Websites:

UCF Home: http://www.med.ucf.edu/
Florida Bioethics Network: http://fbn.med.miami.edu/

Quick Facts

• All “individually identifiable health information” from patients is legally protected under confidentiality rules. (U.S. Health and Human Services)
• Informed consent protocol requires physicians to initiate a learning and communication process with his or her patient. (AMA)
• Certain minority communities may have high rates of dissatisfaction in health care treatment due to cultural differences between patients and providers. (JGIM)
• One out of five primary care doctors who have worked in religious health care institutions has experienced ethical conflict over faith-oriented medical protocols. (Amednews)
• Physician attitudes towards pharmaceutical and medical device company promotional gifts tends to vary across medical practice specialty. (Businessweek)
• Basic medical research standards recommend that researchers protect not only human health, but also animal and environmental health to some extent. (NIH)

Confidentiality

• AMA: Patient Confidentiality: This website provides a general overview of ethical and legal requirements regarding patient-physician confidentiality.  The article also discusses exceptions to confidentiality and general suggestions for how to maintain confidentiality.
• Center for Health Ethics: Confidentiality: This resource from the University of Missouri School of Medicine discusses issues of confidentiality in modern medical settings.  Information includes a discussion of electronic records and confidentiality involving minors.
• Confidentiality: Ethical Topic in Medicine: This website, through the University of Washington School of Medicine, provides an overview of patient confidentiality duties for physicians.  The site also provides examples of exception cases.
• Electronic Records, Patient Confidentiality, and the Impact of HIPAA: This article discusses medical confidentiality challenges as records are converted to electronic files.  The article also gives a historical overview of efforts to protect patient confidentiality.
• Summary of the HIPAA Privacy Rule: Here the U.S. Department of Health and Human Services provides an expandable list of information about the Health Insurance Portability and Accountability Act of 1996.  Among other regulations, the act created confidentiality protocols that healthcare providers must follow.

Informed Consent

• AMA: Informed Consent: This webpage outlines what informed consent means in the medical context.  The information also discusses how medical providers can protect themselves from legal repercussions related to informed consent issues.
• American Cancer Society: Informed Consent: This page provides examples for what informed consent means from a patient’s point of view.  Health care providers can benefit by looking through these specific steps that ensure informed consent is achieved.
• Exceptions to Informed Consent in Emergency Medicine: This article provides a legal analysis of the cases that constitute an exception to informed consent protocols.  The report cites several patient situations and court precedents.
• Informed Consent: Ethical Topic in Medicine: This webpage from the University of Washington School of Medicine discusses the basics of informed consent.  Content includes a comprehensive description of what informed consent encompasses and exceptions to the rule.
• Informed Consent, Parental Permission, and Assent in Pediatric Practice: This paper from the American Academy of Pediatrics, describes the issue of informed consent as applicable to minors.  The report is a helpful resource for any healthcare professional working with children.

Cultural Considerations

• Cultural Competence Health Practitioner Assessment: This online assessment tool helps health care providers discover their own strengths and weaknesses in providing culturally competent care.  The tool is provided by Georgetown University’s Center for Child and Human Development, and was originally developed at the wishes of the U.S. Department of Health and Human Services.
• Ensuring Culturally Effective Pediatric Care: Implications for Education and Health Policy: This article discusses the importance of culturally competent pediatric care in an age of increasing diversity.  Culture in the article relates not only to ethnicity, but also to sexual orientation, socioeconomic status, religion, and gender.
• Language Barriers to Health Care in the United States: This article from The New England Journal of Medicine discusses the issue of language translation in medical care.  The article cites several specific cases and also general statistics and policy information about the subject.
• Linguistic and Cultural Barriers to Care: Perspectives of Chinese and Vietnamese Immigrants: This article from the Journal of General Internal Medicine discusses the unique issues of providing culturally competent care for Asian and Pacific Islander communities.  The study particularly focused on Chinese and Vietnamese immigrants.
• Listening to Patients: Cultural and Linguistic Barriers to Health Care Access: This research study seeks to examine the factors which encourage and discourage low-income ethnic minorities from accessing health care.  Too many non-physician intermediaries was seen as a barrier to care, among other elements.
• National Standards on Culturally and Linguistically Appropriate Services: This resource from the U.S. Department of Health and Human Services is a set of standards that health care practitioners should follow to provide culturally and linguistically sensitive care.  The standards are applicable across a range of health care service types.

