Medex Behavioral Science Page

Medex Behavioral Science Page

MEDEX Objectives Home: http://faculty.washington.edu/alexbert/MEDEX/

WE’RE ALL IN THIS TOGETHER

Behavior Science CheatSheet (Printable version)

References Gino likes to see on ethics papers:

Ethics in Medicine, University of Washington School of Medicine
http://depts.washington.edu/bioethx/

Brief articles and sample cases for over 30 topics central to clinical ethics. "Bioethics Tools" section offers a summary of the methodology from Jonsen, Siegler and Winslade, Clinical Ethics, and a summary of Beauchamps and Childress, Principles of Biomedical Ethics.

Clinical ethics : a practical approach to ethical decisions in clinical medicine. Albert R. Jonsen, Mark Siegler, William J. Winslade. 5th Edition, 2002.

The introduction to 4th editions of this text, and a summary of its methodology can be found on UW's Ethics in Medicine website.
Publisher's description: "Shows health care professionals how to identify, analyze, and resolve ethical issues in clinical medicine, using the Four-Box Method ( medical indications, patient preferences, quality of life, and contextual features). The Fifth Edition emphasizes evidence-based medicine, and explores new issues in treatment and research."

Clinical Ethics Resources

Internet Sites

Ethics in Medicine, University of Washington School of Medicine
http://eduserv.hscer.washington.edu/bioethics/topics/index.html

Brief articles and sample cases for over 30 topics central to clinical ethics. "Bioethics Tools" section offers a summary of the methodology from Jonsen, Siegler and Winslade, Clinical Ethics, and a summary of Beauchamps and Childress, Principles of Biomedical Ethics.

BMC Medical Ethics Online Journal
http://www.biomedcentral.com/1472-6939

Part of the BioMed Central suite of open access online journals. See Peter A. Singer's Clinical ethics revisited (published April 26, 2001) and responses.

CMAJ Canadian Medical Association Journal: Bioethics for clinicians
http://www.cmaj.ca/cgi/collection/bioethics_for_clinicians_series

Thirteen articles published by CMAJ since October 2000 on current issues in clinical ethics.
Internet Sites Publications Find Library Materials Find Articles

Publications

Classic cases in medical ethics: accounts of cases that have shaped medical ethics, with philosophical, legal, and historical backgrounds. Gregory E. Pence. 2004.
Health Sciences Library Basement : W 50 P397c 2004

Clinical ethics : a practical approach to ethical decisions in clinical medicine. Albert R. Jonsen, Mark Siegler, William J. Winslade. 5th Edition, 2002.

The introduction to 4th editions of this text, and a summary of its methodology can be found on UW's Ethics in Medicine website.
Publisher's description: "Shows health care professionals how to identify, analyze, and resolve ethical issues in clinical medicine, using the Four-Box Method ( medical indications, patient preferences, quality of life, and contextual features). The Fifth Edition emphasizes evidence-based medicine, and explores new issues in treatment and research."

Encyclopedia of bioethics. Warren Thomas Reich, editor in chief. Revised Edition, 1995.

Publisher's description: "Five-volume revision of the 1979 Dartmouth Medal-winner provides well-balanced, informative articles on the moral and ethical dimensions of modern medicine, science, and technology. Articles explore such complex issues as Abortion, Animal Rights, the Death Penalty, Euthanasia, Genetic Engineering, Organ Procurement, Substance Abuse, and more."
Read review

Ethics Casebook for Hospitals: Practical Approaches to Everyday Cases. Mark G. Kuczewski, Ros Lynn B. Pinkus. 1999.

Publisher's description and Table of contents.

Ethics Manual. American College of Physicians. 1998.

Online at http://www.acponline.org/journals/annals/01apr98/ethicman.htm

Health Care Ethics: Principles and Problems. Thomas M. Garrett, Harold W. Baillie, Rosellen M. Garrett. 4th Edition, 2000.

Publisher's description and Table of contents.

Nursing ethics through the life span. Elsie Bandman and Bertram Bandman. 4th Edition, 2002

Publisher's description and Table of contents.

Principles of biomedical ethics. Tom L. Beauchamp, James F. Childress. 5th Edition, 2001.

Classic text in biomedical ethics identifies and defines the four core principles of respect for autonomy, nonmaleficence, beneficence, and justice.
Summary of four principles from UW's Ethics in Medicine website.
Publisher's description and Table of Contents

Paradigm

Medical Indications:

Consider each medical condition and its proposed treatment. Ask the following questions:

Does it fulfill any of the goals of medicine?
With what likelihood?
If not, is the proposed treatment futile?

Patient Preferences:

Address the following:

What does the patient want?
Does the patient have the capacity to decide? If not, who will decide for the patient?
Do the patient's wishes reflect a process that is
- informed?
- understood?
- voluntary?

Quality of Life:

Describe the Patient's quality of life in the patient's terms.
What is the patient's subjective acceptance of likely quality of life?
What are the views of the care providers about the quality of life?
Is quality of life "less than minimal?" (i.e., qualitative futility)

Contextual Features:

Social, legal, economic, and institutional circumstances in the case that can:

influence the decision
be influenced by the decision

e.g., inability to pay for treatment; inadequate social support

Clinical Lessons

Cover up your last name on your ID badge
Know when to have a PNA (Psychiatric Nursing Assistant) in the room - ask the staff it pt is safe to be with alone
Always have a good exit plan out of the room
Don't give antidepressants until you are sure pt isn't bipolar
All Ψ patients are suicidal till proven otherwise
Consider CO poisoning, ETOH, drugs, liver problems, thyroid, nutritional deficiencies, head injuries/tumors, and other problems before you diagnose someone as just nuts
Order/check lipid panel for pts you think are psychotic (to track lipids with antipsychotic treatment)
Ψ = psych
Psychiatrists don't know anything about medicine

MEDEX 37

Fall

Syllabus

ERes Behavioral Sci (requires student login)

The Importance of Empathy as an Interviewing Skill in Medicine

Materials of course:

Title	Author	Call#
+ LIST OF ELECTRONIC RESERVE MATERIALS FOR MEDEX 457	(no author)	Available Online
Clinical ethics : a practical approach to ethical decisions in clinical medicine / Albert R. Jonsen, Mark Siegler, William J. Winslade	Jonsen, Albert R	Health Reserve -- W 50 J81c 1998
Diagnostic and statistical manual of mental disorders, fourth edition : primary care version / [by] American Psychiatric Association	(no author)	Health Reserve -- WM 15 D5365 1995
Diagnostic criteria from DSM-IV / American Psychiatric Association	(no author)	Health Reserve -- WM 15 D532 1994
Evidence-based medicine : how to practice and teach EBM / David L. Sackett ... [et al.]	(no author)	Health Reserve -- WB 102 E93 2000 text
Getting to yes : negotiating agreement without giving in / by Roger Fisher and William Ury ; with Bruce Patton, editor	Fisher, Roger, 1922-	Health Reserve -- BF637.N4 F57 1991
Physician assistant : a guide to clinical practice / [edited by] Ruth Ballweg, Sherry Stolberg, Edward M. Sullivan	(no author)	Health Reserve -- W 21.5 P5775 1994
Physician assistant : guide to clinical practice / [edited by] Ruth Ballweg, Sherry Stolberg, Edward M. Sullivan	(no author)	Health Reserve -- W 21.5 P5775 1999
Primary care psychiatry / David J. Knesper, Michelle B. Riba, Thomas L. Schwenk	Knesper, David J	Health Reserve -- WM 400 K68p 1997