Academic literature on the topic 'Medicine Research Moral and ethical aspects Australia'

The term therapeutic misconception was coined by Paul Appelbaum and his colleagues to describe the tendency of patients enrolled in clinical trials to confuse research participation with the personal clinical attention characteristic of medical care. It has not been recognized that an analogous therapeutic misconception pervades ethical thinking about clinical research with patient-subjects. Investigators and bioethicists often judge the ethics of clinical research based on ethical standards appropriate to the physician-patient relationship in therapeutic medicine. This ethical approach to clinical research constitutes a misconception because it fails to appreciate the ethically significant differences between clinical research and clinical care.In this article I argue that the assumption that the ethical principles governing the practice of therapeutic medicine should also apply to clinical research with patient- subjects produces incoherence in research ethics and erroneous guidance concerning certain controversial research designs.

Brain organoid research raises ethical challenges not seen in other forms of stem cell research. Given that brain organoids partially recapitulate the development of the human brain, it is plausible that brain organoids could one day attain consciousness and perhaps even higher cognitive abilities. Brain organoid research therefore raises difficult questions about these organoids' moral status – questions that currently fall outside the scope of existing regulations and guidelines. This paper shows how these gaps can be addressed. We outline a moral framework for brain organoid research that can address the relevant ethical concerns without unduly impeding this important area of research.

The author analyzes the problem of upbringing the moral and ethical qualities of the future doctor through the prism of the value perception of professional requirements, reveals the tasks of educational influence on the student in the educational process, ensures the formation of a humanistic, professionally verified system of values as a basis for perfect moral choice in professional activity. With the purpose of research, the criteria (motivational-value, cognitive, procedural-analytical) and levels (elementary, low, medium, high) education of the moral and ethical qualities of the future doctor, which can be achieved in the educational process of medical education, are described and described. requirements for professional activities in the field of medicine. The means of the confirmatory experiment noted how stable the pattern of positive dynamics of education of moral and ethical qualities of future physicians from the first to the graduation course, which was achieved by the traditional means of organizing the educational process in higher education, which allows us to conclude that the orientation of professional training for the education of each student as highly moral, conscious regarding his professional duty of the individual. As a direction of further research, a hypothesis was formulated in relation to the growth of the established dynamics, provided that the future system of exercises that include the axiological aspect of the education of moral and ethical qualities is included in the humanitarian training of future physicians.

Premise Ethical considerations are made when an experiment is planned and take a regulatory system of moral principles into account. Discussion Ethical considerations should first and foremost be made in order to protect the individual subject/animal from being exposed to any unethical and perhaps even illegal intervention and to ensure that the experimental conditions used are appropriate. Summary The main role of research ethics committees is to assess the scientific and ethical aspects of submitted protocols and follow up the trial until its closure.

With developed country governments and high resource institutions engaging in research in low- and middle-income countries (LMIC), we argue that these entities have a moral obligation to help build and strengthen research infrastructure and capacity so local scientists and institutions can adequately conduct studies to understand and resolve the health burdens in low and middle income countries. We explore the moral justifications and motivations behind engaging in research capacity strengthening in the health sector in LMIC at multiple levels. In highlighting these issues, this paper aims to initiate a global discourse around why capacity development in LMIC has a moral basis at the individual, institutional and system levels.

