Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · Aug 2006
ReviewEthical and practical aspects of disclosing adverse events in the emergency department.
Physicians and hospitals should be aware of the ethical duty to disclose a medical error that causes harm to a patient. Disclosure should be made to the affected patient or, when appropriate, to a family member of the patient. ⋯ The initial disclosure can be conducted in a way that maintains or even improves the relationship with the patient, or in a manner that damages trust. This article discusses the importance of disclosure in emergency medicine; the ethical basis for, and barriers to, disclosure; and the key elements of the disclosure process.
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Early American physician education lacked quality and consistency. Poorly funded institutions with weak curricula and little patient contact before graduation trained our earliest doctors. ⋯ The importance of physician education increased, leading to the production of specialty boards and requirements for continuing medical education and culminating in a continuous certification process now required of all specialties including the American Board of Emergency Medicine. While the utility of continuing medical education has been questioned, technological advances, the Internet, and improved education techniques are helping physicians practice modern medicine in a time of rapidly expanding science.
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Emerg. Med. Clin. North Am. · Aug 2006
ReviewThe interface: ethical decision making, medical toxicology, and emergency medicine.
The overwhelming social and economic costs of alcohol, tobacco, and other substances of abuse are discussed, as are some of the important public health interventions appropriate for emergency physicians. This article addresses the complexity of ethical decision making when toxicologic emergencies occur in emergency medicine. ⋯ The balance between confidentiality and support for an individual patient and responsibility of the physician to society is discussed. The relative importance of HIPAA is compared with an individual physician's code of ethics.
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Emerg. Med. Clin. North Am. · Aug 2006
ReviewExpert witness testimony: the ethics of being a medical expert witness.
Giving testimony as an expert witness in court carries numerous ethical obligations, which are rarely delineated by the individuals who seek such testimony or even known to those who provide it. Because most expert medical witness testimony about the performance of physicians requires that a witness be medically licensed, and because verdicts based on expert testimony directly influence the standard of care that will be applied in the future, providing medical testimony legitimately can be considered to come within the realm of the practice of medicine. Testifying as an expert in legal matters should be undertaken with the same degree of integrity as the practice of medicine and is rightfully subject to the same degree of scrutiny and regulation.
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Neither law nor religion, bioethics absorbs and applies elements of both. Its theories, principles, and methods stem from various philosophical schools. ⋯ Emergency clinicians must be able to recognize bioethical dilemmas, have action plans based on their readings and discussions, and have a method through which to apply ethical principles in clinical settings. This article provides an overview of ethical considerations and guidelines for emergency clinicians.