attempt to contribute to a better understanding of the impact of defensive medicine on ethical practice and to the identification of effective strategies for accomplishing the valid goals of legal regulation of health care delivery without impairing the ability to respect fundamental ethical values.
I have suggested in some earlier writings that the law, as the current best expression of society's values and authority regarding specific issues, may not be ignored, but neither should it automatically dictate disregard of other important sources of those values. It is the constellation of values from a broad range of perspectives, law included but by no means alone, that ought to guide those who have undertaken the awesome clinical and ethical obligations of patient well-being. It is the goal of this book to make physicians feel safer to recognize and respect that rich constellation of values, and thereby to practice medicine more ethically. It is my hope that "[f] or a change, law may be the handmaiden of ethics and ethics served by the law rather than vice versa" ( Abrams & Veenhuis, 1986, p. 9).
Abrams R. A., & Veenhuis P. ( 1986). Ethical questions raised by a proposed randomized, double-blind study involving placebo, standard drug therapy, and experimental antipsychotic drug therapy for patients with schizophrenia. Clinical Research, 34, 6-9.
Annas G. J. ( 1996). "Facilitating choice: Judging the physician's role in abortion and suicide". Quinnipiac Health Law Journal, 1, 93-112.
Callahan D. ( 1996, November-December). "Escaping from legalism: Is it possible?" Hastings Center Report, 26, 34-35.
De K Ville. ( 1994a). "What does the law say?" Law, ethics and medical decision making. Western Journal of Medicine, 160, 478-480.
De K Ville. ( 1994b). Response to letter. Western Journal of Medicine, 161, 192-193.
Frengley J. D. ( 1996). The use of physical restraints and the absence of kindness. Journal of the American Geriatrics Society, 44, 1125-1127.
Logan R. L., & Scott P. J. ( 1996). "Uncertainty in clinical practice: Implications for quality and costs of health care". Lancet, 347, 595-598.
Mohr J. C. ( 1993). Doctors and the law: Medical jurisprudence in nineteenth-century America. New York: Oxford University Press.
"President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (1982)". Making health care decisions, vol. 1. Washington, DC: U.S. Government Printing Office.
Schuck P. H. ( 1994). "Rethinking informed consent". Yale Law Journal, 103, 899-959.
Solzhenitsyn A. ( 1978). "The exhausted West". Harvard Magazine, 82( 6), 22.
Wachsman H. F. ( 1993). Lethal medicine: The epidemic of medical malpractice in America. New York: Henry Holt and Company.