Background: Moral distress occurs when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action. Moral distress was found to cause negative feelings, burnout, and/or resignation. Not only external factors such as lack of staff but also internal ones affect moral distress. Moral sensitivity, which is thought of as an advantage of nurses, could effect moral distress, as nurses being unaware of existing ethical problems must feel little distress. Objectives: To examine the impact of moral sensitivity on moral distress among psychiatric nurses, and affirm the hypothesis that nurses with higher moral sensitivity will suffer moral distress more than nurses with less moral sensitivity in two different samples. Ethical consideration: The study obtained ethical approval from the Research Ethics Committee of the Faculty of Medicine at Mie University (# 1111, 20.4.2010), and by the Turku University Ethics Board (29.5.2012). Permissions to undertake the study was obtained from the in two hospital districts and in one city (§ 48/4.10.2012, § 63/4.9.2012, 51/2012 27.8.2012). Informed consent was not formally obtained, because the questionnaire was anonymously reported by the participants who volunteered to answer. The participants responded voluntarily and anonymously. Methods: An anonymous questionnaire containing the Revised Moral Sensitivity Questionnaire and the Moral Distress Scale for Psychiatric nurses was conducted to 997 nurses in 12 hospitals in Japan, and 974 nurses in 10 hospitals in Finland after obtaining of approval by research ethics committees. Data were analyzed using a multi-group structural equation model analysis. Findings: A set of analyses imply that the association of moral sensitivity with moral distress is significant and similar between Japan and Finland, whereas the factor structures of moral sensitivity and moral distress may be partially different. Discussion: The result of this study may indicate that nurses with high moral sensitivity can sense and identify moral problems, but not resolve them. Therefore, supporting nurses to solve ethical problems, not benumbing them, can be important for better nursing care and prevention of nurses’ resignation. Conclusion: Moral sensitivity and moral distress were positively correlated among psychiatric nurses in both Japan and Finland, although the participating nurses from the two countries were different in qualification, age, and cultural background. Nurses with high moral sensitivity suffer from moral distress.

The empirical literature exploring lawyers and their moral decision making is limited despite the “crisis” of unethical and unprofessional behavior in the bar that has been well documented for over a decade. In particular we are unaware of any empirical studies that investigate the moral landscape of the health lawyer’s practice. In an effort to address this gap in the literature, an interdisciplinary team of researchers at Vanderbilt University designed an empirical study to gather preliminary evidence regarding the moral reasoning of health care attorneys. The primary research question was how health lawyers respond when they encounter ethical or moral dilemmas in their practice for which the law fails to offer a bright-line solution. In exploring this question, we sought to understand better what motivations or influences guide action when health lawyers confront ethical quandaries, and whether there are specific differences, e.g., gender, experience, or religiosity, that are associated with specific responses to situations testing ethical or moral boundaries.

In the research ethics literature, there is strong disagreement about the ethical acceptability of placebo-controlled trials, particularly when a tested therapy aims to alleviate a condition for which standard treatment exists. Recently, this disagreement has given rise to debate over the moral appropriateness of the principle of clinical equipoise for medical research. Underlying these debates are two fundamentally different visions of the moral obligations that investigators owe their subjects.Some commentators and ethics documents claim that physicians, whether acting as care givers or researchers, have the same duty of beneficence towards their patients and subjects: namely, that they must provide optimal medical care. In discussing placebo surgery in research on refractory Parkinson's disease, Peter Clark succinctly states this view: “The researcher has an ethical responsibility to act in the best interest of subjects.”

The article considers the basic principles of professional ethics of educational experts in conducting institutional audits of educational institutions, including the rule of law, public interest as the main criteria of professional activity of an expert, professional competence, exclusion of self-profit actions, objectivity and independence, confidentiality of information, etc. The rules of interaction with representatives of educational institutions engaged in educational activities are presented. Emphasis is placed on the psychological aspects of business relations and relationships with colleagues. It is noted, that the work of an educational expert does not only require comprehensive knowledge of legislation in the field of education, but also includes certain moral obligations based on generally accepted norms, which guide the expert in conducting institutional audits in educational institutions. The Code of Professional Ethics of an institutional audit expert in educational institutions is a set of moral and ethical obligations and requirements based on generally accepted norms, which experts have to follow during the institutional audit procedure in educational institutions. The following theoretical research methods were used to solve certain problems: systematic analysis, comparison, systematization, classification and generalization of scientific and methodological literature on the problem; method of systematic analysis of philosophical, psychological-pedagogical, sociological literature for theoretical generalization of leading scientific approaches; interpretation of key provisions of the study.

