Emergency medicine clinics of North America
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At its root, medical professionalism is service delivered according to patient's interest. It is essential to reinforce this notion because financial pressures threaten the integrity of the patient-physician relationship. Excessive commercialism directly contrasts the ideals of medical professionalism. ⋯ If historical standards of professionalism give way to market-driven incentives, the provision of medical care will become a commodity and the practitioners will be only agents of service delivery. Such a model not only threatens the the physician's identity, but also threatens the patient's interests. Medicine can never succeed as a transaction; it can only succeed as a partnership, a trusting exchange with patients, which is the hallmark of professionalism.
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There is a wide variety of ethical issues and dilemmas involving resuscitation, the act of restoring life to a patient in cardiorespiratory arrest. Decisions must be made rapidly and often must be based on suboptimal levels of information available at the time. Certain issues should be considered when one is making decisions in the resuscitation arena, including positive-aspects of resuscitation, not only the possibility of restoring life to the patient but also providing a sense of closure and resolution of guilt for the survivors. During and following resuscitative efforts, the psychologic and emotional well-being of the survivors should also be given close attention.
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Emerg. Med. Clin. North Am. · May 1999
Review Case ReportsEmergency department treatment of minors.
This article discusses the practical application of ethical issues in the ED treatment of minors, beginning with a brief discussion of basic principles (including differences between adults and minors), and issues of consent and confidentiality. The remainder of the article focuses on case studies that explore the topics of drug and alcohol screening, sexually transmitted diseases, pregnancy, and sexual assault.
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The elderly consume medical services in an amount disproportionate to their number. Disability and dementia are commonly underdiagnosed and misunderstood in any emergency department setting. Educating emergency physicians regarding the evaluation of dementia, disability, and abuse is crucial to appropriate management and optimal outcome of these clinical problems.
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Ethical issues in emergency medicine often are accompanied by legal issues. Although the legal aspects of an ethical problem are important factors to take into consideration, the law may not directly address the problem, and following the law does not always ensure an ethical outcome. Emergency physicians should have an understanding of ethics and law, understand the legal aspects of bioethical issues in emergency medicine, and finally have a guide to analyze ethical issues, including the consideration of legal issues that may have an impact on the case.