This book is designed to consolidate the relevant literature as well as the thoughts of professionals currently working in the field into a practical and accessible reference for the emergency medical technician, student, nurse, resident, and attending emergency physician. Each chapter is divided into four sections: case presentation, discussion, review of the current literature, and recommendations. Designed to serve simultaneously as a learning and reference tool, each chapter begins with a real case that was encountered in an ED setting. The case presentation is followed by a short…mehr
This book is designed to consolidate the relevant literature as well as the thoughts of professionals currently working in the field into a practical and accessible reference for the emergency medical technician, student, nurse, resident, and attending emergency physician. Each chapter is divided into four sections: case presentation, discussion, review of the current literature, and recommendations. Designed to serve simultaneously as a learning and reference tool, each chapter begins with a real case that was encountered in an ED setting. The case presentation is followed by a short discussion of the case, as if at a morbidity and mortality conference, by a panel of experienced attending physicians explaining how they would approach the ethical dilemmas associated with the case, and a review of the existing literature.
John Jesus, MD, Chief Resident, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Clinical Instructor, Department of Emergency Medicine, Christiana Care Health System, Newark, DE, USA. Peter Rosen, MD, FACS, FACEP, Director of Education, Beth Israel Deaconess Medical Center; Senior Lecturer in Medicine, Harvard Medical School, Boston, MA, USA. Shamai A. Grossman, MD, MS, FACEP, Vice Chair for Resource Utilization; Director, Cardiac Emergency Center, Division of Emergency Medicine, Beth Israel Deaconess Medical Center; Assistant Professor of Medicine, Harvard Medical School, Boston, MA, USA. Arthur R. Derse, MD, JD, FACEP, Director, Center for Bioethics and Medical Humanities, Julia and David Uihlein Professor of Medical Humanities; Professor of Bioethics and Emergency Medicine, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA. James G. Adams, MD, Professor and Chair, Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Northwestern Memorial Hospital, Chicago, IL, USA. Richard Wolfe, MD, Chief of Emergency Medicine, Beth Israel Deaconess Medical Center; Associate Professor of Medicine, Harvard Medical School, Boston, MA, USA.
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Contributors ix Preface xiii Section One: Challenging professionalism 1 Physician care of family friends or colleagues 3 Taku Taira Joel Martin Geiderman 2 The impaired physician 15 Peter Moffett Christopher Kang 3 Disclosure of medical error and truth telling 27 Abhi Mehrotra Cherri Hobgood 4 Conflicts between patient requests and physician obligations 37 Shellie L. Asher 5 Judgmental attitudes and opinions in the emergency department 47 V. Ramana Feeser 6 Using physicians as agents of the state 57 Jeremy R. Simon Section Two: End-of-life decisions 7 Family-witnessed resuscitation in the emergency department: making sense of ethical and practical considerations in an emotional debate 69 Kirsten G. Engel Arthur R. Derse 8 Palliative care in the emergency department 79 Tammie E. Quest Paul DeSandre 9 Refusal of life-saving therapy 89 Catherine A. Marco Arthur R. Derse 10 Revisiting comfort-directed therapies: death and dying in the emergency department including withholding and withdrawal of life-sustaining treatment 99 Raquel M. Schears Terri A. Schmidt 11 Futility in emergency medicine 117 Arthur R. Derse Section Three: Representing vulnerable populations 12 The care of minors in the emergency department 129 Chloë-Maryse Baxter 13 Chemical restraints physical restraints and other demonstrations of force 139 Michael P. Wilson Christian M. Sloane 14 Capacity determination in the patient with altered mental status 149 Michael C. Tricoci Catherine A. Marco 15 Obstetric emergency: perimortem cesarean section 15 Kenneth D. Marshall Carrie Tibbles Section Four: Outside influence and observation 16 Non-medical observers in the emergency department 169 Joel Martin Geiderman 17 Religious perspectives on do-not-resuscitate (DNR) documents