrary, persons who lack mental capacity are generally treated according to their best interests. On the other hand, persons who have the mental capacity to make end-of-life decisions have the right to refuse treatment and choose an early death if that is what they truly want. In such cases, psychiatrists and psychologists are typically part of protecting that right.[6]
[edit]Beneficence
The term beneficence refers to actions that promote the well being of others. In the medical context, this means taking actions that serve the best interests of patients. However, uncertainty surrounds the precise definition of which practices do in fact help patients.
James Childress and Tom Beauchamp in Principle of Biomedical Ethics (1978) identify beneficence as one of the core values of health care ethics. Some scholars, such as Edmund Pellegrino, argue that beneficence is the only fundamental principle of medical ethics. They argue that healing should be the sole purpose of medicine, and that endeavors like cosmetic surgery, contraception and euthanasia fall beyond its purview.
[edit]Non-Maleficence
Main article: Primum non nocere
The concept of non-maleficence is embodied by the phrase, "first, do no harm," or the Latin, primum non nocere. Many consider that should be the main or primary consideration (hence primum): that it is more important not to harm your patient, than to do them good. This is partly because enthusiastic practitioners are prone to using treatments that they believe will do good, without first having evaluated them adequately to ensure they do no (or only acceptable levels of) harm. Much harm has been done to patients as a result, as in the saying, "The treatment was a success, but the patient died." It is not only more important to do no harm than to do good; it is also important to know how likely it is that your treatment will harm a patient. So a physician should go further than not prescribing medications they know to be harmful - he or she should not prescribe medications (or otherwise treat the patient) unless s/he knows that the treatment is unlikely to be harmful; or at the very least, that patient understands the risks and benefits, and that the likely benefits outweigh the likely risks.
In practice, however, many treatments carry some risk of harm. In some circumstances, e.g. in desperate situations where the outcome without treatment will be grave, risky treatments that stand a high chance of harming the patient will be justified, as the risk of not treating is also very likely to do harm. So the principle of non-maleficence is not absolute, and balances against the principle of beneficence (doing good), as the effects of the two principles together often give rise to a double effect (further described in next section).
Depending on the cultural consensus conditioning (expressed by its religious, political and legal social system) the legal definition of non-maleficence differs. Violation of non-maleficence is the subject of medical malpractice litigation. Regulations therefore differ over time, per nation.
[edit]Double effect
Main article: Principle of double effect
Double effect refers to two types of consequences which may be produced by a single action,[7] and in medical ethics it is usually regarded as the combined effect of beneficence and non-maleficence.[8]
A commonly cited example of this phenomenon is the use of morphine or other analgesic in the dying patient.[9] Such use of morphine can have the beneficial effect of easing the pain and suffering of the patient, while simultaneously having the maleficent effect of hastening the death of the patient through suppression of the respiratory system.
[edit]Conflicts between autonomy and beneficence/non-maleficence
Autonomy can come into conflict with beneficence when patients disagree with recommendations that health care professionals believe are in the patient's best interest. When the patient's interests conflict with the patient's welfare, different societies settle the conflict in a wide range of manners. Western medicine generally defers to the wishes of a mentally competent patient to make his own decisions, even in cases where the medical team believes that he is not acting in his own best interests. However, many other societies prioritize beneficence over autonomy.
Examples include when a patient does not want a treatment because of, for example, religious or cultural views. In the case of euthanasia, the patient, or relatives of a patient, may want to end the life of the patient. Also, the patient may want an unnecessary treatment, as can be the case in hypochondria or with cosmetic surgery; here, the practitioner may be required to balance the desires of the patient for medically unnecessary potential risks against the patient's informed autonomy in the issue. A doctor may want to prefer autonomy because refusal to please the patient's will would harm the doctor-patient relationship.
Individuals' capacity for informed decision making may come into question during resolution of conflicts between autonomy and beneficence. The role of surrogate medical decision makers is an extension of the principle of autonomy.
On the other hand, autonomy and beneficence/non-maleficence may also overlap. For example, a breach of patients' autonomy may cause decreased confidence for medical services in the population and subsequently less willingness to seek help, which in turn may cause inability to perform beneficence. Beneficence is a task worthy of many to complete due to its difficulty to perform under extreme circumstances that are not correlated directly with individuals seeking euthanasia.
The principles of autonomy and beneficence/non-maleficence may also be expanded to include effects on the relatives of patients or even the medical practitioners, the overall population and economic issues when making medical decisions.
[edit]Euthanasia
Main article: Euthanasia

The neutrality of this section is disputed. Please see the discussion on the talk page. Please do not remove this message until the dispute is resolved. (February 2012)
Some American physicians[who?] interpret the non-maleficence principle to exclude the practice of euthanasia, though not all concur. Probably the most extreme example in recent history of the violation of the non-maleficence dictum was Dr. Jack Kevorkian, who was convicted of second-degree homicide in Michigan in 1998 after demonstrating active euthanasia on the TV news show 60 Minutes.
In some countries such as Switzerland, euthanasia is accepted as standard medical practice.[citation needed] Legal regulations assign this to the medical profession. In such nations, the aim is to alleviate the suffering of patients from diseases known to be incurable by the methods known in that culture. In that sense, the "Primum no Nocere" is based on the belief that the inability of the medical expert to offer help, creates a known great and ongoing suffering in the patient.[citation needed]
[edit]Informed consent

Main article: Informed consent
Informed consent in ethics usually refers to the idea that a person must be fully informed about and understand the potential benefits and risks of their choice of treatment. An uninformed person is at risk of mistakenly making a choice not reflective of his or her values or wishes. It does not specifically mean the process of obtaining consent, nor the specific legal requirements, which vary from place to place, for capacity to consent. Patients can elect to make their own medical decisions, or can delegate decision-making authority to another party. If the patient is incapacitated, laws around the world designate different processes for obtaining informed consent, typically by having a person appointed by the patient or their next of kin make decisions for them. The value of informed consent is closely related to the values of autonomy and truth telling.
A correlate to "informed consent" is the concept of informed refusal.
[edit]Confidentiality

