Medical ethics is primarily a field of applied ethics, the study of moral values and judgments as they apply to medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology. Applied ethics takes a theory of ethics, such as utilitarianism, social contract theory, or deontology, and applies its major principles to a particular set of circumstances and practices. ... Moral values are things held to be right or wrong or desirable or undesirable. ... medicines, see Medication. ...

Historically , Western medical ethics may be traced to guidelines on the duty of physicians in antiquity, such as the Hippocratic Oath) and early rabbinic and Christian teachings. In the medieval and early modern period, the field is indebted partly to a few Jewish and Islamic thinkers (e.g., Maimonides) and especially to Roman Catholic scholasticism ranging from Aquinas to the case-oriented analysis (casuistry) of Catholic moral theology. By the 18th and 19th centuries, medical ethics emerged as a more self-conscious discourse. For instance, authors such as Thomas Percival (1740-1804) wrote about "medical jurisprudence" and reportedly coined the phrase "medical ethics." In 1847, the AMA adopt its first code of ethics. While the secularized field borrowed largely from Catholic medical ethics, in the 20th century a distinctively liberal Protestant approach was articulated by thinkers such as Joseph Fletcher. In the 1960's and 1970's, building upon liberal theory and procedural justice, much of the discourse of medical ethics went through a dramatic shift and largely reconfigured itself into bioethics.^[1] Today, medical ethics tends to be understood narrowly as an applied professional ethics, whereas bioethics appears to have more expansive concerns, touching upon the philosophy of science and the critique of biotechnology. Still, the two fields often overlap and the distinction is more a matter of style than professional consensus. Duty is a term loosely appliedDuty to any action (or course of action) whichDutyDuty is regarded as morally incumbent, apart from personal likes and dislikes or any external compulsion. ... A twelfth-century Byzantine manuscript of the Oath in the form of a cross. ... A Rabbi (Classical Hebrew רִבִּי ribbī; modern Ashkenazi and Israeli רַבִּי rabbī) is a religious Jewish scholar who is an expert in Jewish law. ... Commonly used image indicating one artists conception of Maimonidess appearance Maimonides (March 30, 1135 or 1138–December 13, 1204) was a Jewish rabbi, physician, and philosopher in Spain, Morocco and Egypt during the Middle Ages. ... The Roman Catholic Church, most often spoken of simply as the Catholic Church, is the largest Christian church, with over one billion members. ... Scholasticism comes from the Latin word scholasticus, which means that [which] belongs to the school, and is the school of philosophy taught by the academics (or schoolmen) of medieval universities circa 1100–1500. ... Saint Thomas Aquinas (1225 - March 7, 1274) was a Catholic philosopher and theologian in the scholastic tradition, who gave birth to the Thomistic school of philosophy, which was long the primary philosophical approach of the Roman Catholic Church. ... Casuistry (argument by cases) is an attempt to determine the correct response to a moral problem, often a moral dilemma, by drawing conclusions based on parallels with agreed responses to pure cases, also called paradigms. ... Ethics is a branch of philosophy dealing with right and wrong in human behaviour. ... Thomas Percival (1740-1804) was an English physician best known for crafting perhaps the first modern code of medical ethics. ... AMA is used as an abbreviation for the following: Academy of Model Aeronautics Alberta Motor Association American Management Association American Marketing Association American Medical Association American Motorcyclist Association American Music Awards Associación Médica Argentina Australian Medical Association Against medical advice - a patient that leaves a medical facility early... In the context of a code adopted by a profession or by a governmental or quasi-governmental organ to regulate that profession, an ethical code may be styled as a code of professional responsibility, which may dispense with difficult issues of what behavior is ethical. Some codes of ethics are... Topics in Christianity Movements · Denominations Ecumenism · Preaching · Prayer Music · Liturgy · Calendar Symbols · Art · Criticism Important figures Apostle Paul · Church Fathers Constantine · Athanasius · Augustine Anselm · Aquinas · Palamas · Luther Calvin · Wesley Arius · Marcion of Sinope Pope · Archbishop of Canterbury Patriarch of Constantinople Christianity Portal This box:      In the United States, the mainline... Joseph Fletcher (1905-1991) was an American professor who founded the theory of situational ethics in the 1960s, and was a pioneer in the field of bioethics. ... Liberalism is an ideology, philosophical view, and political tradition which holds that liberty is the primary political value. ... Procedural justice concerns the fairness of the processes by which decisions are made--as contrasted with the distributive justice (fairness in the distribution of rights or resources) and corrective justice (fairness in the rectification of wrongs). ... {{}} Bioethics are the ethics of biological science and medicine. ... Philosophy of science is the study of assumptions, foundations, and implications of science, especially in the natural sciences and social sciences. ... The structure of insulin Biological technology is technology based on biology, especially when used in agriculture, food science, and medicine. ...

