Medical ethics History
Historically, Western medical ethics may be traced to guidelines on the duty of physicians in antiquity, such as the Hippocratic Oath, and early Christian teachings.
By the 18th and 19th centuries, medical ethics emerged as a more self-conscious discourse. In England, Thomas Percival, a physician and author, crafted the first modern code of medical ethics. He drew up a pamphlet with the code in 1794 and wrote an expanded version in 1803, in which he coined the expressions “medical ethics” and “medical jurisprudence
In 1815, the Apothecaries Act was passed by the Parliament of the United Kingdom. It introduced compulsory apprenticeship and formal qualifications for the apothecaries of the day under the license of the Society of Apothecaries. This was the beginning of regulation of the medical profession in the UK.
In 1847, the American Medical Association adopted its first code of ethics, with this being based in large part upon Percival’s work
Values in medical ethics
A common framework used in the analysis of medical ethics is the “four principles” approach postulated by Tom Beauchamp and James Childress in their textbook Principles of biomedical ethics. Respect for autonomy – the patient has the right to refuse or choose their treatment. Beneficence – a practitioner should act in the best interest of the patient. Non-maleficence – “first, do no harm Justice – concerns the distribution of scarce health resources, and the decision of who gets what treatment
Other values which are sometimes discussed include:
Respect for persons – the patient (and the person treating the patient) have the right to be treated with dignity. Truthfulness and honesty – the concept of informed consent has increased in importance since the historical events of the Doctors’ Trial of the Nuremberg trials and Tuskegee syphilis exFinal 3-Year Report Published From the SYMPLICITY HTN-1 Study
November 7, 2013—The final 3-year report of the SYMPLICITY HTN-1 study of percutaneous renal denervation in patients with treatment-resistant hypertension renal denervation (RDN) were published by Professor Henry Krum, MD, et al online ahead of print in The Lancet: The investigators reported that 88 patients had complete data at 36 months. At baseline the mean age was 57 years (standard deviation [SD], 11); 37 (42%) patients were women; 25 (28%) had type 2 diabetes mellitus; the mean estimated glomerular filtration rate was 85 (SD, 19) mL/min per 1.73 m2; and mean blood pressure was 175/98 (SD, 16/14) mm Hg. At 36 months, significant changes were seen in systolic (−32 mm Hg, 95% confidence interval [CI], −35.7 to −28.2) and diastolic blood pressure (−14.4 mm Hg, −16.9 to −11.9). Decreases of 10 mm Hg or more in systolic blood pressure were seen in 69% of patients at 1 month, 81% at 6 months, 85% at 12 months, 83% at 24 months, and 93% at 36 months. One new renal artery stenosis requiring stenting and three deaths unrelated to RDN occurred during follow-up. Changes in blood pressure after RDN persist long term in patients with treatment-resistant hypertension, with good safety, concluded the SYMPLICITY HTN-1 investigators inThe Lancet.
First commercial implantations of Crux vena cava filter announced
Volcano has announced the commercial release and initial implantations of its innovative Crux vena cava filter in patients at risk for recurrent pulmonary embolism. It is the only filter with a double helical design that self-centres to help prevent filter tilt and offers the Bi-Trieval option of retrieval via either the jugular or femoral vein.