Training nurses on spiritual principles and values helps to stimulate moral imagery and a deep understanding of moral problems in them. However, spirituality issue was not included in ethical educational content. There was still no interventional study on the effect of spirituality education on ethical sensitivity. This study was conducted to determine the effect of spirituality training on moral sensitivity of nursing students. A randomized controlled trial design was used. Data were collected by a moral sensitivity questionnaire and analyzed using Chi-square, Fisher, independent and paired t-test in SPSS 13v. This research was performed on 60 nursing students of Kashan University of Medical Sciences, Iran, in 2018. Participants were randomly assigned to two groups. The intervention group was under the spirituality group training in seven 60 min sessions. The control group was traditionally trained. Baseline characteristics were similar in the two groups. The differences between the two groups were statistically significant in the moral sensitivity score ( p < 0.0001). A significant difference was observed between the mean of moral sensitivity score of the intervention group, before and after the training ( p < 0.001), while no significant change was observed in the control group, before and after the study ( p = 0.93). The spirituality education increased the moral sensitivity of nursing students. That provides a new perspective on the role and effect of spirituality education on the ethical sensitivity of nursing students.

Over the past few years, embryo research has been a widely discussed topic. New techniques such as embryo stem cell research or therapeutic cloning are considered by scientists to be very promising. Nevertheless, opponents of these experimentations warn against the commodification of human life forms and argue that the moral status of embryos should protect them from being destroyed purely for research.
Legislations on this topic have been enacted in most Western countries, though they are still much criticised. Is there an adequate way of regulating embryo research? Our argument suggests that consensus can only be procedurally obtained. That is, we believe that only legislative assemblies should have authority to take a position on this controversial topic, which is subject to moral disagreement, and as such, judges should only have a minor role.

Numerous ethical guidelines are referred to when medical research is conducted on human participants. These guidelines include the Nuremberg Code, the Declaration of Helsinki, and the International Ethical Guidelines for Biomedical Research Involving Human Subjects. From a Western viewpoint, these guidelines may seem like well-reasoned, universally applicable codes for conducting medical research on human subjects. Some of the guidelines, however, merely impose Western values on developing countries without giving adequate consideration to their worldviews. I explore the applicability of current codes and guidelines of ethics on medical research with human subjects to the Zulu of South Africa and the Kikuyu of Kenya. Through a study of African traditional religions and philosophy and the community mindset that flows out of them, I have gained insight into the limitations of current universal codes when applied to traditional Kikuyu and Zulu communities.