Medical ethics shares many principles with other branches of healthcare ethics, such as nursing ethics. Health care or healthcare is one of the worlds largest and fastest growing professions. ... // Nursing ethics is the discipline of evaluating the merits, risks, and social concerns of activities in the field of nursing. ...

Values in medical ethics

Six of the values that commonly apply to medical ethics discussions are:

• Beneficence - a practitioner should act in the best interest of the patient. (Salus aegroti suprema lex.)
• Non-maleficence - "first, do no harm" (primum non nocere).
• Autonomy - the patient has the right to refuse or choose their treatment. (Voluntas aegroti suprema lex.)
• Justice - concerns the distribution of scarce health resources, and the decision of who gets what treatment.
• Dignity - the patient (and the person treating the patient) have the right to dignity.
• Truthfulness and honesty - the concept of informed consent has increased in importance since the historical events of the Nuremberg trials and Tuskegee Syphilis Study

Values such as these do not give answers as to how to handle a particular situation, but provide a useful framework for understanding conflicts. Beneficence Beneficence serves as the motto and logo for Ball State University, located in Muncie, Indiana. ... Primum non nocere is a Latin phrase that means First, do no harm. ... J.L. Urban, statue of Lady Justice at court building in Olomouc, Czech Republic Justice concerns the proper ordering of things and persons within a society. ... This article is about virtue. ... A common dictionary definition of truth is agreement with fact or reality.[1] There is no single definition of truth about which the majority of philosophers agree. ... Look up honesty in Wiktionary, the free dictionary. ... Informed consent is a legal condition whereby a person can be said to have given consent based upon an appreciation and understanding of the facts and implications of an action. ... The Süddeutsche Zeitung announces The Verdict in Nuremberg. ... // The Pelkola Syphilis Study (1932–1972), also known as the Public Health Service Syphilis Study or the Tuskegee Experiment(s) was a clinical study, conducted around Tuskegee, Alabama, where 399 (plus 200 control group without syphilis) poor -- and mostly illiterate -- African American sharecroppers became part of a study on the...

When moral values are in conflict, the result may be an ethical dilemma or crisis. Writers about medical ethics have suggested many methods to help resolve conflicts involving medical ethics. Sometimes, no good solution to a dilemma in medical ethics exists, and occasionally, the values of the medical community (i.e., the hospital and its staff) conflict with the values of the individual patient, family, or larger non-medical community. Conflicts can also arise between health care providers, or among family members. For example, the principles of autonomy and beneficence clash when patients refuse life-saving blood transfusion, and truth-telling was not emphasized to a large extent before the HIV era. Look up Dilemma in Wiktionary, the free dictionary For the Nelly song, see Dilemma (song). ... Donating blood Blood transfusion is the process of transferring blood or blood-based products from one person into the circulatory system of another. ...

In the United Kingdom, General Medical Council provides clear modern guidance in the form of its 'Good Medical Practice' statement. The General Medical Council (the GMC) is the regulator of the medical profession in the United Kingdom. ...