Religious Considerations

• Doctors At Religious Hospitals Face Ethical Conflicts Over Care: This article reviews some of the ethical difficulties physicians may encounter when working in religious hospitals.  The article cites a study which asked physicians what course of action they recommended when faced with this conflict.
• How Do Physicians Respond When Religion and Medicine Conflict?: This resource is oriented toward patients, but provides a clear explanation of the main kinds of religious conflicts that health care providers face.  The article is a response to a study conducted for the Archives of Internal Medicine.
• Physicians’ Observations and Interpretations of the Influence of Religion and Spirituality on Health: Though religion and spirituality are often cited as factors that clash with medical recommendations, this study examined physician perceptions of their positive effects on medical outcomes.  Most physicians believed that religion and spirituality had a significant effect on health outcomes.
• Religion and Mental Health: What Should Psychiatrists Do?: This study examines the long-standing connections between religion and psychiatry.  Some psychiatrists see religion as a potential contributor to mental illnesses while others find religion to be a healing factor.
• Rule Backs Doctors Opposed to Abortion: This article highlights abortion as a situation in which physicians may opt out of treating a patient for ethical reasons.  It illustrates that a doctor’s religious and moral views can affect care as much as a patient’s views.
• When Medicine and Religion Conflict Around Children: The Case of Daniel Hauser: This article discusses several of the most prominent medical-religious controversies through specific case explanations.  The cases illustrate the difficulty in resolving treatment disputes among individuals of different beliefs about medicine.

Conflicts of Interest

• Controlling Conflict of Interest: Proposals from the Institute of Medicine: This article discusses the definition of a conflict of interest in medicine and outlines common conflicts of interest that occur.  The article then goes on to offer suggestions for handling these conflicts of interest.
• Ethical Guidelines for Managing Conflicts of Interest in Health Services Research: This report discusses conflicts of interest in medical-related research.  The comprehensive guide offers both explanations of the issue and suggestions for change.
• Many Docs Don’t Mind Taking Gifts From Industry: Study: This article from Businessweek shows that physicians tend not to consider themselves influenced by medical industry gifts.  The article also discusses the gray area between an appropriate industry gift and an inappropriate gift.
• Prescribing Under the Influence: This resource from Santa Clara University evaluates pharmaceutical gifting and medical practices.  The article includes anecdotes and analysis.
• Tighter Controls Recommended to Prevent Conflicts of Interest Between Doctors and Pharmaceutical Companies: This article discusses recent recommendations from the Attorney General regarding perks from pharmaceutical companies.  The discussion includes information about regulations on company perks throughout various states.

Medical Research Ethics

• Distinguishing Dilemmas in the Ethics of Placebo-Controlled Trials: This article discusses the question of whether or not placebo-controlled trials can be considered ethical.  The analysis includes consideration of the researcher’s ability to remain impartial to which patients are assigned to each trial type.
• Ethical Issues in Clinical Research: This short article contains a general overview of conducting medically ethical research.  It contains links to fundamental documents in this ethical field.
• The Ethics of Clinical Research: This resource examines the purpose of clinical research in comparison with ethical obligations as a researcher.  Though the approach is theoretical, every health researcher should consider the points of this article.
• The Ethics of Human Embryonic Stem Cell Research: This article is an overview of the moral issues surrounding human stem cell research.  This is a good initial resource for individuals who would eventually like to explore the topic more deeply.
• The Ethics of Medical Research on Children: This article brings a human face to the discussion of ethics in medical research.  The case history presents a unique dilemma in considering the limits of research on human subjects.
• Regulations and Ethical Guidelines: This website maintained by the National Institutes of Health contains the text from the World Medical Association Declaration of Helsinki.  The declaration sets the ethical standards for research across the world.

