Encyclopedia of Ethics. Lawrence and Charlotte Becker, eds. 2nd edition. Garland 1998 MEDICAL ETHICS by William Ruddick Until recently, philosophers took little interest in medical practice or physicians' codes of ethics Since the 1960,s, however, they have joined physicians, theologians, and lawyers in founding journals, research centers, hospital and medical school committees, departments, programs, and special degrees in medical ethics, primarily in North America but increasingly world-wide. This exponential growth invites differentiation of medical ethics(primarily, physician-centered) and health care ethics(including nurses and other healthcare providers), clinical ethics(focused on ospital case decisions with the aid of diverse committees and consultants), and bioethics (including general issues of reproduction, fair distribution of organs and other scarce life-saving resources, and protection of the biosphere) Principal topics in medical ethics include: physicians'paternalistic deceptions and violations of atient confidentiality; the rights of patients or their surrogates to refuse life-sustaining treatments or request assistance in dying; drug experiments on children, demented or dying patients, and other incompetent or desperate patients bias-free definitions of health death, disease, and futility of treatment; removing viable organs from patients who are brain dead or in cardiac arrest grounds for fetal testing, selection, and abortion; involuntary hospitalization and treatment of mentally disturbed people, conflicts of interest between physicians and their employers and third-party payers, public and private Physician-philosopher collaboration on this range of topics has posed meta-ethical questions about the role of professional codes, religious principles, ethical theories and principles, committee consensus,clinical experience, and moral intuitions in the analysis and decision of clinical cases As clinicians increasingly share or preempt medical ethics teaching in medical schools, the issue of appropriate philosophical training has arisen Physicians and Patients Traditional medical oaths and codes prescribe a phy sicians character, motives, and duties Typically they portray ideal physicians as devoted to the welfare of patients and to advancement of the medical profession and medical knowledge, responding compassionately to the suffering of patients, humbly mindful of the limits of their curative powers and the harms they may unintentionally cause. The Hippocratic injunction"Strive to help, but above all, do no harm"is the ruling maxim. In current discussion, this maxim has been codified in oft-cited"principles of nonmaleficence and beneficence Although still supported by religious texts and medical tradition this ideal physician increasingly criticized as "paternalistic, "too willing to act on judgments of a patient's best1 Encyclopedia of Ethics. Lawrence and Charlotte Becker, eds. 2nd edition. Garland 1998 MEDICAL ETHICS by William Ruddick Until recently, philosophers took little interest in medical practice or physicians' codes of ethics. Since the 1960's, however, they have joined physicians, theologians, and lawyers in founding journals, research centers, hospital and medical school committees, departments, programs, and special degrees in medical ethics, primarily in North America but increasingly world-wide. This exponential growth invites differentiation of medical ethics (primarily, physician-centered) and health care ethics (including nurses and other healthcare providers), clinical ethics (focused on hospital case decisions with the aid of diverse committees and consultants), and bioethics (including general issues of reproduction, fair distribution of organs and other scarce life-saving resources, and protection of the biosphere). Principal topics in medical ethics include: physicians’ paternalistic deceptions and violations of patient confidentiality; the rights of patients or their surrogates to refuse life-sustaining treatments or request assistance in dying; drug experiments on children, demented or dying patients, and other incompetent or desperate patients; bias-free definitions of health, death, disease, and futility of treatment; removing viable organs from patients who are brain dead or in cardiac arrest; grounds for fetal testing, selection, and abortion; involuntary hospitalization and treatment of mentally disturbed people; conflicts of interest between physicians and their employers and third-party payers, public and private. Physician-philosopher collaboration on this range of topics has posed meta-ethical questions about the role of professional codes, religious principles, ethical theories and principles, committee consensus, clinical experience, and moral intuitions in the analysis and decision of clinical cases. As clinicians increasingly share or preempt medical ethics teaching in medical schools, the issue of appropriate philosophical training has arisen. Physicians and Patients Traditional medical oaths and codes prescribe a physician's character, motives, and duties. Typically they portray ideal physicians as devoted to the welfare of patients and to advancement of the medical profession and medical knowledge, responding compassionately to the suffering of patients, humbly mindful of the limits of their curative powers and the harms they may unintentionally cause. The Hippocratic injunction "Strive to help, but above all, do no harm" is the ruling maxim. In current discussion, this maxim has been codified in oft-cited "principles of nonmaleficence and beneficence." Although still supported by religious texts and medical tradition, this ideal physician is increasingly criticized as "paternalistic," too willing to act on judgments of a patient's best