Informed consent

Main article: Informed consent

Informed Consent in ethics usually refers to the idea that an uninformed agent is at risk of mistakenly making a choice not reflective of his or her values. It does not specifically mean the process of obtaining consent, nor the legal requirements for decision-making capacity. Patients can elect to make their own medical decisions, or can delegate decision-making authority to another party. In some cases, the patient may be incapacitated, in which case U.S. state law designates a process for obtaining informed consent. In some American states, family members have differing levels of precedence over one another in making medical decisions for the patient, while other states recognize all family members equally in making medical decisions. Informed consent is a legal condition whereby a person can be said to have given consent based upon an appreciation and understanding of the facts and implications of an action. ...

The value of informed consent is closely related to the values of autonomy and truth telling. American culture places a high value on these principles, finding justification in the U.S. Constitution and Declaration of Independence.

Confidentiality

Main article: Confidentiality

Confidentiality is commonly applied to conversations between doctors and patients. This concept is commonly known as patient-physician privilege. Legal protections prevent physicians from revealing their discussions with patients, even under oath in court. Confidentiality is mandated in America by HIPAA laws, specifically the Privacy Rule. Confidentiality is challenged in cases such as the diagnosis of a sexually transmitted disease in a patient who refuses to reveal the diagnosis to a spouse, or in the termination of a pregnancy in an underage patient, without the knowledge of the patient's parents. Many states in the U.S. have laws governing parental notification in underage abortion[2] Confidentiality has been defined by the International Organization for Standardization (ISO) as ensuring that information is accessible only to those authorized to have access and is one of the cornerstones of Information security. ... Motto: (Out Of Many, One) (traditional) In God We Trust (1956 to date) Anthem: The Star-Spangled Banner Capital Washington D.C. Largest city New York City None at federal level (English de facto) Government Federal constitutional republic  - President George Walker Bush (R)  - Vice President Dick Cheney (R) Independence from... The Health Insurance Portability and Accountability Act (HIPAA) was enacted by the U.S. Congress in 1996. ...

Beneficence

The concept of doing good to humanity in general.

Autonomy

The principle of Autonomy recognizes the rights of individuals to self determination. This is rooted in society’s respect for individuals’ ability to make informed decisions about personal matters. Autonomy has become more important as social values have shifted to define medical quality in terms of outcomes that are important to the patient rather than medical professionals. The increasing importance of Autonomy can be seen as a social reaction to a “paternalistic” tradition within healthcare. Respect for autonomy is the basis for informed consent and advance directives. Autonomy can often come into conflict with Beneficence when patients disagree with recommendations that health care professionals believe are in the patient’s best interest. Individuals’ capacity for informed decision making may come into question during resolution of conflicts between Autonomy and Beneficence. The role of surrogate medical decision makers is an extension of the principle of Autonomy.

Non-maleficence

The concept of non-maleficence is embodied by the phrase, "first, do no harm," or the latin, primum non nocere. Physicians are obligated under medical ethics to not prescribe medications they know to be harmful. American physicians interpret this value to exclude the practice of euthanasia, though not all concur. Probably the most extreme example in recent history of the violation of the non-maleficence dictum was Dr. Jack Kevorkian, who was convicted of second-degree homicide in Michigan in 1998 after demonstrating active euthanasia on the TV news show, 60 Minutes. Primum non nocere is a Latin phrase that means First, do no harm. ... Euthanasia (from Ancient Greek: ευθανασία, good death) is the practice of ending the life of a terminally ill person in a painless or minimally painful way, for the purpose of limiting suffering. ... Jack Kevorkian, M.D. (IPA pronunciation: [1]) (born May 20, some sources say May 26[2], 1928) is a controversial American pathologist. ...

Non-maleficence is a legally definable concept. Violation of non-maleficence is the subject of medical malpractice litigation. Medical malpractice is an act or omission by a health care provider which deviates from accepted standards of practice in the medical community and which causes injury to the patient. ...