and the dying patient 179 Avraham Steinberg 18 Non-physician influence on the scope and responsibilities of emergency physicians 187 Laura G. Burke Jennifer V. Pope 19 Privacy and confidentiality: particular challenges in the emergency department 197 Jessica H. Stevens Michael N. Cocchi Section Five: Emergency medicine outside the emergency department 20 Short-term international medical initiatives 209 Matthew B. Allen Christine Dyott John Jesus 21 Disaster triage 221 Matthew B. Allen John Jesus 22 The emergency physician as a bystander outside the hospital 237 Zev Wiener Shamai A. Grossman 23 Military objectives versus patient interests 247 Kenneth D. Marshall Kathryn L. Hall-Boyer Section Six: Public health as emergency medicine 24 Treatment of potential organ donors 261 Glen E. Michael John Jesus 25 Mandatory and permissive reporting laws: conflicts in patient confidentiality autonomy and the duty to report 271 Joel Martin Geiderman 26 Ethics of care during a pandemic 287 John C. Moskop Section Seven: Education and research 27 Practicing medical procedures on the newly or nearly dead 301 Ajay V. Jetley Catherine A. Marco 28 Ethics of research without informed consent 311 Dave W. Lu Jonathan Burstein John Jesus Appendix: useful resources 321 Alexander Bracey Index 325
Contributors ix Preface xiii Section One: Challenging professionalism 1 Physician care of family friends or colleagues 3 Taku Taira Joel Martin Geiderman 2 The impaired physician 15 Peter Moffett Christopher Kang 3 Disclosure of medical error and truth telling 27 Abhi Mehrotra Cherri Hobgood 4 Conflicts between patient requests and physician obligations 37 Shellie L. Asher 5 Judgmental attitudes and opinions in the emergency department 47 V. Ramana Feeser 6 Using physicians as agents of the state 57 Jeremy R. Simon Section Two: End-of-life decisions 7 Family-witnessed resuscitation in the emergency department: making sense of ethical and practical considerations in an emotional debate 69 Kirsten G. Engel Arthur R. Derse 8 Palliative care in the emergency department 79 Tammie E. Quest Paul DeSandre 9 Refusal of life-saving therapy 89 Catherine A. Marco Arthur R. Derse 10 Revisiting comfort-directed therapies: death and dying in the emergency department including withholding and withdrawal of life-sustaining treatment 99 Raquel M. Schears Terri A. Schmidt 11 Futility in emergency medicine 117 Arthur R. Derse Section Three: Representing vulnerable populations 12 The care of minors in the emergency department 129 Chloë-Maryse Baxter 13 Chemical restraints physical restraints and other demonstrations of force 139 Michael P. Wilson Christian M. Sloane 14 Capacity determination in the patient with altered mental status 149 Michael C. Tricoci Catherine A. Marco 15 Obstetric emergency: perimortem cesarean section 15 Kenneth D. Marshall Carrie Tibbles Section Four: Outside influence and observation 16 Non-medical observers in the emergency department 169 Joel Martin Geiderman 17 Religious perspectives on do-not-resuscitate (DNR) documents and the dying patient 179 Avraham Steinberg 18 Non-physician influence on the scope and responsibilities of emergency physicians 187 Laura G. Burke Jennifer V. Pope 19 Privacy and confidentiality: particular challenges in the emergency department 197 Jessica H. Stevens Michael N. Cocchi Section Five: Emergency medicine outside the emergency department 20 Short-term international medical initiatives 209 Matthew B. Allen Christine Dyott John Jesus 21 Disaster triage 221 Matthew B. Allen John Jesus 22 The emergency physician as a bystander outside the hospital 237 Zev Wiener Shamai A. Grossman 23 Military objectives versus patient interests 247 Kenneth D. Marshall Kathryn L. Hall-Boyer Section Six: Public health as emergency medicine 24 Treatment of potential organ donors 261 Glen E. Michael John Jesus 25 Mandatory and permissive reporting laws: conflicts in patient confidentiality autonomy and the duty to report 271 Joel Martin Geiderman 26 Ethics of care during a pandemic 287 John C. Moskop Section Seven: Education and research 27 Practicing medical procedures on the newly or nearly dead 301 Ajay V. Jetley Catherine A. Marco 28 Ethics of research without informed consent 311 Dave W. Lu Jonathan Burstein John Jesus Appendix: useful resources 321 Alexander Bracey Index 325
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