The Four Topics: Case Analysis in Clinical Ethics

Clinical ethics is a practical discipline that provides a structured approach for identifying—,analyzing, and resolving ethical issues in clinical medicine. The practice of good clinical medicine requires a working knowledge about ethical issues, such as informed consent, truth telling, confidentiality, end-of-life care, pain relief, and patient rights. Medicine, even at its most technical and scientific levels, i.s an encounter between human beings, and the physician's work of diagnosing disease, offering advice, and providing treatment is embedded in a moral context. The willingness of physician and patient to endorse moral values, such as mutual respect, honesty trustworthiness, compassion, and a commitment to pursue shared goals, usually ensures that significant conflicts between physician and patient rarely occur. Occasionally, physicians and patients may disagree about values or may face choices that challenge their values. It is then that ethical problems arise. Clinical ethics concerns both the ethical features that are present in every clinical encounter and the ethical problems that occasionally occur in those encounters. Clinical ethics relies on the conviction that, even when perplexity is great and emotions run high, physicians, nurses, and patients and their families can work constructively to identify, analyze, and resolve many of the ethical problems that appear in clinical medicine.