Medical Ethics Manual

Article excerpt

Medical ethics manual Author: John R Williams Publisher: World Medical Association, Ferney-Voltaire, France; 2005 ISBN: 92-990028-1-9; softcover; 134 pages; English, French and Spanish full-text versions can be downloaded free from the World Medical Association's web site: of the English print version can be obtained by contacting the publisher)

In 1999 the Fifty-first Annual General Assembly of the World Medical Association (WMA) passed a resolution that medical ethics and human rights be included as obligatory courses in all medical school curricula. Subsequently, the WMA went through an extensive global consultation process, resulting in publication of its Medical ethics manual. The stated goal of this manual is "to fill the void of a basic, universally used curriculum for the teaching of medical ethics". This is an ambitious but worthy goal. In view of the complexity of today's multicultural and legal bounds to medical practice, burgeoning information overload, and rapid technological advances in medicine, the challenges to producing this manual were enormous. WMA has risen to these challenges well and published a book that has an attractive pocket-size format, is easy to read, and is appealing to a wide audience.

The first chapter outlines the principles of medical ethics. The next three chapters deal separately with the principal ethical issues of concern to a physician--those related to the patient, society at large, and colleagues --and in this way the book elegantly simplifies a very complex topic. The penultimate chapter, on the ethics of medical research, is followed by one on the responsibilities and privileges of a physician. These six chapters cover the entire range of issues relevant to medical ethics. Strengthening the teaching of medical ethics; Internet resources; WMA resources; a glossary, and several case studies are subsequently dealt with in five appendixes.

One can easily visualize a young doctor in a remote setting having to deal with a patient with a terminal illness but who refuses treatment. The doctor feels morally bound to insist on some treatment--any treatment--for this patient who has entrusted himself to his care. What is this young doctor to do? Does he accept the patient's request to stop treating him, or does he continue prescribing medicines knowing that they may be futile? He has no senior colleague or bioethicist with whom to discuss his dilemma. The Medical ethics manual, particularly the section on the right of self-determination, may provide him with some guidance. There will be many other such instances, in many countries, in many remote settings, where physicians will use this manual to understand better the issues of patient rights, their own responsibilities, and the role of families and others in the care of patients. It deals very comprehensively not only with traditional concepts such as confidentiality, communication, and consent but also with more topical issues: the care of HIV-positive patients; beginning-of-life issues such as assisted reproductive technologies, prenatal genetic screening and abortion; and end-of-life issues such as euthanasia and assisted suicide--topics that are relevant to practising physicians worldwide.

Moral and ethical actions are often underpinned by philosophical discourses that can be quite daunting; their presence in a practical book such as this could have been a diversion. The author has deftly skirted this difficult issue by highlighting issues through the use of case studies. These case studies--one per chapter--have been chosen with great care, in that they could apply to a wide variety of settings and are almost universal in their relevance. However, they merely illustrate what is right or wrong. The really interesting and challenging case studies appear in Appendix E. These are examples of what today's doctors commonly and increasingly have to face in their practice but which are moral dilemmas with no clear solutions. …


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