Main article: Confidentiality
Confidentiality is commonly applied to conversations between doctors and patients. This concept is commonly known as patient-physician privilege.
Legal protections prevent physicians from revealing their discussions with patients, even under oath in court.
Confidentiality is mandated in America by HIPAA laws, specifically the Privacy Rule, and various state laws, some more rigorous than HIPAA. However, numerous exceptions to the rules have been carved out over the years. For example, many states require physicians to report gunshot wounds to the police and impaired drivers to the Department of Motor Vehicles. Confidentiality is also challenged in cases involving the diagnosis of a sexually transmitted disease in a patient who refuses to reveal the diagnosis to a spouse, and in the termination of a pregnancy in an underage patient, without the knowledge of the patient's parents. Many states in the U.S. have laws governing parental notification in underage abortion.[10][11]
Traditionally, medical ethics has viewed the duty of confidentiality as a relatively non-negotiable tenet of medical practice. More recently, critics like Jacob Appel have argued for a more nuanced approach to the duty that acknowledges the need for flexibility in many cases.[12]
Confidentiality is an important issue in primary care ethics, where physicians care for many patients from the same family and community, and where third parties often request information from the considerable medical database typically gathered in primary health care.
[edit]Criticisms of orthodox medical ethics

It has been argued that mainstream medical ethics is biased by the assumption of a framework in which individuals are not simply free to contract with one another to provide whatever medical treatment is demanded, subject to the ability to pay. Because a high proportion of medical care is typically provided via the welfare state, and because there are legal restrictions on what treatment may be provided and by whom, an automatic divergence may exist between the wishes of patients and the preferences of medical practitioners and other parties. Tassano[13] has questioned the idea that Beneficence might in some cases have priority over Autonomy. He argues that violations of Autonomy more often reflect the interests of the state or of the supplier group than those of the patient.
Routine regulatory professional bodies or the courts of law are valid social recourses.
[edit]Importance of communication

Many so-called "ethical conflicts" in medical ethics are traceable back to a lack of communication. Communication breakdowns between patients and their healthcare team, between family members, or between members of the medical community, can all lead to disagreements and strong feelings. These breakdowns should be remedied, and many apparently insurmountable "ethics" problems can be solved with open lines of communication.[citation needed]
[edit]Control and resolution

To ensure that appropriate ethical values are being applied within hospitals, effective hospital accreditation requires that ethical considerations are taken into account, for example with respect to physician integrity, conflicts of interest, research ethics and organ transplantation ethics.
[edit]Guidelines
There are various ethical guidelines. For example, the Declaration of Helsinki is regarded as authoritative in human research ethics.[14]
In the United Kingdom, General Medical Council provides clear overall modern guidance in the form of its 'Good Medical Practice' statement. Other organisations, such as the Medical Protection Society and a number of university departments, are often consulted by British doctors regarding issues relating to ethics.
[edit]Ethics committees
Often, simple communication is not enough to resolve a conflict, and a hospital ethics committee must convene to decide a complex matter.
These bodies are composed primarily of health care professionals, but may also include philosophers, lay people, and clergy - indeed, in many parts of the world their presence is considered mandatory in order to provide balance.
With respect to the expected composition of such bodies in the USA, Europe and Australia, the following applies [3].
U.S. recommendations suggest that Research and Ethical Boards (REBs) should have five or more members, including at least one scientist, one non-scientist and one person not affiliated with the institution. The REB should include people knowledgeable in the law and standards of practice and professional conduct. Special memberships are advocated for handicapped or disabled concerns, if required by the protocol under review. The European Forum for Good Clinical Practice (EFGCP) suggests that REBs include two practicing physicians who share experience in biomedical research and are independent from the institution where the research is conducted; one lay person; one lawyer; and one paramedical professional, e.g. nurse or pharmacist. They recommend that a quorum include both sexes from a wide age range and reflect the cultural make-up of the local community. The 1996 Australian Health Ethics Committee recommendations were entitled, "Membership Generally of Institutional Ethics Committees". They suggest a chairperson be preferably someone not employed or otherwise connected with the institution. Members should include a person with knowledge and experience in professional care, counselling or treatment of humans; a minister of religion or equivalent, e.g. Aboriginal elder; a layman; a laywoman; a lawyer and, in the case of a hospital-based ethics committee, a nurse.
The assignment of philosophers or religious clerics will reflect the importance attached by the society to the basic values involved. An example from Sweden with Torbjörn Tännsjö on a couple of such committees indicates secular trends gaining influence.
[edit]Medical ethics in an online world

Increasingly, medical researchers are researching activities in online environments such as discussion boards and bulletin boards, and there is concern that the requirements of informed consent and privacy are not as stringently applied as they should be, although some guidelines do exist.[15]
One issue that has arisen, however, is the disclosure of information. While researchers wish to quote from the original source in order to argue a point, this can have repercussions. The quotations and other information about the site can be used to identify the site, and researchers have reported cases where members of the site, bloggers and others have used this information as 'clues' in a game in an attempt to identify the site.[16] Some researchers have employed various methods of "heavy disguise,"[16] including discussing a different condition from that under study,[17][18] or even setting up bogus sites (called 'Maryut sites') to ensure that the researched site is not discovered.[19]
[edit]Cultural concerns

Culture differences can create difficult medical ethics problems. Some cultures have spiritual or magical theories about the origins of disease, for example, and reconciling these beliefs with the tenets of Western medicine can be difficult.
[edit]Truth-telling
Some cultures do not place a great emphasis on informing the patient of the diagnosis, especially when cancer is the diagnosis. American culture rarely used truth-telling especially in medical cases, up until the 1970s. In American medicine, the principle of informed consent now takes precedence over other ethical values, and patients are usually at least asked whether they want to know the diagnosis.
[edit]Online business practices
The delivery of diagnosis online leads patients to believe that doctors in some parts of the country are at the direct service of drug companies. Finding diagnosis as convenient as what drug still has patent rights on it. Physicians and drug companies are found to be competing for top ten search engine ranks to lower costs of selling these drugs with little to no patient involvement.[20]
[edit]Conflicts of interest