Thesis (DPhil)--University of Stellenbosch, 2004.
ENGLISH ABSTRACT: Human participant research raises a conflict between medical progress as a societal good and the protection of participants as an individual good. Prior to 1960 the discretionary authority for the protection of participants resided in the hands of individual investigators. However, a wave of research atrocities from Tuskegee in 1932 to the Beecher expose in 1966 stimulated a change to a principle based system of regulation. Research Ethics Committees (RECs) and Institutional Review Boards (IRBs) were henceforth charged with the responsibility of human participant protection. Since 1966, this system of research review was established internationally and at one institution in South Africa. In 1997, placebo-controlled HIV vertical transmission trials in a number of developing countries including South Africa raised unprecedented controversy in research ethics internationally and nationally. In 2000, the fraudulent breast cancer trials conducted by Dr Bezwoda at Baragwanath Hospital drew international attention to research ethics in South Africa. However, the events that called into question the efficiency of the system of ethical review most poignantly were the recent deaths of volunteers in research at centres of excellence in the United States. It was charged that if there were deficiencies in the research ethics review system in developed countries, these were more likely to be present in developing countries. Around the same time the Interim National Health Research Ethics Committee (INHREC) was established in South Africa to explore and regulate the ethical review system in South Africa. Cognisant of these issues, the current study was undertaken to establish the various structural, procedural and substantive ethical challenges facing justifiable and ethical review of research in South Africa. A combination of conceptualphilosophical reflection and empirical research was employed in this dissertation. The empirical work employed both quantitative and qualitative research methodology. The quantitative survey explored the composition of RECs reviewing clinical trials research in South Africa with an emphasis on committee composition and structure as well as the review process. The qualitative research was conducted using semi-structured interviews of ten REC Chairpersons in South Africa to explore complex substantive issues like informed consent, standards of care and participant remuneration, inter alia. While the review system in South Africa is functioning at a reasonable level, there is wide variation from one REC to the next. RECs are geographically distant and function in isolation without opportunity to communicate and share ideas. Amongst institutional RECs, there is a stark contrast between historically disadvantaged institutions and historically advantaged institutions. REC membership, ten years into democracy remains white male dominated. Community representation is inadequate. Most RECs are dominated by scientists and clinicians. The review process is widely variable with delays in review ranging from ten days to ten weeks. Procedural and bureaucratic demands impact on the ability of REC members to engage in debate on important substantive ethics issues like standards of care, informed consent and participant remuneration. Research ethics training and educational needs vary widely across the country. Serious attention must be paid to the way in which RECs are constituted in South Africa. Restructuring of RECs with a view to improving representation in terms of race, gender and religion must be prioritized. There is a need for community representation and non-scientific membership to be explored. RECs in South Africa need to revisit the question of whether they should be conducting both scientific and ethics review or ethics review alone. The review process requires a paradigm shift in emphasis from adverse event reporting to monitoring, from informed consent forms to a culturally relevant informed consent process. Aparadigm shift is indicated to shift the focus from informed consent to a more comprehensive review framework. Policies regarding standards of care and participant remuneration must be clarified and articulated. Although the role of RECs in human participant protection has been questioned, it is clear that in the vast majority of cases, they are fulfilling an important role. Their function could certainly be enhanced. This is being facilitated by training programs and an electronic newsletter. However, responsibility for human participant protection does not reside in the domain of the REC alone. A collective responsibility shared by researchers, institutions, research ethics committees, sponsors and participants is integral to human participant protection and the generation of new, valid and relevant scientific knowledge.
