Compassion, consensus, and conflict: should caregivers' needs influence the ethical dialectic?

There are three important principles to be derived from this case. First, it is essential not to confound the technical problem of assessing pain and suffering with the ethical issue of judgments about pain and suffering. Second, in most cases, the apparent limitations of traditional ethical theory in critical care decisions are precisely that: apparent limitations only. The alternatives, especially intuitionism, are far more troublesome. Finally, the claim of health-care workers to be professionals places legitimate constraints on the extent to which they may be permitted to have their needs and wants influence the ethical dialectic. The achievement and maintenance of "comfortable, compatible relationships" cannot be legitimately construed as a major objective of biomedical ethics--although one would hope it will become a cherished, if serendipitous, byproduct. In short, paraphrasing (and reversing) Archibald MacLeish on poetry: Ethics should not be/but mean.     

Curriculum reform in death education: The modern resurrection ofArs Moriendi

... The purpose of death education, therefore, must be to teach medical personnel how to assist their patients to achieve their private needs. Philosophically and religiously, the good death is purposeful and meaningful. It may or may not entail relief of suffering. Medically, the experience of death may be manipulated in a number of different directions. Whether sentience is worth preserving at the expense of pain, or vice versa, for example, is not the physician's decision: it is the patient's. One cannot guarantee that death will be easy for anyone: but because medical personnel must generally turn from the dying to attend to the living, thoughtful educational curricula can improve the lot of all three.     

Physicians and obligatory social activism

This essay examines the claim that physicians have a special obligation to engage in social and political activism. Four ethical paradigms are considered. Two paradigms, the preventive medicine and the social medicine models, embody a limited professional obligation to advocate the priority of health in society; the justification for a more aggressive stance is limited by the failings of paternalism. The radical model and the heroic model speak to issues of personal virtue rather than professional obligation; they are not strictly comparable.