Who's in Charge? The Relationship Between Medical Law, Medical Ethics, and Medical Morality?

Foster, Charles; Miola, José

doi:10.1093/medlaw/fwv004

Cited by 35 publications

(21 citation statements)

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“…Professional ethics represent the common ethics of a particular group of people and are meant to guide that profession's relationships with other people, other organizations and other professions (Pettifor, ). Today, most professions develop a written code or statement of ethics that members are expected to follow, and these documents can be useful to members in understanding the group's ethical course of professional action (Foster & Miola, ). Depending upon the particular profession, some codes may adopt a moralistic or philosophical tone while others reflect more practical and specific guidance for members (Ray, ).…”

Section: Key Definitionsmentioning

confidence: 99%

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But it’s legal, isn’t it? Law and ethics in nursing practice related to medical assistance in dying

et al. 2019

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In June 2015, the Supreme Court of Canada struck down the Criminal Code's prohibition on assisted death. Just over a year later, the federal government crafted legislation to entrench medical assistance in dying (MAiD), the term used in Canada in place of physician‐assisted death. Notably, Canada became the first country to allow nurse practitioners to act as assessors and providers, a result of a strong lobby by the Canadian Nurses Association. However, a legislated approach to assisted death has proven challenging in a number of areas. Although it facilitates a degree of accountability, precision and accessibility, it has also resulted in particular challenges negotiating the diverse perspectives of such a morally contentious act. One of these challenges is the tendency to conflate what is legal and what is moral in a modern liberal constitutionalism that places supreme value on autonomy and choice. Such a conflation tends to render invisible the legal and moral/ethical considerations necessary for nurses and nurse practitioners to remain ethical actors. In this paper, we introduce this conflation and then discuss the process of lawmaking in Canada, including the legalization of MAiD and the contributions of nursing to that legalization. We then engage in a hypothetical dialogue about the legal and moral/ethical implications of MAiD for nursing in Canada. We conclude with an appeal for morally sustainable workspaces that, when implementing MAiD, appropriately balance patient choices and nurses’ moral well‐being.

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Section: Key Definitionsmentioning

confidence: 99%

“…The law sets out the minimum acceptable standards for the behaviour of societal members and, in contrast to morals and ethics, must be followed. If a person or organization does not meet the legal requirements, liabilities and punishments can result (Duthie, Jiwani, & Steele, ; Foster & Miola, ; Olick, ; Sokol, ).…”

Section: Key Definitionsmentioning

confidence: 99%

But it’s legal, isn’t it? Law and ethics in nursing practice related to medical assistance in dying

et al. 2019

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“…Law and ethics (although they occupy importantly different, though overlapping, domains)16 should speak with one voice about this. The legal presumption is simply an enactment of the precautionary principle.…”

Section: Evidence About Diagnosis and Prognosis: Legal And Ethical Comentioning

confidence: 99%

It is never lawful or ethical to withdraw life-sustaining treatment from patients with prolonged disorders of consciousness

Foster

2019

J Med Ethics

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In English law there is a strong (though rebuttable) presumption that life should be maintained. This article contends that this presumption means that it is always unlawful to withdraw life-sustaining treatment from patients in permanent vegetative state (PVS) and minimally conscious state (MCS), and that the reasons for this being the correct legal analysis mean also that such withdrawal will always be ethically unacceptable. There are two reasons for this conclusion. First, the medical uncertainties inherent in the definition and diagnosis of PVS/MCS are such that, as a matter of medical fact, it can never be established, with the degree of certainty necessary to rebut the presumption, that it is not in the patient’s best interest to remain alive. And second (and more controversially and repercussively), that even if permanent unconsciousness can be unequivocally demonstrated, the presumption is not rebutted. This is because there is plainly more to human existence than consciousness (or consciousness the markers of which can ever be demonstrated by medical investigations). It can never be said that the identity of the patient whose best interests are at stake evaporates (so eliminating the legal or ethical subject) when that person ceases to be conscious. Nor can it be said that the best interests of an unconscious person do not mandate continued biological existence. We simply cannot know. That uncertainty is legally conclusive, and (subject to resource allocation questions and views about the relevance of family wishes and the previously expressed wishes of the patient) should be ethically conclusive.

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“…Ethics and law occupy different but overlapping domains,8 but the process by which ethical duties become hardened into legal obligations and prohibitions is identical in relation to laypeople and all professional people. A negligent plumber is judged by materially the same standard in the law of tort and contract as a negligent obstetrician.…”

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confidence: 99%

Doctors should be morally common: a reply to Rosamond Rhodes

Foster

2019

J Med Ethics

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Rosamond Rhodes contends, by reference to seven examples, that medical ethics is distinctly different from non-medical ethics. Each of those examples, on proper examination, illustrates precisely the opposite contention. It is clear not only that medical ethics relies on the same principles as non-medical (and indeed non-professional) ethics, but that it should so rely. A distinctively medical ethics would be dangerous: it would divorce ethical medical decision-making from the patients whom medicine exists to serve.

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Who's in Charge? The Relationship Between Medical Law, Medical Ethics, and Medical Morality?

Cited by 35 publications

References 0 publications

But it’s legal, isn’t it? Law and ethics in nursing practice related to medical assistance in dying

But it’s legal, isn’t it? Law and ethics in nursing practice related to medical assistance in dying

It is never lawful or ethical to withdraw life-sustaining treatment from patients with prolonged disorders of consciousness

Doctors should be morally common: a reply to Rosamond Rhodes

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