Double effect

Some interventions undertaken by physicians can create a positive outcome while also potentially doing harm. The combination of these two circumstances is known as the "double effect." The most applicable example of this phenomenon is the use of morphine in the dying patient. Such use of morphine can ease the pain and suffering of the patient, while simultaneously hastening the demise of the patient through suppression of the respiratory drive. Morphine (INN) (IPA: ) is a highly potent opiate analgesic drug and is the principal active agent in opium and the prototypical opiate. ... Respiration can refer to: Cellular respiration, which is the use of oxygen in the metabolism of organic molecules. ...

Importance of communication

Many so-called "ethical conflicts" in medical ethics are traceable back to a lack of communication. Communication breakdowns between patients and their healthcare team, between family members, or between members of the medical community, can all lead to disagreements and strong feelings. These breakdowns should be remedied, and many apparently insurmountable "ethics" problems can be solved with open lines of communication.

Ethics committees

Many times, simple communication is not enough to resolve a conflict, and a hospital ethics committee of ad hoc nature must convene to decide a complex matter. Permanent bodies, ethical boards are established to a greater extent as ethical issues tend to increase. These bodies are comprised of health care professionals, philosophers, lay people, and still clergy. Ad hoc is a Latin phrase which means for this [purpose]. It generally signifies a solution that has been tailored to a specific purpose, such as a tailor-made suit, a handcrafted network protocol, and specific-purpose equation and things like that. ... A philosopher is a person who thinks deeply regarding people, society, the world, and/or the universe. ... Clergy is the generic term used to describe the formal religious leadership within a given religion. ...

The assignment of philosophers or clergy will reflect the importance attached by the society to the basic values involved. An example from Sweden with Torbjörn Tännsjö on a couple of such committees indicates secular trends gaining influence. Young people interacting within an ethnically diverse society. ... Torbjörn Tännsjö is a Swedish professor of philosophy who was born in 1946. ... This article concerns secularity, that is, being secular, in various senses. ...

Cultural concerns

Culture differences can create difficult medical ethics problems. Some cultures have spiritual or magical theories about the origins of disease, for example, and reconciling these beliefs with the tenets of Western medicine can be difficult.

Truth-telling

Some cultures do not place a great emphasis on informing the patient of the diagnosis, especially when cancer is the diagnosis. Even American culture did not emphasize truth-telling in a cancer case, up until the 1970s. In American medicine, the principle of informed consent takes precedence over other ethical values, and patients are usually at least asked whether they want to know the diagnosis. Informed consent is a legal condition whereby a person can be said to have given consent based upon an appreciation and understanding of the facts and implications of an action. ...

Conflicts of interest

Physicians should not allow a conflict of interest to influence medical judgment. In some cases, conflicts are hard to avoid, and doctors have a responsibility to avoid entering such situations. Unfortunately, research has shown that conflicts of interests are very common among both academic physicians^[2] and physicians in practice^[3]. The The Pew Charitable Trusts has announced the Prescription Project for "academic medical centers, professional medical societies and public and private payers to end conflicts of interest resulting from the $12 billion spent annually on pharmaceutical marketing".

Self-referral

For example, doctors who receive income from referring patients for medical tests have been shown to refer more patients for medical tests ^[4]. This practice is proscribed by the American College of Physicians Ethics Manual ^[5].

Vendor relationships

Studies show that doctors can be influenced by drug company inducements, including gifts and food. ^[6] Industry-sponsored Continuing Medical Education (CME) programs influence prescribing patterns. ^[7] Many patients surveyed in one study agreed that physician gifts from drug companies influence prescribing practices. ^[8] A growing movement among physicians is attempting to diminish the influence of pharmaceutical industry marketing upon medical practice, as evidenced by Stanford University's ban on drug company-sponsored lunches and gifts. Other academic institutions that have banned pharmaceutical industry-sponsored gifts and food include the University of Pennsylvania, and Yale University. ^[9]

Treatment of family members

Many doctors treat their family members. Doctors who do so must be vigilant not to create conflicts of interest or treat inappropriately.^[10][11].

Sexual relationships

Sexual relationships between doctors and patients can create ethical conflicts, since sexual consent may conflict with the fiduciary responsibility of the physician. Doctors who enter into sexual relationships with patients face the threats of deregistration and prosecution. It is estimated that between 2% and 9% of doctors have violated this rule based on a study in the early 1990s ^[12].

