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Neurology Student Education Director
Maike Blaya, M.D.
131 S. Robertson St.
Suite 1340, Room 1369
Office: 504-988-3888
Fax: 504-988-9197
Email: mblaya1@tulane.edu

Program Coordinator
Zenobia Colón
131 S. Robertson St.
Suite 1340, Room 1345
Office: 504-988-3888
Fax: 504-988-9197
Email: zcolon@tulane.edu

 

Neurology Clerkship
Neurology > Programs > Ethical Issues

Ethical Issues in Neurology

Download printable version (requires Adobe Acrobat Reader)

Jeffrey S. Nicholl, M.D.
   
1. "The rules or principles which govern right conduct."

      The analysis of moral decision making.

2. Ethical models:
         1. Agent--virtue theories the nature of the agent and his motivation determine the morality of an act.
         2. Acts deontology some acts are inherently wrong.
         3. Ends teleology the intent justifies the means.
         4. Consequences utilitarianism the actual effects determine the morality of the act.
  
3. Principles in medical ethics:
         1. Respect for the individual (autonomy)
         2. Beneficence (nonmaleficence)
         3. Justice (distribution)
         4. Confidentiality
         5. Utility (greatest good)
         6. Fidelity (to the individual patient’s best interest.)
         7. Truthfulness
         8. Universality (The Golden Rule)

      Medical ethics involves the balancing of conflicting principles in a particular case.

4. Codes of medical ethics:
         1. Hippocratic
         2. AMA (varies from country to country)
         3. Religious (varies among religions)
         4. Nuremburg/Helsinki

5. Death and dying:
         1. Definition of death
               a. Whole body (death of the organism)
               b. Brain death (Uniform Brain Death Act)
               c. Irreversible coma (PVS)
               d. Loss of higher cortical function (death of the person)
         2. Benefit v. Burden
         3. Withholding v. withdrawing treatment
         4. Ordinary v extraordinary treatment
         5. Killing v. allowing to die
         6. Physician-assisted suicide v. euthanasia
         7. Futile care
         8. Competence
         9. Double effect
        10. Substituted judgment v. explicit wishes of the patient (advance directives)

6. Persistent Vegetative State -- Quinlan, Cruzon, Barber

 7. Dementia

 8. Amyotrophic Lateral Sclerosis

 9. Neonates

10. Medical economics

11. The "slippery slope"

 

 

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