AFRIKAANSE OPSOMMING: Navorsing op menslike subjekte gee aanleiding tot ‘n konflik tussen mediese vooruitgang as ‘n voordeel vir die samelewing en die beskerming van deelnemers as iets waarby die individu direkte belang het. Voor 1960 het die diskresionêre gesag vir die beskerming van deelnemers by die individuele navorsers berus. ‘n Golf van navorsingsvergrype, van Tuskegee in 1932 tot die Beecher onthulling in 1966, het egter veranderinge in die rigting van ‘n stelsel van beginsel-gebaseerde regulasie gestimuleer. Navorsingsetiekkomitees (NEKs) en Institusionele Beoordelings- en toesigrade (IBRs) is gevolglik belas met die verantwoordelikheid om toe te sien dat mense wat deelneem, sover moontlik beskerm word. Sedert 1966 is hierdie stelsel van navorsingshersiening en -toesig internasionaal tot stand gebring – ook, aanvanklik, by een instansie in Suid-Afrika. In 1997 het plasebo-beheerde HIV-vertikale oordrag-proewe in ‘n aantal ontwikkelende lande, insluitend Suid-Afrika, tot ongekende kontroversie op die terrein van navorsingsetiek aanleiding gee, internasionaal en nasionaal. In 2000 het die bedrog met borskankerproewe, uitgevoer deur dr Bezwoda by Baragwanath Hospitaal, internasionale aandag op navorsing in Suid-Afrika gevestig. Hierdie gebeure het egter die effektiwiteit van die stelsel van etiese toesig in Suid-Afrika en elders in die wêreld bevraagteken. Die mees kommerwekkende onlangse insident was die dood van navorsingsvrywilligers by sentra van uitmuntendheid in die Verenigde State. Daar is beweer dat as daar tekortkominge in die navorsingsetiektoesigsisteem in ontwikkelende lande is, daar ‘n groter moontlikheid bestaan dat dit ook (en moontlik meer) in ontwikkelende lande voorkom. Ongeveer dieselfde tyd is die Interim Nasionale Gesondheidsnavorsings-etiekkomitee (INGNEK) [Interim National HealthResearch Ethics Committee (INHREC)] in Suid-Afrika gestig om die etiekoorsigstelsel in Suid-Afrika te ondersoek en te reguleer. Met dit in gedagte is die huidige studie onderneem om die verskillende strukturele-, prosedurele- en substantiewe etiese uitdagings wat regverdigbare en etiese oorsig van en toesig oor navorsing in Suid-Afrika in die gesig staar, vas te stel. Daar is van ‘n kombinasie van konseptuele, filosofiese refleksie en empiriese navorsing in hierdie proefskrif gebruik gemaak. Die empiriese werk maak gebruik van sowel kwantitatiewe as kwalitatiewe navorsingsmetodes. Die kwantitatiewe opname bestudeer die samestelling van NEKs wat toesig hou oor kliniese proewe in Suid-Afrika, met die klem op komiteesamestelling, -struktuur en die toesigproses. Die kwalitatiewe navorsing is gedoen met behulp van van semi-gestruktureerde onderhoude van tien NEK-voorsitters in Suid-Afrika om die komplekse substantiewe aspekte, soos onder andere ingeligte toestemming, standaard van versorging en deelnemervergoeding, te ondersoek. Terwyl die etiek-toesigstelsel in Suid-Afriks op ‘n redelike vlak funksioneer, is daar ‘n groot verskil tussen verskillende NEKs. NEKs is geografies verspreid en funksioneer dikwels in isolasie sonder ‘n geleentheid om te kommunikeer en idees te deel. Ten opsigte van die institusionele NEKs bestaan daar ‘n duidelike kontras tussen histories benadeelde instansies en histories bevoordeelde instansies. NEK-lidmaatskap word, tien jaar na demokrasie, steeds gedomineer deur blanke mans. Gemeenskapsverteenwoordiging is onvoldoende. Die meerderheid NEKs word gedomineer deur wetenskaplikes en klinici. Die toesig- en hersieningsprosesse in die verskillende komitees verskil grootliks, met vertragings wat wissel van 10 dae to 10 weke. Prosedurele- en burokratiese vereistes het ‘n impak op die vermoëns van NEK-lede om by debatte oor belangrike substantiewe etiese aangeleenthede betrokke te raak, soos byvoorbeeld die standaard van versorging, ingeligte toestemming en deelnemervergoeding. Opleiding en opvoedkundige behoeftes verskil wyd oor die land.Ernstige aandag moet geskenk word aan die wyse waarop NEKs in Suid-Afrika saamgestel is. Herstrukturering van NEKs met ‘n visie op verbeterde verteenwoordiging in terme van ras, geslag en geloof is ‘n prioriteitsvereiste. Gemeenskapsverteenwoordiging en lidmaatskap van nie-wetenskaplikes moet verder ondersoek word. NEKs in Suid-Afrika moet die vraag of hulle sowel wetenskaplike- as etiektoesig moet uitvoer, of sl slégs etiektoesig, opnuut ondersoek. Die nasiensproses vereis ‘n paradigmaskuif, vanaf ‘n klem op rapportering van gebeurtenisse, na monitering van ingeligte toestemmingsvorms sowel as na ‘n kultureel toepaslike ingeligte toestemmingsproses. ’n Paradigmaskuif is noodsaaklik ten einde die fokus te verskuif vanaf ingeligte toestemming na ‘n meer omvattende toesig- en nasiensraamwerk. Beleid rakende standaard van versorging en deelnemervergoeding moet verduidelik en geartikuleer word. Alhoewel die rol van NEKs in die beskerming van menslike deelnemers aan navorsing bevraagteken word, is dit duidelik dat NEKs in die meerderheid van gevalle wel ‘n belangrike rol vervul. Hul funksie kan natuurlik uitgebrei word. Dit sal gefasiliteer word deur opleidingsprogramme en ‘n elektroniese nuusbrief. Verantwoordelikheid vir die beskerming van mense wat deelneem aan navorsing berus egter nie uitsluitlik by NEKs nie. ‘n Kollektiewe verantwoordelikheid, gedeel deur navorsers, instellings, navorsingsetiekkomitees, borge en deelnemers is ‘n integrale vereiste vir hierdie beskerming sowel as vir die verwerwing van nuwe, geldige en relevante wetenskaplike kennis.