Futility

Advanced directives include living wills and durable powers of attorney for healthcare. (See also Do Not Resuscitate and cardiopulmonary resuscitation) In many cases, the "expressed wishes" of the patient are documented in these directives, and this provides a framework to guide family members and health care professionals in decisionmaking when the patient is incapacitated. Undocumented expressed wishes can also help guide decisionmaking, in the absence of advanced directives. "Substituted judgement" is the concept that a family member can give consent for treatment if the patient is unable (or unwilling) to give consent himself. The key question for the decisionmaking surrogate is not, "What would you like to do," but instead, "What do you think the patient would want in this situation." Courts have supported family's arbitrary definitions of futility to include simple biological survival, as in the Baby K case. A more in-depth discussion of futility is available at medical futility. A DNR/DNI, or Do Not Resuscitate/Do Not Intubate order, is a written order from a doctor that resuscitation should not be attempted if a person suffers cardiac or respiratory arrest. ... Wikibooks has more about this subject: First Aid/CPR Cardiopulmonary resuscitation (CPR) is an emergency first aid procedure for a victim of cardiac arrest. ... Baby K was born in an anencephalic state on October 13, 1992, at Fairfax Hospital in Virginia. ...

• Baby Doe Law Establishes state protection for a disabled child's right to life, ensuring that this right is protected even over the wishes of parents or guardians in cases where they want to withhold treatment.

There are very few or no other articles that link to this one. ...

See also

• Bioethics
• The Citadel
• Empathy
• Euthanasia
• Hastings Center
• Hippocratic Oath
• Medical Law International
• World Medical Association

{{}} Bioethics are the ethics of biological science and medicine. ... The Citadel is a novel by A. J. Cronin, first published in 1937 (in Britain by Gollancz, July, and in the US by Little, Brown, & Co. ... Not to be confused with Pity, Sympathy, or Compassion. ... Euthanasia (from Ancient Greek: ευθανασία, good death) is the practice of ending the life of a terminally ill person in a painless or minimally painful way, for the purpose of limiting suffering. ... The Hastings Center, founded in 1969, is an independent, nonpartisan, non-profit bioethics research institute dedicated to examination of essential questions in health care, biotechnology, and the environment. ... A twelfth-century Byzantine manuscript of the Oath in the form of a cross. ... Medical Law International is an academic legal periodical published by A B Academic Publishers. ... The World Medical Association (WMA), an international organization of physicians, was formally established on 17 September 1947, pursuant to deliberations and decisions taken in the First General Assembly of WMA held in Paris, France. ...

Reproductive medicine

• Abortion/Abortion debate
• Circumcision/Bioethics of neonatal circumcision
• Human cloning
• Gene splicing
• Human genetic engineering
• Eugenics

Issues of discussion The abortion debate can be found in every level of politics and ethics. ... Seixas Family circumcision set and trunk, ca. ... The bioethics of neonatal circumcision are controversial within practicing cultures. ... Although genes are recognized as influencing behavior and cognition, genetically identical does not mean altogether identical; identical twins, despite being natural human clones with identical DNA, are separate people, with separate experiences and not altogether overlapping personalities. ... Genetic engineering, genetic modification (GM), and gene splicing (once in widespread use but now deprecated) are terms for the process of manipulating genes in an organism, usually outside of the organisms normal reproductive process. ... This article does not cite any references or sources. ... Eugenics is the self-direction of human evolution: Logo from the Second International Congress of Eugenics, 1921, depicting it as a tree which unites a variety of different fields. ...

