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Neurology, Ethics: Ethical Issues in Neurology

Neurology, Ethics: Ethical Issues in Neurology Since the writing of Bernat's first edition of Ethical Issues in Neurology, the field of medical ethics has been inundated with dilemmas. These new issues, regularly discussed in the popular media, impact the daily practice of medicine, the health care delivery system, and the conduct of clinical research. In the second edition of Ethical Issues in Neurology, Bernat has revised his comprehensive text to address these issues. Chapters have been updated, and three new chapters added, which discuss palliative care, withholding and withdrawing life-sustaining treatment, and clinical research. The section on genetic testing and gene therapy is particularly timely, although, unfortunately, fetal stem cell research is not fully explored. Despite its title, Ethical Issues in Neurology would be a valuable resource for a much wider range of readers. The initial chapters provide an excellent discussion of general principles useful for anyone involved in medical ethics. This section includes a lengthy discussion of the theories, schools, and practice of clinical ethics. These chapters would be of particular value to members of ethics committees or those who perform ethics consultation. Bernat then explores a number of issues that could be faced by almost any clinician: end-of-life issues, AIDS, assisted suicide, and medical futility. Finally, issues more specific to neurology are covered, including brain death, persistent vegetative state, dementia, mental retardation, and neurogenetic diseases. Over the past decade there has been an enormous increase in interest in clinical research. Its conduct is evolving rapidly, with studies being carried out in private offices and in cooperation with industry. This makes the chapter on clinical research particularly timely and useful. Bernat discusses the history of clinical research and rationale for the development of regulatory codes. Issues such as obtaining consent, use of placebos, randomization, conflicts of interest, and scientific misconduct are explored in depth. Bernat works to make many topics that may seem overwhelming more approachable. He points out that, initially, cases in clinical practice are perceived as being unsolvable but goes on to provide a logical empirical approach to resolution. He emphasizes that the field of clinical ethics is not entirely theoretical and urges that existing data be used in decision making. In particular scenarios, he spells out his perspective and discusses the approach that led him to his conclusions. His opinions are clearly delineated as such, and the reader should remember that other perspectives may exist. Ethical Issues in Neurology provides a comprehensive discussion of clinical ethics in general as well as in neurology. It would be useful to clinical ethicists, members of ethics committees, neurologists, and any other physicians who face similar ethical issues in their practice of medicine. Bernat's years of personal experience as both a neurologist and ethicist are evident in this text. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Neurology, Ethics: Ethical Issues in Neurology

JAMA , Volume 288 (16) – Oct 23, 2002
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Publisher
American Medical Association
Copyright
Copyright © 2002 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.288.16.2051-JBK1023-3-1
Publisher site
See Article on Publisher Site

Abstract

Since the writing of Bernat's first edition of Ethical Issues in Neurology, the field of medical ethics has been inundated with dilemmas. These new issues, regularly discussed in the popular media, impact the daily practice of medicine, the health care delivery system, and the conduct of clinical research. In the second edition of Ethical Issues in Neurology, Bernat has revised his comprehensive text to address these issues. Chapters have been updated, and three new chapters added, which discuss palliative care, withholding and withdrawing life-sustaining treatment, and clinical research. The section on genetic testing and gene therapy is particularly timely, although, unfortunately, fetal stem cell research is not fully explored. Despite its title, Ethical Issues in Neurology would be a valuable resource for a much wider range of readers. The initial chapters provide an excellent discussion of general principles useful for anyone involved in medical ethics. This section includes a lengthy discussion of the theories, schools, and practice of clinical ethics. These chapters would be of particular value to members of ethics committees or those who perform ethics consultation. Bernat then explores a number of issues that could be faced by almost any clinician: end-of-life issues, AIDS, assisted suicide, and medical futility. Finally, issues more specific to neurology are covered, including brain death, persistent vegetative state, dementia, mental retardation, and neurogenetic diseases. Over the past decade there has been an enormous increase in interest in clinical research. Its conduct is evolving rapidly, with studies being carried out in private offices and in cooperation with industry. This makes the chapter on clinical research particularly timely and useful. Bernat discusses the history of clinical research and rationale for the development of regulatory codes. Issues such as obtaining consent, use of placebos, randomization, conflicts of interest, and scientific misconduct are explored in depth. Bernat works to make many topics that may seem overwhelming more approachable. He points out that, initially, cases in clinical practice are perceived as being unsolvable but goes on to provide a logical empirical approach to resolution. He emphasizes that the field of clinical ethics is not entirely theoretical and urges that existing data be used in decision making. In particular scenarios, he spells out his perspective and discusses the approach that led him to his conclusions. His opinions are clearly delineated as such, and the reader should remember that other perspectives may exist. Ethical Issues in Neurology provides a comprehensive discussion of clinical ethics in general as well as in neurology. It would be useful to clinical ethicists, members of ethics committees, neurologists, and any other physicians who face similar ethical issues in their practice of medicine. Bernat's years of personal experience as both a neurologist and ethicist are evident in this text.

Journal

JAMA – American Medical Association

Published: Oct 23, 2002

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