This thesis seeks to demonstrate, by way of a multidisciplinary study, that consent is, despite its legal definition which refers to the free and enlighted expression of individual will, in fact, at times limited if not eliminated, by social considerations, arising from the medical, economic and legal context. These considerations reflect what one might call the social norm. An appropriate understanding of consent serves, therefore, to express the social norm as a constraint, which, in turn, acts as a measure of what it means to belong in society. Thus, while consent is often presented as the fundamental principle to be respected in biomedical research, it is in reality, merely one principle to respect among others. These limitations connected to consent are exacerbated in emergency situations where consent is sometimes reduced to mere signature, and in some cases it has been recognized that research can be undertaken without the subject's prior consent.

In this thesis, the author studies the ethical and legal aspects of research conducted on stored tissue samples of deceased persons in North America.
The first part of this thesis presents an overview of what constitutes human tissues and how are they used in research. The author describes the process in which human tissues are acquired and stored by health facilities, their utility for scientific research, and currently used techniques.
The second part is dedicated to the analysis of the current normative framework associated with research involving human tissue samples in North America. The author underlines the presence of two different normative regimes depending on whether the human tissues were removed before or after death. Finally, the author examines international documents in order to evaluate whether or not they can provide guidance to North American national legislation.
The third part evaluates the normative limitations associated with the use of stored tissue samples of deceased persons for research. The author considers that these limitations are related to the presence of conflicting interests, the difficulties in establishing rights over human tissues, the difficulties of establishing the rights of the dead, and the limitations of the theory of informed consent with regards to stored tissue samples.
The last part of this thesis suggests that stored human tissues should be interpreted as if they were part of an individual's medical record. After presenting some of the philosophical arguments in favour of such an interpretation, the author underlines the presence of legal precedents supporting the "tissue as information" model. The author finally examines the legal implications and the potential limitations of this proposal.

Dissertation in compliance with the requirements for the Master's Degree in Technology: Journalism, Durban University of Technology, 2013.
Ethical behaviour by investigators is the cornerstone of scientific research. Recognizing, declaring and avoiding a conflict of interest are key responsibilities for biomedical researchers, particularly since commercial enterprises, such as pharmaceutical companies, have become major funding sources of research. Proactive disclosure of researchers' financial relationships is now a requirement for publication in most scientific journals. The question that arises is whether this same increased scrutiny of financial disclosure and potential for conflict of interest has extended to the mainstream press in Canada. A content analysis of biomedical research articles that appeared in Canadian daily newspapers from 2001 to 2008 showed that 82 per cent of the articles failed to identify the financial connection that existed between the researcher(s) and the commercial funder, and nearly half of the articles did not even identify the commercial funding source of the research. A text analysis showed that 94 per cent of the articles were positive about the drug/device cited by the research, and positive, optimistic words such as “breakthrough”, “significant”, “hope” and “promising” were often used in the news articles. Reporters frequently frame biomedical research articles using a battle-like template that describes a fight between good and evil. Another common approach was to frame the article as a message of hope for the future. A genre analysis showed that the genre of medical research news articles published in newspapers is highly dissimilar to the genre of medical research articles published in scientific journals. It is likely these two genres have been constructed to appeal to very different target audiences. The study results show overwhelmingly that readers are not provided with key information about potential financial conflicts of interest involving the researchers and the commercial sources of funding for the research. Such lack of transparency thwarts the reader’s ability to reach informed conclusions about whether or not the research has been either explicitly or implicitly influenced by the researcher’s potential conflict.

