Ethical Problems In Emergency Medicine

This book is designed to consolidate the relevant literature as well as the thoughts of professionals currently working in the field into a practical and accessible reference for the emergency medical technician, student, nurse, resident, and attending emergency physician. Each chapter is divided into four sections: case presentation, discussion, review of the current literature, and recommendations. Designed to serve simultaneously as a learning and reference tool, each chapter begins with a real case that was encountered in an ED setting. The case presentation is followed by a short discussion of the case, as if at a morbidity and mortality conference, by a panel of experienced attending physicians explaining how they would approach the ethical dilemmas associated with the case, and a review of the existing literature.

1. General Introduction -- 2. Unique Aspects of Ethics in Emergency Medicine -- 3. Legal Setting of Emergency Medicine -- 4. What is Ethics? -- 5. An Approach to Ethical Problems in Emergency Medicine -- 6. Autonomy and Informed Consent -- 7. Education and Research -- 8. Privacy and Confidentiality -- 9. Life-Sustaining Treatment - Emergency Department -- 10. Life-Sustaining Treatment - Prehospital -- 11. Professional Relations -- 12. Allocation of Health Care Resources -- 13. Quality of Care -- 14. Threatening Situations -- 15. Ethical Statements - Overview -- Appendix. Prehospital Advance Directives.

Part of the "What Do I Do Now?: Emergency Medicine" series, Legal and Ethical Issues in Emergency Medicine uses a case-based approach to cover common and important topics in the legal and ethical dilemmas that surface in the practice of emergency medicine. Each unique case draws upon the four well-established principles of bioethics: beneficence, non-maleficence, respect for autonomy, and justice. Other ethical principles, such as honesty and personal integrity, are also addressed. Chapters are rounded out by key points to remember and selected references for further reading. Legal and Ethical Issues in Emergency Medicine addresses a wide range of topics including HIPPA and confidentiality, advance directives, suicidal patients, refusal of care, expert witness testimony, and more. This book is an engaging collection of thought-provoking cases which clinicians can utilize when they encounter difficult situations in the emergency department. The volume is also a self-assessment tool that tests the reader's ability to answer the question, "What do I do now?"

This book addresses the ethical problems that physicians have to face every day while caring for critically ill patients. Advances in medical technology, ageing societies worldwide, and their increased demands on health care systems have, on the one hand, led to better care and remarkable longevity in many parts of the world. On the other hand, however, improved treatments in many medical fields, amongst others in emergency and critical care, have resulted in more patients surviving with reduced quality of life. This entails tradeoffs for many patients, their families, and the teams caring for them. At the same time, health care expenditures have risen dramatically and have to be balanced against costs for other public goods. Finally, the humane aspects of care have often failed to keep pace with the remarkable technological strides made in recent years. In this book, experts in their respective fields describe compelling ethical challenges resulting from these discrepancies and discuss potential solutions. The book is primarily intended for clinicians who care for two of the most vulnerable patient subpopulations – those being treated in ambulances or emergency rooms, and those being treated at intensive care units – due in part to the fact that they may be temporarily or permanently incapacitated. Core medical skills, such as diagnosis and predicting outcomes, as well as implementing treatment, remain challenging. However, without adequate communication and collaboration both within the inter-professional treatment teams and between the teams and the patients/their families, delivering excellent care is difficult at best. Therefore, the so-called “soft skills” are given the attention they deserve in order to overcome the gap between technological progress and interpersonal standstill.

Emergency Ethics brings together leading scholars in the fields of public health ethics and bioethics to discuss disaster or emergency ethics and ethical aspects of preparedness and response with specific application to public health policy and practice. The book fills a gap in the existing public health ethics literature by providing a comprehensive ethical conception of emergency preparedness as a distinctive form of civic practice brought about by the interrelationships and coordination of many groups, disciplines, and interests and drawing on numerous bodies of knowledge and expertise. It addresses particular aspects of preparedness and response plans, particular decisions that planners and communities have to make, decisions that require balancing many diverse and sometimes conflicting values and identifying and applying a framework of basic ethical principles for preparedness planning, emergency response, and post-disaster recovery. It also explores the relationship between emergency preparedness to other facets of public health practice. The book begins with a broad and synthetic overview of emergency ethics that addresses the central components and ethically significant issues arising in public health preparedness planning, disaster response, and recovery. Following that overview are five chapters that in a philosophically innovative and detailed way delve deeply into important and problematic issues in emergency planning and response, including the allocation of scarce resources, conducting ethical research in the context of public health emergencies, the obligations of public health professionals, communication and engagement with the public, and special moral obligations surrounding vulnerable populations.

The emergency department is a place of challenging ethical dilemmas and little time and resources to solve them. Ethical Dilemmas in Emergency Medicine provides invaluable information, perspectives, and solutions to common ethical dilemmas in emergency medicine. It addresses important topics seen in the emergency department, including medicolegal issues, triage, privacy and confidentiality, social media, difficult patients, minors, research, patient safety, disasters, suicide, and end of life issues. The accompanying educational modules provide a unique educational opportunity for resident and staff education on ethical issues in emergency medicine. Featuring twenty-three case-based discussions of ethical dilemmas in emergency medicine along with numerous multimedia resources, including media presentations, case based discussions, and multiple choice questions, this book is an invaluable resource for residents in training as well as practicing physicians.

Now in its Fifth Edition, this respected reference helps readers tackle the common and often challenging ethical issues that affect patient care. The book begins with a concise discussion of clinical ethics that provides the background information essential to understanding key ethical issues. Readers then explore a wide range of real-world ethical dilemmas, each accompanied by expert guidance on salient issues and how to approach them. The book’s two-color design improves retention of material for visual learners. An accompanying website lets readers access the full text, along with features designed to reinforce understanding and test knowledge. New to the Fifth Edition: This edition includes new discussions of ethical issues as they relate to clinical practice guidelines and evidence-based medicine, electronic medical records, genetic testing, and opioid prescription. The book also includes an increased focus on ethical issues in ambulatory care. Readers will also find more detailed analysis of cases, more examples of ethical reasoning, more highlight pages relating clinical ethics to emergency medicine, oncology, palliative care, and family medicine. Also new are discussions of quality improvement and use of advance care planning rather than advance directives.