Emergency medicine clinics of North America
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There is a wide variety of ethical issues and dilemmas involving resuscitation, the act of restoring life to a patient in cardiorespiratory arrest. Decisions must be made rapidly and often must be based on suboptimal levels of information available at the time. Certain issues should be considered when one is making decisions in the resuscitation arena, including positive-aspects of resuscitation, not only the possibility of restoring life to the patient but also providing a sense of closure and resolution of guilt for the survivors. During and following resuscitative efforts, the psychologic and emotional well-being of the survivors should also be given close attention.
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This article discusses the art of medicine as it relates to effective teaching. Valuable contributions to such teaching are made through applying ethical considerations to situations unique to emergency medicine. The author includes several appendices for further information on this vital topic.
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The elderly consume medical services in an amount disproportionate to their number. Disability and dementia are commonly underdiagnosed and misunderstood in any emergency department setting. Educating emergency physicians regarding the evaluation of dementia, disability, and abuse is crucial to appropriate management and optimal outcome of these clinical problems.
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Good Samaritan Acts are those in which aid is rendered to a needy victim of injury or sudden illness. No antecedent relationship exists with the good samaritan, and no remuneration is anticipated. Emergency physicians have an ethical obligation beyond that of other citizens to provide aid in such situations of medical need; professional and legal standards support that obligation.
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Ethical issues in emergency medicine often are accompanied by legal issues. Although the legal aspects of an ethical problem are important factors to take into consideration, the law may not directly address the problem, and following the law does not always ensure an ethical outcome. Emergency physicians should have an understanding of ethics and law, understand the legal aspects of bioethical issues in emergency medicine, and finally have a guide to analyze ethical issues, including the consideration of legal issues that may have an impact on the case.