Our Hands Are Tied: Legal Tensions and Medical Ethics

By Marshall B. Kapp | Go to book overview

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).


REFERENCES

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.

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Our Hands Are Tied: Legal Tensions and Medical Ethics
Table of contents

Table of contents

  • Title Page iii
  • Contents vii
  • Preface ix
  • References xiv
  • Acknowledgments xv
  • 1 - Losing at the Lottery: Physician Perceptions of the Legal Environment 1
  • Notes 22
  • Notes 23
  • 2 - The Lawyer Made Me Do It: from Legal Perception to Medical Practice 27
  • Note 46
  • References 46
  • 3 - Risk Managers and Legal Counsel: Ethical Enablers or Paid Paranoids? 53
  • References 64
  • 4 - Doing Everything: Treating Legal Fears near the End of Life 65
  • Note 87
  • References 88
  • 5 - Who Is Responsible for This? Everyday Patient Intrusions to Protect the Provider 97
  • Note 118
  • References 118
  • 6 - A Dispirited Lot: Malpractice and What Else? 123
  • 7 - Reconciling Risk Management and Medical Ethics: Opportunities and Obstacles 141
  • References 164
  • Index 171
  • Bout the Author 177
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