Physicians should not allow a conflict of interest to influence medical judgment. In some cases, conflicts are hard to avoid, and doctors have a responsibility to avoid entering such situations. Unfortunately, research has shown that conflicts of interests are very common among both academic physicians[21] and physicians in practice.[22] The The Pew Charitable Trusts has announced the Prescription Project for "academic medical centers, professional medical societies and public and private payers to end conflicts of interest resulting from the $12 billion spent annually on pharmaceutical marketing".
[edit]Referral
For example, doctors who receive income from referring patients for medical tests have been shown to refer more patients for medical tests.[23] This practice is proscribed by the American College of Physicians Ethics Manual.[24]
Fee splitting and the payments of commissions to attract referrals of patients is considered unethical and unacceptable in most parts of the world.
[edit]Vendor relationships
See also: Pharmaceutical_marketing#To_health_care_providers
Studies show that doctors can be influenced by drug company inducements, including gifts and food.[25] Industry-sponsored Continuing Medical Education (CME) programs influence prescribing patterns.[26] Many patients surveyed in one study agreed that physician gifts from drug companies influence prescribing practices.[27] A growing movement among physicians is attempting to diminish the influence of pharmaceutical industry marketing upon medical practice, as evidenced by Stanford University's ban on drug company-sponsored lunches and gifts. Other academic institutions that have banned pharmaceutical industry-sponsored gifts and food include the Johns Hopkins Medical Institutions, University of Michigan, University of Pennsylvania, and Yale University.[28][29]
[edit]Treatment of family members
Many doctors treat their family members. Doctors who do so must be vigilant not to create conflicts of interest or treat inappropriately.[30][31]
[edit]Sexual relationships
Sexual relationships between doctors and patients can create ethical conflicts, since sexual consent may conflict with the fiduciary responsibility of the physician. Doctors who enter into sexual relationships with patients face the threats of deregistration and prosecution. In the early 1990s, it was estimated that 2-9% of doctors had violated this rule.[32] Sexual relationships between physicians and patients' relatives may also be prohibited in some jurisdictions, although this prohibition is highly controversial.[33]
[edit]Futility

Further information: Futile medical care
The concept of medical futility has been an important topic in discussions of medical ethics. What should be done if there is no chance that a patient will survive but the family members insist on advanced care? Previously, some articles defined futility as the patient having less than a one percent chance of surviving. Some of these cases wind up in the courts.
Advanced directives include living wills and durable powers of attorney for health care. (See also Do Not Resuscitate and cardiopulmonary resuscitation) In many cases, the "expressed wishes" of the patient are documented in these directives, and this provides a framework to guide family members and health care professionals in the decision making process when the patient is incapacitated. Undocumented expressed wishes can also help guide decisions in the absence of advanced directives, as in the Quinlan case in Missouri.
"Substituted judgment" is the concept that a family member can give consent for treatment if the patient is unable (or unwilling) to give consent themselves. The key question for the decision making surrogate is not, "What would you like to do?", but instead, "What do you think the patient would want in this situation?".
Courts have supported family's arbitrary definitions of futility to include simple biological survival, as in the Baby K case (in which the courts ordered a child born with only a brain stem instead of a complete brain to be kept on a ventilator based on the religious belief that all life must be preserved).
In some hospitals, medical futility is referred to as "non-beneficial care."
Baby Doe Law establishes state protection for a disabled child's right to life, ensuring that this right is protected even over the wishes of parents or guardians in cases where they want to withhold treatment.
[edit]Further reading

The Journal of Law, Medicine & Ethics, ISSN: 1748-720X (electronic) 1073-1105 (paper), Blackwell Publishing
Linacre Quarterly
A History and Theory of Informed Consent by Ruth Faden
Core Content Of Learning by The Institute Of Medical Ethics
Medical Ethics - A Practical guide to patient care related ethics,conventions and laws,By Dr.Mansoor Elahi, Written from both Western and practical Asian cum Muslim viewpoint.Hard cover, 400 pages, MTRO Publishing,Pakistan,2011,ISBN 978-969-8186-02-9
[edit]See also

Bioethics
Clinical governance
The Citadel
Empathy
Euthanasia
Evidence-based medical ethics
Resources for clinical ethics consultation
Fee splitting
Hastings Center
Health care
Health ethics
Human experimentation in the United States
Human radiation experiments
Jewish medical ethics
Research ethics consultation
Joint Commission International, JCI
Military medical ethics
Nazi human experimentation
Medical torture
Philosophy of Healthcare
Nursing ethics
Hippocratic Oath
Project MKULTRA
Asher's Seven Sins of Medicine
Medical Code of Ethics
Medical law
Medical Law International
UN Principles of Medical Ethics
World Medical Association
[edit]Reproductive medicine
Abortion/Abortion debate
Circumcision/Bioethics of neonatal circumcision
Human cloning
Gene splicing
Human genetic engineering
Eugenics
[edit]Medical research
Animal research
CIOMS Guidelines
Declaration of Geneva
Declaration of Helsinki
Declaration of Tokyo
Ethical problems using children in clinical trials
First-in-man study
Good clinical practice
Health Insurance Portability and Accountability Act
Institutional Review Board
Nuremberg Code
Clinical Equipoise
Patients' Bill of Rights
Universal Declaration of Human Rights
[edit]Sources and references