Medical research

• Animal research
• CIOMS Guidelines
• Common rules. Adopted by 17 United States departments and agencies (1991).
• Nuremberg Code
• Declaration of Geneva
• Declaration of Helsinki
• Declaration of Tokyo
• Good clinical practice
• Health Insurance Portability and Accountability Act
• Patients' Bill of Rights
• Universal Declaration of Human Rights
• Institutional Review Board
• First-in-man study

Enos the space chimp before insertion into the Mercury-Atlas 5 capsule in 1961. ... The CIOMS Guidelines, formally known as International Ethical Guidelines for Biomedical Research Involving Human Subjects, is a set of ethical principles regarding human experimentation. ... The examples and perspective in this article or section may not represent a worldwide view. ... This article is about the Declaration of Geneva pertaining to the medical profession. ... The Declaration of Helsinki, developed by the World Medical Association, is a set of ethical principles for the medical community regarding human experimentation. ... The Declaration of Tokyo was adopted in October 1975 on the 29th General assembly of the World Medical Association. ... Good clinical practice is a set of rules and regulations that is provided by International Conference on Harmonisation (ICH) - an international body that regulates clinical trials involving human subjects. ... The Health Insurance Portability and Accountability Act (HIPAA) was enacted by the U.S. Congress in 1996. ... President Bush meets with House leaders to discuss Patients Bill of Rights legislation The Patients Bill of Rights Consumer Bill of Rights and Responsibilities The following was adopted by the US Advisory Commission on Consumer Protection and Quality in the Health Care Industry in 1998. ... Eleanor Roosevelt with the Spanish version of the Universal Declaration of Human Rights. ... An institutional review board/independent ethics committee (IRB/IEC) is an appropriately constituted group that has been formally designated to review and monitor biomedical and behavioral research involving human subjects. ... A first-in-man study is a clinical trial where a medical procedure, previously developed and assessed through in vitro or animal testing, or through mathematical modelling is tested on human subjects for the first time. ...

Famous cases in medical ethics

Many famous cases in medical ethics illustrate and helped define important issues.

• Willowbrook Study
• Tuskegee Study
• Terry Schiavo
• Jack Kervorkian
• Nancy Cruzan
• Karen Ann Quinlan
• Baby K
• HeLa
• TGN1412

Willowbrook State School was a state-supported institution for mentally retarded children located in central Staten Island in New York City. ... The Tuskegee Study of Untreated Syphilis in the Negro Male[1] also known as the Tuskegee Syphilis Study, Pelkola Syphilis Study, Public Health Service Syphilis Study or the Tuskegee Experiments was a clinical study, conducted between 1932 and 1972 in Tuskegee, Alabama, in which 399 (plus 201 control group without... Terri Schiavo before her 1990 collapse. ... Dr. Jack Kevorkian Jack Kevorkian, M.D. (born Pontiac, Michigan, May 20, 1928) is a controversial Armenian American pathologist. ... Nancy Beth Cruzan (July 20, 1957–December 26, 1990) was a figure in the right-to-die movement. ... Karen Ann Quinlan (March 29, 1954 – June 11, 1985) was an important figure in the history of the right to die debate in United States. ... Baby K was born in an anencephalic state on October 13, 1992, at Fairfax Hospital in Virginia. ... Dividing HeLa cells as seen by electron microscopy for other meanings, see also the disambiguation page Hela A HeLa cell (also Hela or hela cell) is an immortal cell line used in medical research. ... TGN1412 (also known as CD28-SuperMAB) is the working name of an immunomodulatory drug which was withdrawn from development, originally intended for the treatment of B cell chronic lymphocytic leukemia (B-CLL) and rheumatoid arthritis. ...

Distribution and utilization of research and care

• Accessibility of health care
• Basis of priority for organ transplantation
• Institutionalization of care access through HMOs and medical insurance companies

A physician visiting the sick in a hospital. ... An organ transplant is the moving of a whole or partial organ from one body to another (or from a donor site on the patients own body), for the purpose of replacing the recipients damaged or failing organ with a working one from the donor site. ... This article does not cite any references or sources. ... Insurance, in law and economics, is a form of risk management primarily used to hedge against the risk of a contingent loss. ...

Sources and References

Beauchamp, Tom L., and Childress, James F. 2001. Principles of Biomedical Ethics. New York: Oxford University Press.

