•  87
    Consensus guidelines on analgesia and sedation in dying intensive care unit patients
    with Laura Hawryluck, Louise Lemieux-Charles, and Peter Singer
    BMC Medical Ethics 3 (1): 1-9. 2002.
    Background Intensivists must provide enough analgesia and sedation to ensure dying patients receive good palliative care. However, if it is perceived that too much is given, they risk prosecution for committing euthanasia. The goal of this study is to develop consensus guidelines on analgesia and sedation in dying intensive care unit patients that help distinguish palliative care from euthanasia. Methods Using the Delphi technique, panelists rated levels of agreement with statements describing h…Read more
  •  30
    Philosopy of medicine focuses inter alia on metaphysics and epistemology that are instantiated in biomedicine as physicalism (or materialism) and empiricism. The Golubchuck case reveals how the clinicans failed to recognize the relation between medical science and medical ethics and made biomedical decsions devoid of medical ethics. That is, they failed to make medical judgments that by defintion include a normative ethical component.
  •  236
    Pain, competency and consent
    with George C. Webster and Derek L. Jones
    HEC Forum 5 (3): 205-211. 1993.
    The paper is written in response to those who fail to recognize the relation between a patient's mental competency and her state of pain. Some clinicians claim that a proper diagnosis can only be made in the absent of analgesia. Rather, the patient's state of pain directly affects her mental competency and thus her ability to give valid consent. Clinicians should rethink their approach to diagnosis when the patient is in pain.
  •  48
    Competency and practical judgment
    with Robert Pepper-Smith and M. Silberfeld
    Theoretical Medicine and Bioethics 17 (2). 1996.
    At least four different frameworks — psychiatric, cognitive, functional and decision-making — are used in the evaluation of competence, all of which remain more or less unrelated in the literature. In the first section of this paper we consider various meanings of competence, in order to arrive at a definition of the term relevant to the medical and legal setting. Patient or client competence, we conclude, refers to the practical abilities that individuals employ in pursuing their own autonomous…Read more