The modern challenges of healthcare require an increasing awareness of the ethical and moral issues that encompass not only the welfare of patients but also the functioning of healthcare organizations, and the role of research in society. Health care ethics has also evolved as a crucial component in academic medicine given the related challenges of education, training, and research. The MU Center for Health Ethics seeks to address these difficult issues through dialogue across multiple related disciplines, as well as in the broader academic and public community.

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  • Ethical Issues: Ethics Consultation 

    Fleming, David A. (Center for Health Ethics, 2003-09)
    Making decisions within the complexities of modern health care is not easy. This is especially true in a training environment. Ethical dilemmas often present themselves, and having a mechanism available to effectively ...
  • Organizational Ethics Committees 

    Fleming, David A. (Center for Health Ethics, 2009-10)
    The first official healthcare ethics committee convened in 1971. But the origin of such committees came years earlier in response to a rising tide of moral concern in health care. “Committees for the Discussion of Morals ...
  • Partial DNR Orders 

    Fleming, David A. (Center for Health Ethics, 2003-12)
    Writing formal “Do Not Resuscitate” (DNR) orders is a relatively new practice that has come about over the last 30 years as a result of medical innovation coupled with a growing understanding that sometimes it's just not ...
  • Ethical Issues: The Difficult Family 

    Fleming, David A. (Center for Health Ethics, 2004-01)
    Some of the most difficult situations faced by physicians have been when loving and caring families, often out of guilt or misunderstanding, disagree or become demanding. This challenge intensifies when those demands do ...
  • Ethical Issues: Spirituality and Health Care 

    Fleming, David A. (Center for Health Ethics, 2004-02)
    Faith and spirituality, and their place in professional relationships, are getting a great deal of press these days. From an airline pilot proselytizing to his captive passengers at the beginning of a four hour coast to ...
  • The Terri Schiavo Crisis 

    Fleming, David A. (Center for Health Ethics, 2003-11)
    Terri Schindler-Schiavo has lived in a persistent vegetative state in Florida for thirteen years, since her collapse and resuscitation at age 26 due to apparent severe hypokalemia. She has been kept alive with a jejunal ...
  • Ethical Issues: Caring for the Caregiver 

    Fleming, David A. (Center for Health Ethics, 2004-03)
    One of the important details we tend to overlook when taking care of patients with debilitating or life-threatening disease is the welfare of those family members taking care of the patient at home. The burden of providing ...
  • Ethical Issues: Malpractice Crisis 

    Fleming, David A. (Center for Health Ethics, 2004-04)
    Medicine is in crisis. Doctors, especially those in high-risk specialties like obstetrics and neurosurgery, are leaving their practices in response to ballooning malpractice costs. Malpractice rates for physicians are ...
  • Ethical Issues: Communication 

    Fleming, David A. (Center for Health Ethics, 2004-05)
    Nothing is more important to the welfare of patients, providers, and health care systems than effective patient centered communication. This occurs by having the knowledge, attitudes, skills, and organizational infrastructure ...
  • Ethical Issues: The Uninsured 

    Fleming, David A. (Center for Health Ethics, 2004-06)
    There is ongoing debate as to the importance of the “problem of the uninsured” in this country and in Missouri. This institution, as an academic state hospital, seems to get more than its share of uninsured patients who ...
  • Ethical Issues: The Pope and Terri's Tube 

    Fleming, David A. (Center for Health Ethics, 2004-07)
    On March 20, 2004, in a papal allocution delivered at the Vatican, Pope John Paul II made statements regarding the feeding of patients diagnosed as being in a persistent vegetative state. These statements have rekindled ...
  • Ethical Issues: “The Patient Just Wants to Go Home” 

    Fleming, David A. (Center for Health Ethics, 2004-08)
    Not infrequently in the busy practice of medicine we come across patients who, regardless of the severity of illness or need for acute care, demand to go home from the hospital against our advice. At these times the physician ...
  • Ethical Issues: Disparities in End of Life Care 

    Fleming, David A. (Center for Health Ethics, 2004-09)
    Market strategies tend to work as a negative force when it comes to ensuring adequate health care for the underserved in our society. When it comes to health care, and in particular end of life care, color still divides.
  • The Ethical Use of New Drugs 

    Fleming, David A. (Center for Health Ethics, 2004-10)
    The practice of medicine requires clinical judgments within the context of an inexact and very complicated science, the end result of which has profound implication for the welfare of patients. The ethical question for the ...
  • Ethical Issues: Engaging Patients 

    Fleming, David A. (Center for Health Ethics, 2004-11)
    The Institute for Ethics at the American Medical Association initiated the Ethical Force Program in 1997. The purpose of E Force is to develop performance measures for ethical behavior and practices that can be useful ...
  • Ethical Issues: Ethical Research 

    Fleming, David A. (Center for Health Ethics, 2004-12)
    In academic medicine we are ruled by many masters—the need to see patients, the expectations of teaching, the desire (and expectation) to advance our careers through scholarship and research, and the ever present specter ...
  • Ethical Issues: Organ Donation and Procurement 

    Fleming, David A. (Center for Health Ethics, 2005-01)
    The list of people waiting for organ transplants continues to grow. According to the Missouri Hospital Association more than 80,000 men, women and children nationwide are waiting for new organs, including more than 1,800 ...
  • Ethical Issues: Futility Policies 

    Fleming, David A. (Center for Health Ethics, 2005-03)
    Futility, in general, is the inability to achieve an intended goal or outcome. Biomedical futility more specifically is a clinical judgment that, in light of the patient's current clinical circumstance, it is not physiologically ...
  • Ethical Issues: Reflections on HB 905 

    Fleming, David A. (Center for Health Ethics, 2005-04)
    In times of crisis there are opportunities to grow and learn. With the suffering and demise of Terri Shiavo patients, families, and health care providers again find themselves in doubt as to what to do in the midst of very ...
  • Ethical Issues: Communication and Prevention 

    Fleming, David A. (Center for Health Ethics, 2005-05)
    Health illiteracy is a serious and growing problem in this country. According to the Institute of Medicine (IOM) nearly half of all American adults (that's 90 million people) have difficulty understanding and using health ...

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