^ Berlant, Jeffrey (1975). Profession and Monopoly: a study of medicine in the United States and Great Britain. University of California Press. ISBN 0-520-02734-5.
^ Percival, Thomas (1849). Medical ethics. John Henry Parker. pp. 49–57 esp section 8 pg.52.
^ Walter, Klein eds. The Story of Bioethics: From seminal works to contemporary explorations.
^ Lakhan SE, Hamlat E, McNamee T, Laird C (2009). "Time for a unified approach to medical ethics". Philosophy, Ethics, and Humanities in Medicine 4 (3): 13. DOI:10.1186/1747-5341-4-13. PMC 2745426. PMID 19737406.
^ Autonomy and paternalism in medicine. [Med J Aust. 1993 Dec 6-20] - PubMed Result
^ Ryan CJ. Ethical issues, part 2: ethics, psychiatry, and end-of-life issues. Psychiatr Times. 2010;27(6):26-27.
^ Medical.Webends.com Double effect Retrieved September 2010
^ Page 424 in:Tefferi, Ayalew (2001). Primary hematology. Totowa, NJ: Humana Press. ISBN 0-89603-664-2. [1]
^ TheFreeDictionary double effect Citing: McGraw-Hill Concise Dictionary of Modern Medicine. 2002
^ http://www.ncsl.org/IssuesResearch/Health/AbortionLaws/tabid/14401/Default.aspx#parent
^ National Conference of State Legislatures Abortion Laws Parental Involvement in Minors' Abortions
^ Appel, JM. Must My Doctor Tell My Partner? Rethinking Confidentiality In the HIV Era, Medicine and Health Rhode Island, Jun 2006
^ Tassano, Fabian. The Power of Life or Death: Medical Coercion and the Euthanasia Debate. Foreword by Thomas Szasz, MD. London: Duckworth, 1995. Oxford: Oxford Forum, 1999.
^ Kimmelman, J.; Weijer, C; Meslin, E (2009). "Helsinki discords: FDA, ethics, and international drug trials". The Lancet 373 (9657): 13–4. DOI:10.1016/S0140-6736(08)61936-4. PMID 19121708.
^ Eysenbach G, Till JE (2001). "Ethical issues in qualitative research on internet communities". BMJ 323 (7321): 1103–5. DOI:10.1136/bmj.323.7321.1103. PMC 59687. PMID 11701577.
^ a b Bruckman A (2002). "Studying the amateur artist: A perspective on disguising data collected in human subjects research on the Internet". Ethics and Information Technology 4 (3): 217–31. DOI:10.1023/A:1021316409277.
^ Turkle S (1994). "Constructions and Reconstructions of Self in Virtual Reality". Mind, Culture, and Activity 1 (3): 158–167.
^ Turkle S (1997). "Multiple subjectivity and virtual community at the end of the Freudian century". Sociological Inquiry 67 (1): 72–84. DOI:10.1111/j.1475-682X.1997.tb00430.x.
^ Masters, K. (2010). "Non-disclosure in Internet-based research: the risks explored through a case study". The Internet Journal of Medical Informatics 5 (2).
^ http://www.prnewsnow.com/Public_Release/Managed_Care_And_HMO/209319.html PRNewsNow.com; Priest, ER (2007). "Physicians Competing for TopTen Search Engine Placements Find Success Inexpensive". JAMA: the Journal of the American Medical Association 267 (13): 1810–2. DOI:10.1001/jama.267.13.1810. PMID 1545466.
^ Bekelman JE, Li Y, Gross CP (2003). "Scope and impact of financial conflicts of interest in biomedical research: a systematic review". JAMA 289 (4): 454–65. DOI:10.1001/jama.289.4.454. PMID 12533125.
^ Ross JS, Lackner JE, Lurie P, Gross CP, Wolfe S, Krumholz HM (2007). "Pharmaceutical company payments to physicians: early experiences with disclosure laws in Vermont and Minnesota". JAMA 297 (11): 1216–23. DOI:10.1001/jama.297.11.1216. PMID 17374816.
^ Swedlow A, Johnson G, Smithline N, Milstein A (1992). "Increased costs and rates of use in the California workers' compensation system as a result of self-referral by physicians". N Engl J Med 327 (21): 1502–6. DOI:10.1056/NEJM199211193272107. PMID 1406882.
^ Jordan, M. C. (1998). "Ethics manual. Fourth edition. American College of Physicians". Ann Intern Med 128 (7): 576–94. DOI:10.1001/archinte.128.4.576. PMID 9518406.
^ Güldal D, Semin S (2000). "The influences of drug companies' advertising programs on physicians". Int J Health Serv 30 (3): 585–95. DOI:10.2190/GYW9-XUMQ-M3K2-T31C. PMID 11109183.
^ Wazana A (2000). "Physicians and the pharmaceutical industry: is a gift ever just a gift?". JAMA 283 (3): 373–80. DOI:10.1001/jama.283.3.373. PMID 10647801.
^ Blake R, Early E (1995). "Patients' attitudes about gifts to physicians from pharmaceutical companies". J Am Board Fam Pract 8 (6): 457–64. PMID 8585404.
^ LA Times, "Drug money withdrawals: Medical schools review rules on pharmaceutical freebies", posted 2/12/07, accessed 3/6/07
^ JH Medicine Policy on Interaction with Industry effective date July 1, 2009, accessed July 20, 2011
^ La Puma J, Stocking C, La Voie D, Darling C (1991). "When physicians treat members of their own families. Practices in a community hospital". N Engl J Med 325 (18): 1290–4. DOI:10.1056/NEJM199110313251806. PMID 1922224.
^ La Puma J, Priest E (1992). "Is there a doctor in the house? An analysis of the practice of physicians' treating their own families". JAMA 267 (13): 1810–2. DOI:10.1001/jama.267.13.1810. PMID 1545466.
^ Gartrell N, Milliken N, Goodson W, Thiemann S, Lo B (1992). "Physician-patient sexual contact. Prevalence and problems". West J Med 157 (2): 139–43. PMC 1011231. PMID 1441462.
^ JM Appel. May Physicians Date Their Patients’ Relatives? Rethinking Sexual Misconduct & Disclosure After Long v. Ostroff, Medicine & Health, Rhode Island, May 2004
Beauchamp, Tom L., and Childress, James F. 2001. Principles of Biomedical Ethics. New York: Oxford University Press.
Bioethics introduction
Brody, Baruch A. 1988. Life and Death Decision Making. New York: Oxford University Press.
Curran, Charles E. "The Catholic Moral Tradition in Bioethics" in Walter and Klein (below).
Epstein, Steven (2009). Inclusion: The Politics of Difference in Medical Research. University of Chicago Press. ISBN 978-0-226-21310-1.
Fletcher, Joseph F. 1954. Morals and Medicine: The Moral Problems of: The Patient's Right to Know the Truth, Contraception, Artificial Insemination, Sterilization, Euthanasia. Boston: Beacon.
The Hastings Center's Bibliography of Ethics, Biomedicine, and Professional Responsibility.
Kelly, David. The Emergence of Roman Catholic Medical Ethics in North America. New York: The Edwin Mellen Press, 1979. See especially chapter 1, "Historical background to the discipline."
Sherwin, Susan. 1992. No Longer Patient: Feminist Ethics and Health Care. Philadelphia: Temple University Press.
Veatch, Robert M. 1988. A Theory of Medical Ethics. New York: Basic Books.
Walter, Jennifer and Eran P. Klein eds. The Story of Bioethics: From seminal works to contemporary explorations Georgetown University Press, 2003
Tauber, Alfred I (1999). Confessions of a Medicine Man. Cambridge: MIT Press
Tauber, Alfred I (2005). Patient Autonomy and the Ethics of Responsibility. Cambridge: MIT Press
[edit]External links

