Doing Right

Philip C. Hébert is emeritus professor of family medicine in the Department of Family and Community Medicine at the University of Toronto and former chair of the Research Ethics Board at Sunnybrook Health Sciences Centre. Wayne Rosen is a clinical assistant professor in the Department of Surgery at the University of Calgary.

Cases
Preface
Acknowledgments
1. Ethics Matters
I. Great Expectations: Healthcare Professionals and Ethics
II. Four Ethical Principles and Questions
II. The Principles and Ethical Reasoning in Medicine
IV. Beyond Principles
V. The Hidden Curriculum
VI. Overcoming Obstacles to Ethics
2. Broadening the Horizon: What Law and Ethics Say
I. What the Law Says
II. What Ethics Says: Virtue, Rules, and Consequences in Medicine
III. Expanding the Horizons of Ethics
IV. Professional Ethics
3. Managing Medical Morality
I. Managing Ethical Dilemmas
II. Really Hard Choices Are Not Always About Ethics
III. "Doing Right": A Process For Managing Ethical Choice
IV. The Ethics Process in a Little More Detail
V. Applying the Ethics Process
4. The Times Are Changing: Autonomy and Patient-Based Care
I. The Autonomy Principle
II. Autonomy as the Patient's Preference
III. The Case of Ms. Malette and Dr. Shulman
IV. Choices: The Good, the Bad, and the Ugly
5. Reasonable Persons: The Legal Roots of Informed Consent
I. Medical Consent
II. Informed Consent: A Brief Legal History
III. Informed Consent: The Canadian Context
IV. The Significance of Reibl v. Hughes: The Modified Objective Standard
6. Informed Choice and Truthtelling: The Centrality of Truth and Trust
I. Disclosure and Truthtelling
II. The Elements of Informed Choice
III. Consent as Trust
IV. Other Special Circumstances
V. Special Circumstances and Limits on Truthtelling
7. Keeping Secrets: Confidentiality and Privacy in the Electronic Age
I. Confidentiality and Privacy
II. Privacy, Confidentiality, and Trust
III. New Risks to Privacy
IV. Limits to Confidentiality
V. To Warn and to Protect
8. The Waning and Waxing Self: Capacity and Incapacity in Medical Care
I. Incapacity and its Discontents
II. Assessing Capacity
III. Capacity and Consent
IV. Treating and Protecting the Vulnerable
V. Substitute and Assisted Decision-Making
VI. Mental Illness and the Right to Refuse
VII. Children's Right to Refuse
9. Helping and Not Harming: Beneficence and Non-Maleficence
I. The Principles of Beneficence and Nonmaleficence
II. A Duty to Attend?
III. Risks to the Professional
IV. Endangering One's Self
V. Parental Refusals of Treatment
VI. Parental Requests for Treatment
10. Conduct Becoming: Medical Professionalism
I. Maintaining the Connection
II. A New Professionalism
III. Conflicts of Interest
IV. Professionals and Industry
V. Boundaries Large and Small
VI. Fitness to Practise Medicine
11. The End of Forgetting: Ethical and Professional Issues with Social Media
I. Friends, Boundaries, and Privacy in the Age of Social Media
II. The Personal and the Private
III. Patients Using Social Media
IV. Photographs and Patient Privacy
V. Internet Etiquette and Telling Others' Stories
12. The Error of Our Ways: Managing Medical Error
I. Medical Error
II. Error and Being Responsive to Patients
III. How to Disclose Error
IV. Apologies
V. Large-Scale Adverse Events
13. Beyond the Patient: Doing Justice to Justice
I. Justice in Everyday Medicine
II. A System of Mmutual Recognition
III. Distributive Justice
IV. Squeezing the Balloon
V. Guidelines and Rationing
VI. Justice for All?
14. Labour Pains: Ethics and New Life
I. Birthing and Reproductive Choice
II. Termination and Choice
III. The New Age of Reproduction
IV. Desperately Seeking Stem Cells
15. A Dark Wood: End-of-Life Decisions
I. Allowing Death: Refusals by Patients
II. Competent Cecisions, Living Wills, and Advance Directives
III. Decisions to Withhold or Withdraw Life-Sustaining Treatment
IV. Persistent Vegetative States and Prognostic Error
V. Unilateral Decisions Regarding Life-Sustaining Treatment
VI. Palliative Sedation
16. Medical Assistance in Dying: The Triumph of Autonomy
I. Assisted Death: Terminology and Other Jurisdictions
II. Medically-Assisted Death in Canada: A Brief History
III. Legislating Medical Assistance in Dying: Bill C-14
IV. MAID: Minors, Advance Requests, and Mental Illness
V. MAID and Issues of Conscience
17. Nature and Culture: Of Genes and Memes
I. All in the Genome?
II. Cultural Connections
III. Worlds Apart?
IV. Culture and Defying Death
V. Transcending Culture
18. The Ethical Regulation of Research
I. Medicine's Legacy
II. The Purpose of Research
III. Consent for Research
IV. The Tissue Issue
V. Some Questions and Answers Regarding Research
Conclusion: Setting our Sights
References
Index