Note: Content has been added to this section since the original Galen post.
Discussion Topic: What are the ethical implications of vivisection? How do these implications compare to the implications of dissection?
– animal vs human vivisection, are the implications different?
– animal rights
– life value
– one vs many
– do the ends justify the means?
“Galen viewed the body as consisting of three connected systems: the brain and nerves, which are responsible for sensation and thought; the heart and arteries, responsible for life-giving energy; and the liver and veins, responsible for nutrition and growth.”9
Discussion Topic: the risks of ego.
The chief merit of language is clearness. -Galen1
Discussion Topic: As a doctor, why would clear and precise language be so important to Galen? Hippocrates felt that documentation was a key piece to good medical practice. How do these two men’s ideas of communication compare?
- Bioethics*: “
- Bioethicists*: “are concerned with the ethical questions that arise in the relationships among life sciences, biotechnology, medicine, politics, law, and philosophy. It also includes the study of the more commonplace questions of values (“the ethics of the ordinary”) which arise in primary care and other branches of medicine.”19
Bioethics is a coming together of religion, philosophy and science. While Galen was not part of the history of the field of bioethics, many of the topics that have been discussed have fallen under the realm of bioethics. Medical history is full of these kinds of problems and ethical questions. Thus, introducing some of the concepts of bioethics now will make talking about these topics easier by giving us a frame work.
The Principles of Beneficence and Non-maleficence
- What is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal?
- What are the goals of treatment?
- In what circumstances are medical treatments not indicated?
- What are the probabilities of success of various treatment options?
- In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided?
The Principle of Respect for Autonomy
- Has the patient been informed of benefits and risks of diagnostic and treatment recommendations, understood this information, and given consent?
- Is the patient mentally capable and legally competent, and is there evidence of incapacity?
- If mentally capable, what preferences about treatment is the patient stating?
- If incapacitated, has the patient expressed prior preferences?
- Who is the appropriate surrogate to make decisions for the incapacitated patient? What standards should govern the surrogate’s decisions?
- Is the patient unwilling or unable to cooperate with medical treatment? If so, why?
QUALITY OF LIFE
Beneficence, Nonmaleficence, and Respect for Autonomy
- What are the prospects, with or without treatment, for a return to normal life, and what physical, mental, and social deficits might the patient experience even if treatment succeeds?
- On what grounds can anyone judge that some quality of life would be undesirable for a patient who cannot make or express such a judgment?
- Are there biases that might prejudice the provider’s evaluation of the patient’s quality of life?
- What ethical issues arise concerning improving or enhancing a patient’s quality of life?
- Do quality-of-life assessments raise any questions regarding changes in treatment plans, such as forgoing life-sustaining treatment?
- Are there plans to provide pain relief and provide comfort after a decision has been made to forgo life sustaining interventions?
- Is medically assisted dying ethically or legally permissible?
- What is the legal and ethical status of suicide?
- Are there professional, interprofessional, or business interests that might create conflicts of interest in the clinical treatment of patients?
- Are there parties other than clinicians and patients, such as family members, who have a legitimate interest in clinical decisions?
- What are the limits imposed on patient confidentiality by the legitimate interests of third parties?
- Are there financial factors that create conflicts of interest in clinical decisions?
- Are there problems of allocation of scarce health resources that might affect clinical decisions?
- Are there religious factors that might affect clinical decisions?
- What are the legal issues that might affect clinical decisions?
- Are there considerations of clinical research and education that might affect clinical decisions?
- Are there issues of public health and safety that affect clinical decisions?
- Are there conflicts of interest within institutions or organizations (e.g. hospitals) that may affect clinical decisions and patient welfare?
Discussion Topic: Why is having a frame work for ethical discussions important? How do they help up in considering the larger picture?
*Words to know
References and sites for further reading:
- Jonsen AR, Sieger M, Winslade WJ. Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine, 8th ed. New York, NY: McGraw-Hills; 2015.