Clinical Ethics: Due Care and the Principle of Nonmaleficence

In Clinical Ethics, Robert Timko argues that the moral dilemmas of clinical medical practice can best be resolved within a framework of prima facie duties, and that the most stringent duty is that of nonmaleficence. Timko shows that respect for individual autonomy and the principle of beneficence are inadequate for the moral practice of medicine since simple adherence to either principle may be insufficient for the provision of 'due care.' Clinical health care practitioners should know and understand their clients' perceptions of illness and suffering and their life-plans and values if they wish to avoid bringing further harm to their clients. Additionally, Timko argues that the prevention of harm is best served and 'due care' best provided if the clinical relationship is defined within the framework of a covenantal agreement between health-care practitioners and the moral community. Intrinsic to his argument is the belief that it is not only permissible to limit a client's autonomy, but that is sometimes obligatory to do so. In terms of a community's overall good, paternalistic interventions appear to be justifiable and sometimes necessary. Finally, Joan Hoff provides an insightful commentary on the logic of a communitarian ethic as the foundation for a just health-care system and the understanding of virtue and responsibility in health-care practice.

Table of Contents:
Chapter 1 Preface Chapter 2 Acknowledgements Chapter 3 Overview Chapter 4 Perceptions of Illness and Suffering Chapter 5 Models for the Clinical Relationship Chapter 6 The Questions of Autonomy and Autonomous Choice Chapter 7 The Question of Informed Consent Chapter 8 Refusal and the Duty of Informed Choice Chapter 9 The Principle of Beneficence Chapter 10 The Principle of Nonmaleficence Chapter 11 Conclusions and Proposals Chapter 12 Commentary: Health Care as a Common Good Chapter 13 Bibliography Chapter 14 Index Chapter 15 About the Author