The Hastings Center, an independent, nonpartisan, and nonprofit bioethics research institute founded in 1969
Ethical Decision-Making at the End of Life - video and summary of event held at the Woodrow Wilson International Center for Scholars, March 2008
German Reference Centre for Ethics in the Life Sciences (DRZE)
BEKIS- the Bioethics Communication and Information System
Thesaurus Ethics in the Life Sciences
BMJJournals.com - An international peer review journal for health professionals and researchers in medical ethics
Johns Hopkins Berman Institute of Bioethics
International Association of Bioethics
WHO Global bioethics calendar
The Dark History of Medical Experimentation from the Nazis to Tuskegee to Puerto Rico - video report by Democracy Now!
American National Reference Center for Bioethics Literature
Bioethics for Latin America and Colombia
EURETHICS (European database on ethics in medicine) and ENDEBIT (European database on ethics in non-medical technologies)
German Reference Centre for Ethics in the Life Sciences (DRZE)
BELIT: an extensive world-wide bibliographic directory of literature in the area of bioethics, containing references to monographs, grey literature, legal documents, journal articles, newspaper articles and book contributions
BioEthicWorld: A bioethics information site
Medical Ethics - OpenCourseWare from the University of Notre Dame featuring audio lectures and other resources.
BEKIS The Bioethics Communication and Information System
Nutritional Genomics (NuGO) Bioethics Online Tool
http://www.bioethics.upenn.edu/
Bioethics at the Open Directory Project
Universal Declaration on the Human Genome and Human Rights
International Declaration on Human Genetic Data
Universal Declaration on Bioethics and Human Rights
The Bio-Medical Ethics Reference Server at Stanford University
UNESCO Bioethics Section
Moral Matters in Medicine
Medical Ethics from the Encyclopedia of Jewish Medical Ethics by Prof. Avraham Steinberg]
The Clinic for Boundaries Studies, a UK service providing education on ethics and professional boundary violations
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Categories: Medical ethics
قس آلمانی
Die Medizinische Ethik beschäftigt sich mit den sittlichen Normsetzungen, die für das Gesundheitswesen gelten sollen. Sie hat sich aus der ärztlichen Ethik entwickelt, betrifft aber alle im Gesundheitswesen tätigen Personen, Institutionen und Organisationen und nicht zuletzt die Patienten.
Als grundlegende Werte gelten das Wohlergehen des Menschen, das Verbot zu schaden („Primum non nocere“) und das Recht auf Selbstbestimmung der Patienten (Prinzip der Autonomie), allgemeiner das Prinzip der Menschenwürde.
Inhaltsverzeichnis [Anzeigen]
Inhalte [Bearbeiten]

In fast allen Kulturkreisen finden sich feierliche Selbstverpflichtungen der Ärzte bezüglich ihrer ärztlichen Kunst, des Verhältnisses zu Patienten und zum eigenen Berufsstand. Bei uns dürfte der Eid des Hippokrates (ca. 4. Jahrhundert v. Chr.) am bekanntesten sein. Er wurde im Genfer Ärztegelöbnis (1948, 1968, 1983) zeitgemäß neu formuliert. Beim Nürnberger Ärzteprozess (1947) wurde ein Nürnberger Kodex aufgestellt, der die Grundlage zur Durchführung von notwendigen und ethisch haltbaren medizinischen Versuchen mit Menschen darstellt.
Euthanasie-Programme und Menschenversuche im Nationalsozialismus, japanische Experimente mit Kriegsgefangenen, der Missbrauch der Psychiatrie in der Sowjetunion, gewisse Forschungsexperimente in den USA und andere leidvolle Erfahrungen zeigten aber, dass das ärztliche Ethos nicht ausreicht, um kriminellen Missbrauch ärztlichen Wissens und Ehrgeizes zu verhindern.
Zu einer enormen Differenzierung der medizinischen Ethik führten schließlich die Herausforderungen durch die neuen Entwicklungen in der Medizin. Auch der Umgang mit knappen Ressourcen im Gesundheitswesen ist unter ethischen Aspekten zu diskutieren (vergleiche Fragen der medizinischen Ökonomie, oder dramatisch zugespitzt: die Triage in der Katastrophenmedizin).
Für die humanmedizinische Forschung wurden in Deutschland in den 1980er Jahren Ethikkommissionen bei den medizinischen Fakultäten oder bei den Landesärztekammern angesiedelt. Bei der Prüfung von Forschungsvorhaben orientieren sie sich an gesetzlichen Vorschriften und an den jeweiligen Berufsordnungen für Ärzte. Sie haben den Status eines beratenden Gremiums und werden nur auf Antrag tätig.
Die deutsche Bundesärztekammer hat 1995 eine Zentrale Ethikkommission eingerichtet: sie hat Stellungnahmen unter anderem zur Forschung mit Minderjährigen, zur (Weiter-)Verwendung von menschlichen Körpermaterialien, zur Stammzellforschung, zum Schutz nicht-einwilligungsfähiger Personen, zum Schutz persönlicher Daten in der medizinischen Forschung und zu Prioritäten in der medizinischen Versorgung veröffentlicht.
Der Weltärztebund verabschiedete 1964 eine „Deklaration zu Ethischen Grundsätzen für die medizinische Forschung am Menschen“ (Deklaration von Helsinki), die später mehrfach aktualisiert wurde und in vielen Ländern angewandt wird.
Vier-Prinzipien-Modell von Beauchamp und Childress [Bearbeiten]