Other Topics

• BBC Ethics Guide: Euthanasia: This website is entirely devoted to the subject of physician-assisted suicide.  Resources include an explanation of euthanasia and reasons behind it, as well as legislation related to the practice.
• Do Not Resuscitate Orders: Ethical Topic in Medicine: This website is a great resource for health care practitioners to understand the controversies surrounding Do-Not-Resuscitate orders.  The article offers practical advice on how to handle situations where a Do-Not-Resuscitate order is involved.
• Ethical Issues in Genetic Testing for BRCA2 and BRCA2: This webpage is a source of information about how to handle the controversies surrounding genetic testing for cancer risk.  The site contains an interactive module where practitioners can evaluate a hypothetical case.
• The Ethics of Genetic Testing: This resources covers the ethical issue of genetic testing in general.  The discussion includes both patient decisions and consideration of insurance implications.
• ‘Octo-mom’ Straddles the Line in Reproduction Debate: In this website, a reporter reviews the main points of controversy over in vitro fertilization.  The procedure presents an ethical dilemma on several levels.
• Project to Get Transplant Organs From ER Patients Raises Ethics Questions: This article discusses the pros and cons of policies which aim to increase organ transplantation rates.  The reporter examines the central question of when a physician should stop trying to resuscitate a patient and begin instead to consider organ transplantation.
• Psychiatrists’ Attitudes Toward Involuntary Hospitalization: This article discusses the controversial subject of involuntary psychiatric hospital commitment.  The study illustrates that physicians and the general public tend to have differing views on which populations should be involuntarily committed, but agreed that individuals who pose a risk to themselves or others should be committed for treatment.
• Public Health Ethics: This article discusses medical ethics as applicable to public health.  Topics include disease reporting and preventative health measures.
• Termination of Life-Sustaining Treatment: Ethical Topic in Medicine: Separate from the issues of euthanasia, this article discusses the appropriate conditions for terminating treatment.  Several hypothetical conditions are considered.
• Truth-telling and Withholding Information: Ethical Topic in Medicine: This resource discusses the question of whether it can ever be ethical to withhold information from a patient about his or her illness.  Though disclosure may be difficult at times, in almost all cases physicians have the obligation to disclose.

Book Resources

• Classic Works in Medical Ethics: Core Philosophical Readings by Gregory Pence: This collection of readings provides a background in the important issues of medial ethics.  It serves as a good resource for anyone interested in the history of medical ethics as well as current controversies.
• Doing Right: A Practical Guide to Ethics for Medical Trainees and Physicians by Philip C. Hébert: From this resource individuals entering the medical professions should learn how to create an ethical medical practice.  The book combines theory and practical advice.
• Law and Ethics for Medical Careers by Karen Judson and Carlene Harrison: This book is an overall resource for health care practitioners interested in the legal ramification of medical decisions.  The reader will learn about relevant legal cases and legislation as well as anecdotal scenarios.
• Medical Ethics: A Very Short Introduction by Tony Hope: This short book is a general introduction to some of the key controversies in health care.  This is a good initial resource for those interested in researching biomedical ethics.
• Medical Ethics: Accounts of the Cases that Shaped and Define Medical Ethics by Gregory Pence: This book is a good overview of several issues in medical ethics.  Discussion includes medical research ethics as well as patient treatment considerations.
• Principles of Biomedical Ethics by Tom L. Beauchamp and James F. Childress: This resource provides an encompassing perspective on moral issues in medicine.  The book moves from an examination of moral norms themselves to specific issues in the biomedical realm.
• Tough Decisions: Cases in Medical Ethics by John M. Freeman M.D. and Kevin McDonnell M.D.: This book is a great resource for health care providers who would like to consider medical ethics issues in a practical manner.  The approach is interactive and forces the reader to actually make decisions on a number of ethical scenarios.

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