Emergency medicine clinics of North America
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The interrelationships between biomedical ethics and the law are perhaps nowhere as starkly apparent as in the realm of medical malpractice. Although ethical and legal conduct and practices are often in harmony, in many areas ethical principles and the issues surrounding medical liability appear to come into conflict. Disclosure of errors; quality improvement activities; the practice of defensive medicine; dealing with patients who wish to leave against medical advice; provision of futile care at the insistence of patients or families; and the various protections of Good Samaritan laws are just a few of these. In addition, the ethical principles governing the conduct of physicians serving as expert witnesses in medical malpractice cases have become a subject of intense interest in recent years.
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Emerg. Med. Clin. North Am. · Aug 2006
ReviewPrivacy and confidentiality in emergency medicine: obligations and challenges.
Respect for privacy and confidentiality have been professional responsibilities of physicians throughout recorded history. This article reviews the moral, religious, and legal foundations of privacy and confidentiality and discusses the distinction between these two closely related concepts. ⋯ In the emergency department, privacy and confidentiality often are challenged by physical design, crowding, visitors, film crews, communication, and other factors. These problems are reviewed, and advice and guidelines are offered for helping preserve patients' dignity and rights to privacy and confidentiality.
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When ethical issues arise in emergency medical practice, many emergency physicians turn to the law for answers. Although knowing when and how the law applies to emergency medicine is important, the law is only one factor to consider among many factors. ⋯ Situations where ethics and the law may seem to be in conflict in emergency medicine are described and analyzed in this article, and recommendations are offered. In general, when facing ethical dilemmas in emergency medical practice, the emergency physician should take into account the ethical considerations before turning to the legal considerations.
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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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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.