Beauchamp und Childress beschrieben in ihrem Buch "Principles of Biomedical Ethics"[1] 1977 vier ethisch-moralische Prinzipien, welche im Bereich des heilberuflichen Handelns ethische Orientierung bieten und inzwischen als klassische Prinzipien der Medizinethik gelten. Diese Prinzipien stehen zunächst gleichberechtigt nebeneinander, d.h. im Einzelfall müssen die Prinzipien jeweils konkretisiert und gegeneinander abgewogen werden. Moralische Kontroversen können als Konflikte zwischen den verschiedenen gewichteten Prinzipien dargestellt werden[2].
Respekt vor der Autonomie der Patientin / des Patienten (respect for autonomy) [Bearbeiten]
Das Autonomieprinzip gesteht jeder Person Entscheidungsfreiheit und das Recht auf Förderung der Entscheidungsfähigkeit zu. Es beinhaltet die Forderung des informierten Einverständnisses (informed consent) vor jeder diagnostischen und therapeutischen Maßnahme und die Berücksichtigung der Wünsche, Ziele und Wertvorstellungen des Patienten.
Nicht-Schaden (nonmaleficence) [Bearbeiten]
Das Prinzip der Schadensvermeidung fordert, schädliche Eingriffe zu unterlassen. Dies scheint zunächst selbstverständlich, kommt aber bei eingreifenden Therapien (z.B. Chemotherapie) häufig in Konflikt mit dem Prinzip der Fürsorge.
Fürsorge, Hilfeleistung (beneficence) [Bearbeiten]
Das Prinzip der Fürsorge verpflichtet den Behandler zu aktivem Handeln, das das Wohl des Patienten fördert und ihm nützt. Das Fürsorgeprinzip steht häufig im Konflikt mit dem Prinzip der Schadensvermeidung (s.o.). Hier sollte eine sorgfältige Abwägung von Nutzen und Schaden einer Maßnahme unter Einbeziehung der Wünsche, Ziele und Wertvorstellungen des Patienten vorgenommen werden.
Gleichheit und Gerechtigkeit (justice) [Bearbeiten]
Das Prinzip der Gerechtigkeit fordert eine faire Verteilung von Gesundheitsleistungen. Gleiche Fälle sollten gleich behandelt werden, bei Ungleichbehandlung sollten moralisch relevante Kriterien konkretisiert werden.
Siehe auch [Bearbeiten]

Schwangerschaftsabbruch
Arzt-Patient-Beziehung
Bioethik
Eugenik
Gentherapie
Intensivmedizin
Ethikrat
Organtransplantation
Reproduktionsmedizin
Stammzelltransplantation
Sterbebegleitung
Wunscherfüllende Medizin
Deutsches Referenzzentrum für Ethik in den Biowissenschaften
Einzelnachweise [Bearbeiten]

↑ Beauchamp & Childress: Principles of Biomedical Ethics. 2009.
↑ G. Marckmann, 2000, S. 499-502.
Literatur [Bearbeiten]

Tom L. Beauchamp, James F. Childress: Principles of Biomedical Ethics. 6. Aufl., Oxford University Press, 2008, ISBN 0-19-533570-8.
Alexander Dietz: Gerechte Gesundheitsreform? Ressourcenvergabe in der Medizin aus ethischer Perspektive, Campus-Verlag Frankfurt am Main 2011, ISBN 978-3-593-39511-1
Georg Marckmann: Was ist eigentlich prinzipienorientierte Medizinethik? Ärzteblatt Baden-Württemberg 2000; 56(12), S. 499-502.
Jürgen Barmeyer: Praktische Medizinethik: die moderne Medizin im Spannungsfeld zwischen naturwissenschaftlichem Denken und humanitärem Auftrag - ein Leitfaden für Studenten und Ärzte. 2., stark überarb. Aufl., LIT-Verl., Münster [u.a.] 2003, 175 S., ISBN 3-8258-4984-8
Axel W. Bauer: Medizinische Ethik am Beginn des 21. Jahrhunderts. Theoretische Konzepte, Klinische Probleme, Ärztliches Handeln. J. A. Barth, Heidelberg, Leipzig 1998, ISBN 3-335-00538-4
Kurt Bayertz, Andreas Frewer: Ethische Kontroversen am Ende des menschlichen Lebens. Palm & Enke, Erlangen [u.a.] 2002, ISBN 3-7896-0584-0.
Jan P. Beckmann: Ethische Herausforderungen der modernen Medizin. Verlag Karl Alber, Freiburg/München 2010, ISBN 978-3-495-48394-7.
Marion Großklaus-Seidel: Ethik im Pflegealltag: Wie Pflegende ihr Handeln reflektieren und begründen können. Kohlhammer, 2002, ISBN 3-17-016075-3.
Bernhard Irrgang: Grundriß der medizinischen Ethik. UTB Verlag, München 1995, ISBN 3-8252-1821-X.
A. R. Jonsen, M. Siegler, W. J. Winslade: Klinische Ethik 2006. Deutscher Ärzte-Verlag, Köln 2007, ISBN 978-3-7691-0524-7 (Eine praktische Hilfe zur ethischen Entscheidungsfindung in der Medizin).
Hartmut Kreß: Medizinische Ethik. Verlag Kohlhammer, Stuttgart, ISBN 3-17-017176-3.
Ulrich H. J. Körtner: Grundkurs Pflegeethik. UTB 2514, Wien 2004, ISBN 3-8252-2514-3.
G. Marckmann, J. Meran: Ethische Aspekte der onkologischen Forschung 2006. Deutscher Ärzte-Verlag, Köln 2007, ISBN 978-3-7691-0527-8.
Thomas Schramme: Bioethik. Einführungen. Campus Verlag, Frankfurt, ISBN 3-593-37138-3.
Dieter Sperl: Ethik der Pflege: Verantwortetes Denken und Handeln in der Pflegepraxis. Kohlhammer 2002, ISBN 3-17-017314-6.
Ludwig Siep: Konkrete Ethik. Grundlagen der Natur- und Kulturethik. Suhrkamp, Frankfurt am Main 2004.
Claudia Wiesemann, Nikola Biller-Andorno: Medizinethik. Thieme, Stuttgart 2004, ISBN 3-13-138241-4.
Urban Wiesing (Hrsg.): Ethik in der Medizin. Ein Studienbuch. Reclam, Dietzingen, 2. Auflage 2004, ISBN 3-15-018341-3.
Joachim Bauer: Warum ich fühle, was du fühlst. Intuitive Kommunikation und das Geheimnis der Spiegelneurone. 4. Aufl., Hoffmann und Campe, Hamburg, 2005.
G. Pott: Ethik am Lebensende. Intuitive Ethik, Sorge um einen guten Tod, Patientenautonomie, Sterbehilfen. Schattauer, Stuttgart 2007.
Bettina Schöne-Seifert: Medizinethik. In: J. Nida-Rümelin (Hrsg.): Angewandte Ethik. Alfred Kröner Verlag, Stuttgart 1996.
Weblinks [Bearbeiten]