In the history of public health vaccines have proven to be among the most effective disease prevention tools. It is clear that in the fight against HIV that new and powerful preventive technology such as a vaccine is badly needed. Ethically, however the processes of developing a vaccine against HIV have been distinctly different from that of any previous pharmaceutical products. HIV vaccine trials can be ethically complex for a number of reasons. In 2004 the HIV I AIDS Vaccine Ethics Group undertook a research initiative that aimed to collect data from various South African stake holders of HIV vaccine trials to ascertain what they perceived as the ethical challenges related to HIV vaccine trials. A quantitative content analysis on the data from 31 semistructured interviews revealed that the ethical issue listed spontaneously by most of the respondents was that of informed consent. Further probing and discussion on informed consent identified a number of sub issues which the respondents thought would pose important challenges to HIV vaccine trials in the South African context. This study undertook to do a more in-depth qualitative analysis of the data to ascertain whether the challenges and concerns the stakeholders have are consistent with or different to those already identified in the literature and ethical guidelines on informed consent in medical research. What variables may be impacting on the position stakeholders take was also of interest. Results indicated that many concerns relating to the substantive and procedural elements of informed consent were consistent with those debated in the literature. These issues related to first person consent, the voluntariness of participants' consent, practicing cultural sensitivity, dealing with language issues, promoting and assessing understanding of material disclosed, issues around the vulnerability of .. participants, children and adolescents' capacity to consent and the role of the media. More specific to the South African context, stakeholders were concerned about the legal framework under which the trials take place, the general lack of education and training about HIV vaccine trials, a lack of communication and coordination between stakeholder groups, and the historical influences of apartheid on black South African participants' capacity to consent. The main variables that appeared to impact on the position stakeholders took related to the role the stakeholders play within the trials, the philosophical position underpinning their ethical viewpoints, stakeholders' understanding of vulnerability and capacity to consent, and how they view the universality or relativity of ethical issues.
Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2008.

Significant advancements have been made in Cardiac surgery during the last decades, thanks to technological evolution. The enormous progress achieved has led to a relevant improvement in terms of surgical results, and at the same time, new ethical dilemmas have been addressed. Until the 90’s ethics in cardiac surgery mainly concerned significant moral problems caused by the introduction of extremely innovative techniques. However, today’s ethical issue focuses essentially on the doctor-patient relationship, other aspects of doctor’s practice concern relevant ethical perspectives. Ethics affects today the activity of the surgeon and the doctor in general. It is possible to distinguish clinical ethics, an ethics of health policies, and scientific research ethics. In the following chapter, we try to analyze the main ethical aspects concerning the application of cardiac surgical procedures.

This chapter aims to provide a physician with the foundation and principles of philosophy in medicine for freer and independent thinking. In previous chapters, a sub-branch of the philosophy of medicine related to epistemological concepts and metaphysical implications was highlighted, including ethical and even moral principles. The philosophy of medicine is a blend of medical education and training with philosophical aspects to achieve improvements and innovative findings for public health services. The philosophy of medicine includes the contra-active interactions of diseases, health and the search for effective reciprocity. By asking questions about how medical and health professionals know what to do, and detailed information is given in terms of practical medical wisdom. How should they make the right and wise decisions in morally complex and uncertain situations? And what is the patient’s role in this decision-making process? In medical practice and research, it is recommended to start problem-solving with philosophical thinking and then logical evaluations in order to reveal a better diagnosis, treatment and healing qualities for patient care.