Bioethics introduction

Brody, Baruch A. 1988. Life and Death Decision Making. New York: Oxford University Press.

Curran, Charles E. "The Catholic Moral Tradition in Bioethics" in Walter and Klein (below). Charles Curran is also the name of a dissident Catholic theologian. ...

Fletcher, Joseph F. 1954. Morals and Medicine: The Moral Problems of: The Patient's Right to Know the Truth, Contraception, Artificial Insemination, Sterilization, Euthanasia. Boston: Beacon. Joseph Fletcher (1905-1991) was an American professor who founded the theory of situational ethics in the 1960s, and was a pioneer in the field of bioethics. ...

The Hastings Center's Bibliography of Ethics, Biomedicine, and Professional Responsibility.

Kelly, David. The Emergence of Roman Catholic Medical Ethics in North America. New York: The Edwin Mellen Press, 1979. See especially chapter 1, "Historical background to the discipline."

Sherwin, Susan. 1992. No Longer Patient: Feminist Ethics and Health Care. Philadelphia: Temple University Press.

Veatch, Robert M. 1988. A Theory of Medical Ethics. New York: Basic Books.

Walter, Jennifer and Eran P. Klein eds. The Story of Bioethics: From seminal works to contemporary explorations Georgetown University Press, 2003

1. ^ Walter, Klein eds. The Story of Bioethics: From seminal works to contemporary explorations]]
2. ^ Bekelman JE, Li Y, Gross CP (2003). "Scope and impact of financial conflicts of interest in biomedical research: a systematic review". JAMA 289 (4): 454-65. PMID 12533125. 
3. ^ Ross JS, Lackner JE, Lurie P, Gross CP, Wolfe S, Krumholz HM (2007). "Pharmaceutical company payments to physicians: early experiences with disclosure laws in Vermont and Minnesota". JAMA 297 (11): 1216-23. PMID 17374816. 
4. ^ Swedlow A, Johnson G, Smithline N, Milstein A (1992). "Increased costs and rates of use in the California workers' compensation system as a result of self-referral by physicians". N Engl J Med 327 (21): 1502-6. PMID 1406882. 
5. ^ (1998) "Ethics manual. Fourth edition. American College of Physicians". Ann Intern Med 128 (7): 576-94. PMID 9518406. 
6. ^ Güldal D, Semin S (2000). "The influences of drug companies' advertising programs on physicians". Int J Health Serv 30 (3): 585-95. PMID 11109183. 
7. ^ Wazana A (2000). "Physicians and the pharmaceutical industry: is a gift ever just a gift?". JAMA 283 (3): 373-80. PMID 10647801. 
8. ^ Blake R, Early E (1995). "Patients' attitudes about gifts to physicians from pharmaceutical companies". J Am Board Fam Pract 8 (6): 457-64. PMID 8585404. 
9. ^ [1] LA Times, "Drug money withdrawals: Medical schools review rules on pharmaceutical freebies," posted 2/12/07, accessed 3/6/07]
10. ^ La Puma J, Stocking C, La Voie D, Darling C (1991). "When physicians treat members of their own families. Practices in a community hospital". N Engl J Med 325 (18): 1290-4. PMID 1922224. 
11. ^ La Puma J, Priest E (1992). "Is there a doctor in the house? An analysis of the practice of physicians' treating their own families". JAMA 267 (13): 1810-2. PMID 1545466. 
12. ^ Gartrell N, Milliken N, Goodson W, Thiemann S, Lo B (1992). "Physician-patient sexual contact. Prevalence and problems". West J Med 157 (2): 139-43. PMID 1441462. 

External links

• German Reference Centre for Ethics in the Life Sciences (DRZE)
• BELIT is an extensive bibliographic directory of literature in the area of bioethics unique world wide, containing references to monographs, grey literature, legal documents, journal articles, newspaper articles and book contributions
• BEKIS- the Bioethics Communication and Information System
• Thesaurus Ethics in the Life Sciences
• BMJJournals.com - An international peer review journal for health professionals and researchers in medical ethics