Deutsches Referenzzentrum für Ethik in den Biowissenschaften (DRZE), Bonn
Bioethik-Literaturdatenbank BELIT des Deutschen Referenzzentrums für Ethik in den Biowissenschaften (DRZE), Bonn
Akademie für Ethik in der Medizin (AEM)
Informations- und Dokumentationsstelle Ethik in der Medizin
Zentrum für Medizinische Ethik der Ruhr-Universität Bochum (mit weiteren Links)
Ethik und Geschichte der Medizin, Universitätsmedizin Göttingen (mit weiteren Links)
Institut für Ethik und Recht in der Medizin, Universität Wien
Zentrale Ethikkommission bei der Bundesärztekammer
Historische Überlegungen zur Medizinischen Ethik im naturheilkundlichen Kontext des Dritten Reichs
www.medizinethik-online.de
www.GTEmed.de
Medizinethik: Im Schraubstock der Ökonomie (DÄ 29. Oktober 2004)
Deutsche Übersetzung der Deklaration von Helsinki (pdf, 158 kB)
Text des Genfer Ärztegelöbnisses (pdf, 6 kB)
Medical Ethics Manual des Weltärztebundes
Unterrichtsmaterialien zur Medizinethik (ZUM-Wiki)
Kategorie: Medizinethik
قس اردو
اخلاقیاتِ طب (medical ethics) ، اخلاقیات اور طب کا ایک اھم شعبہ ہے جو طب اور مذہب و معاشرتی زندگی میں ہم آہنگی پیدا کرتا ہے۔ نفاذی اخلاقیات سے متعلق یہ علم ان آدابی اقدار (moral values) سے بحث کرتا ہے کہ جو طب و حکمت کے شعبہ جات پر مذہب و معاشرے کی جانب سے نافذ ہوتی ہوں۔ اخلاقیات طب میں سب سے اہم کردار خود اس پیشے سے تعلق رکھنے والے افراد (طبیب و ممرضات (nurses) وغیرہ) کا ہوتا ہے؛ ان افراد کے آپس میں روابط (طبیب - ممرضہ و ممرضہ - طبیب) کی اخلاقیات ، پھر طبیب و مریض اخلاقیات اور ان افراد کے اپنے پیشہ ورانہ اجازہ حاصل کرنے سے قبل اٹھائے اپنے حلف (عہد پیشہ وری) کی پاسداری کا مطالعہ شامل ہے۔ دنیا کے قریباً تمام معاشروں میں ہی طب کو ایک اعلٰی اور قابل عزت پیشے کے طور پر دیکھا جاتا ہے اور اسی وجہ سے اس شعبے سے تعلق رکھنے والے افراد کی اخلاقیات بھی بلند ہونے کی توقع رکھی جاتی ہے۔ طب کا شعبہ محض ظاہری حالتِ مریض تک محدود نہیں ہوتا بلکہ یہ انسان کے جسم اور معالجے و تحقیق کے دوران اس کی روح تک جاتا ہے اور یوں زندگی بنانے والے خالق کی شہادت اور نشانیوں اور اس کے علم سے منسلک ہوجاتا ہے؛ قرآن کی سورت الذاریات کی آیت 21 میں آتا ہے کہ؛
وَفِی أَنفُسِکُمْ أَفَلَا تُبْصِرُونٍَ
اور تمہارے اپنے وجود میں بھی۔ کیا پھر تم کو سوجھتا نہیں؟[1]
ایک مسلم طبیب یا اسلامی ممالک کے شفاخانوں اور مطوب میں کام کرنے والے افراد کے لیۓ اسلامی عہدِ زریں کے زمانے سے طبی اخلاقیات پر توجہ دی جاتی رہی ہے اور مذکورہ بالا آیت کی روشنی میں طب کے شعبے میں خالق کی نشانیوں کو اشرف المخلوقات میں آشکار کرنے کی وجہ سے طب ، پیشے اور روزگار کے ساتھ ساتھ عبادت کی حیثیت بھی حاصل کرلیتا ہے اور یوں عمومی اخلاقیات طب ، اسلامی شفاخانوں میں خصوصی اسلامی اخلاقیات طب کے ماتحت آجاتی ہے؛ عملاً ایسا (تمام مواقع پر) ہوتا ہے یا نہیں اس بارے میں اعداد و شمار دستیاب نہیں۔ اخلاقیات طب سے متعلق (منسلک) ایک اور وسیع شعبۂ علم اخلاقیات حیات (bioethics) ہوتا ہے جس میں تمام وہ پہلو شامل ہو جاتے ہیں کہ جو حیات سے متعلق ہوں اور ان پر اخلاقیات لازم آتی ہو؛ اس کے برعکس عموماً اخلاقیات طب اپنی حدود اطلاقی طب (یعنی طبیب و مریض) تک محدود رکھتا ہے؛ بعض اوقات یہ دونوں اصطلاحات ایک دوسرے کے متبادل بھی مستعمل نظر آتی ہیں۔
فہرست [غائب کریں]
1 عمومی اخلاقیات طب
2 اسلامی اخلاقیات طب
3 مُطلِع رضامندی
4 اخفائے راز
5 حوالہ جات
[ترمیم]عمومی اخلاقیات طب

