A Casebook of Medical Ethics

Terrence F. Ackerman, Ph.D., is Professor and Chairman, Department of Human Values and Ethics, College of Medicine, University of Tennessee, Memphis. He is co-editor of Clinical Medical Ethics: Exploration and Assessment (University Press of America, 1987). Carson Strong, Ph.D., is Associate Professor in the Department of Human Values and Ethics, College of Medicine, University of Tennessee, Memphis.

1. Paternalism in the Therapeutic Relationship ; 1.1 Ambivalence Toward Electroconvulsive Therapy ; 1.2 Treatment Refusal in the Medical Intensive Care Unit ; 1.3 An Uncooperative Leukemia Patient ; 1.4 Rehabilitation of a Dependent Patient ; 1.5 Alternative Approaches to Informed Consent ; 1.6 Previous Refusal of Treatment by a Presently Comatose Patient ; 1.7 A Family's Refusal of Blood Transfusions for a Mother and Her Son ; 1.8 Deciding Whether to Discharge a Suicidal Patient ; 1.9 A Request for Sex-Reassigning Surgery ; 1.10 Divulging Information Concerning an Infant's Condition ; 2. Duties to Patient and Family ; 2.1 A Daughter's Insistence on Aggressive Treatment ; 2.2 Parental Refusal of Cancer Treatment on Religious Grounds ; 2.3 Informed Consent and the Dying Adolescent ; 2.4 Treatment Refusal for an Infant with Possible Brain Damage ; 2.5 Venereal Disease and Adolescent Confidentiality ; 2.6 Contraceptives for an Adolescent ; 2.7 Request for Abortion for a Retarded Daughter ; 2.8 Request for Hysterectomy for a Retarded Eleven-Year-Old ; 2.9 Conflict About Maintaining a Brain-Dead Woman for the Sake of Her Fetus ; 2.10 Choosing the Method of Delivery for a Fetus with Hydrocephalus ; 3. Deciding for Others ; 3.1 A Bedridden and Cognitively Impaired Elderly Patient ; 3.2 Who Should Decide for a Patient in Persistent Vegetative State? ; 3.3 Nasogastric Tube Feedings for an Elderly Stroke Patient ; 3.4 A Prolonged Stay in the Neonatal ICU ; 3.5 Deciding Treatment When the Preliminary Diagnosis is Trisomy 18 ; 3.6 Risk/Benefit Assessment of Surgery for a Child Suffering from Strokes ; 3.7 Responding to a Family's Decision for Laetrile ; 3.8 Selecting Therapy for a Mentally Retarded Teenager ; 3.9 Birth Control for a Retarded Woman ; 3.10 A Family's Lack of Commitment ; 4. Medical Research Involving Human Subjects ; 4.1 Limited Consent in Alcoholism Research ; 4.2 Disclosure of Preliminary Results in a Randomized Clinical Trial ; 4.3 Constraints on Consent in a Phase I Clinical Trial ; 4.4 Proxy Consent for Incompetent Trauma Patients ; 4.5 Undue Inducement in the Recruitment of Research Subjects ; 4.6 Nontherapeutic Research Procedures Involving Children ; 4.7 Discomfort from Repeated Nontherapeutic Research Procedures Involving Competent Adults ; 4.8 Physicians' Treatment Preferences and Recruitment of Subjects for a Randomized Clinical Trial ; 4.9 Parental Preferences and a Child's Involvement in a Randomized Clinical Trial ; 4.10 Compensating Research Injuries ; 5. Physicians, Third Parties, and Society ; 5.1 Request for Surgery the Physician Considers Unnecessary ; 5.2 Providing Free Care ; 5.3 Risk of Litigation as a Factor in Decision Making ; 5.4 Pressures to Provide Customary Care ; 5.5 Confidentiality and Child Abuse ; 5.6 Rejection of a Consultant's Advice ; 5.7 Abortion Resulting in a Live Birth ; 5.8 Costly Nutrition for a Terminal Patient ; 5.9 Cost Factors in the Choice of Treatment for Kidney Stone Disease ; 5.10 Artificial Insemination for a Single Woman ; Topical Index to Cases