[ترمیم]اسلامی اخلاقیات طب

[ترمیم]مُطلِع رضامندی

[ترمیم]اخفائے راز

[ترمیم]حوالہ جات

^ اس مضمون میں آیات کے تراجم اس قرآن روئے خط سے لیۓ گئے ہیں
زمرہ: اخلاقیات طب
قس ترکی
Tıp etiği, tıbbın ve sağlık alanındaki bilimsel ve pratik çalışmaların etik yönden değerlendirilmesi ve ahlaki ikilemlere bir çözüm bulunmasını hedefleyen disiplindir. Genel konusu insan yaşamıdır.
Konu başlıkları [göster]
Tanım [değiştir]

En genel anlamda tıbbi uygulamlar ve tutumların iyi ya da kötü, doğru ya da yanlış olarak değerlendirilmesi ve bu değerlendirmelerin belirli ilkelere oturtulması girişimi tıp etiğinin alanını oluşturmaktadır. Felsefenin etik alanındaki tarihsel bilgi ve yaklaşımlar bu alanda görülmekte, ortaya atılmış olan soru ve yaklaşımlar tıbbi pratik alanındaki sorunlarla birlikte yeniden temellendirilmeye ya da değerlendirilmeye çalşılmaktadır. Erdem etiğinden mutluluk ahlakına; John Stuart Mill'in pragmatizminden, Kant'ın normatif etiğine kadar birçok etik yaklaşım bu tartışmalar içinde yer almakta ve tartışmaları belirlemektedir. Etiğin ne olup ne olmadığı, evrensel bir etiğin olup olamayacağı, etik ilkelerin genel geçerliliğinin çerçevesinin ne olduğu da birçok etik meselede olduğu gibi somut bir gereklilik olarak bu tartışmalarda yer alır. Biyoetik'ten farklı olarak tıp etiği, insan yaşamı ve sağlığı noktasından etik bir soruşturma yürütmekte, neyin doğru, savunulabilir ve geçerli olduğuna dair çıkarsamaları belirli ilkeler doğrultusunda ortaya koymaya çalışmaktadır. Etiğin tıbbi alanda uygulanması ciddi sorunları beraberinde getirmekte ve bunlar farklı yaklaşımlar arasındaki tartışmalarla sürdürülmektedir. Hangi ilkelerin kesin vazgeçilmez ve koşullar ne olursa olsun geçerli olduğu ya da belirli koşullarda olmadığı, eğer böyleyse ahlaki davranışın hangi koşulda nasıl bir geçerlilikle belirleneceği önemli ve genel tartışma başlıklarıdır.
İlke ve tartışmalar [değiştir]

Üzerinde tartışılan dört temel ilke olduğu belirtilebilir. Bunlar;
Yarar sağlama ilkesi
Zarar vermeme ilkesi
Özerkliğe saygı ilkesi
Adalet ilkesi
Bu ilkelerin kabulünde belirli bir mutabakat var gibi görünse de, genel olarak ilkelerin hepsinin aynı kesinlik ve geçerlilikte mi ele alınacağı, çelişkili durumlarda hangi ilkenin ne şekilde öncelikli ya da ayrıcalıklı olacağı, dahası olup olamayacağı açık olarak belirtilebilmiş görünmemektedir. Yasal ve ahlaki yükümlülükler belirli değerlerle birlikte gelmekte ve ilgili kişilerin bunları bildiği ve uyması gerektiği veri olarak kabul edilmektedir. Deontoloji bu ilke ve kuralların bilgisidir. Böyle olmakla birlikte her gün ve her zaman kurallara uymayan durumlar, koşullar meydana gelebilmekte ya da kurallara bağlanmamış sorunlar belirebilmektedir. Tıp etiği, giderek artan bir önemle hem belirlenen ya da bir şekilde zaten belirlenmiş olan kuralların değerlendirilmesini, hem meydana gelen yeni durumlar içinden meselelerin tartışılmasını yürütmeye çalışır. Ayrıca tıp etiğinin sorguladığı meselelerden biri de, belirlenecek ilke ve davranış modelleri ya da çıkarımların ülkeden ülkeye, kültürden kültüre, değerden değere değişecek nitelikte mi, yoksa uluslararası geçerlilik taşır nitelikte mi olacağı sorunudur.
Kaynak [değiştir]

Tıp etiksiz olamaz
Etik ve tıp ilişkisi
Ayrıca bakınız [değiştir]

Vikikaynak'taki Hipokrat Yemini maddesi
Kürtaj
Ötenazi
Genetik
Klonlama
[gizle] g • t • dFelsefe konuları
Genel
Doğu felsefesi • Batı felsefesi • Felsefe tarihi: Antik • Orta Çağ • Aydınlanma • Rönesans felsefesi • 17. yüzyıl felsefesi • 18. yüzyıl felsefesi • 19. yüzyıl felsefesi • 20. yüzyıl felsefesi
Dallar
Estetik • Etik • Epistemoloji • Mantık • Metafizik • Felsefe tarihi • Eğitim felsefesi • Coğrafya felsefesi • Tarih felsefesi • Felsefi antropoloji • Dil felsefesi • Hukuk felsefesi • Matematik felsefesi • Zihin felsefesi • Meta-Felsefe • Fizik felsefesi • Siyaset felsefesi • Din felsefesi • Bilim felsefesi • Postmodern felsefe • Teknoloji felsefesi • Savaş felsefesi
Ekoller
Analitik felsefe • Kıta felsefesi • Batı felsefesi • Eleştirel teori • Yapısöküm • Determinizm • Diyalektik Materyalizm • Deneycilik • Rasyonalizm • Varoluşçuluk • Hegelcilik • Hermeneutik • Hümanizm • İdealizm • Mantıksal pozitivizm • Materyalizm • Yeniplatonculuk • Nihilizm • Fenomenoloji • Platonizm • Pozitivizm • Postmodernizm • Postyapısalcı felsefe • Pragmatizm • Görecilik • Skolastisizm • Septisizm • Stoisizm • Yapısalcılık • Feminist eleştiri • Sezgicilik
Kategori: Tıbbi etik