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60 - Primary care ethics

Published online by Cambridge University Press:  30 October 2009

Margaret Moon
Affiliation:
Assistant Professor Johns Hopkins University, Baltimore
Mark Hughes
Affiliation:
Assistant Professor Johns Hopkins University, Baltimore
Jeremy Sugarman
Affiliation:
Professor Johns Hopkins University, Baltimore
Peter A. Singer
Affiliation:
University of Toronto
A. M. Viens
Affiliation:
University of Oxford
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Summary

Ms. G is 17 years old and needs a physical examination prior to participating in high school sports. Her physician, Dr. M, has been the primary care clinician for Ms. G and her parents for the last 10 years. During Ms. G's last annual visit, Dr. M engaged her in a routine discussion about sex, birth control, abstinence, and safety. Ms. G asked questions but denied any sexual activity. Dr. M counseled Ms. G to continue the discussion with her mother. At today's clinic visit, Ms. G reports that she has been sexually active for a few months and would like to start birth control. Additionally, she is worried because her menstrual period is a little late and she complains of some abdominal discomfort and a vaginal discharge. Ms. G is adamant that Dr. M does not reveal her sexual activity to her parents.

Mr. H is 47 years old and has hypertension and high cholesterol, despite an active exercise regimen and healthy eating habits. He has a strong family history of hypertension. His mother had a stroke at age 57 and is disabled. Mr. H supports his mother as well as his wife and their three young children. He refuses to take medication, either for his blood pressure or for his elevated cholesterol. He mentions that he has “no faith in medications” and that his mother was taking appropriate medication when she had a stroke.

What is primary care ethics?

To understand the ethics of primary care, it is important to delineate the unique characteristics of primary care.

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Publisher: Cambridge University Press
Print publication year: 2008

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References

American College of Physicians (2005). Ethics Manual, 5th edn. Philadelphia, PA: American College of Physicians (www.acponline.org/ethics/ethicman.htm#init) accessed 29 April 2006.
American Medical Association (2003). Policy E-8.115: Termination of the Physician Patient Relationship. Chicago, IL: American Medical Association (www.ama–assn.org/ama/pub/category/8496.html) accessed 29 April 2006.
Brett, A. (2000). Inappropriate requests for treatment and tests. In 20 Common Problems: Ethics in Primary Care, ed. Sugarman, J.. New York: McGraw-Hill Press, pp. 3–11.Google Scholar
College of Physicians and Surgeons of Ontario (2000). Policy 4–0: Ending the Physician Patient Relationship. Ontario: College of Physicians and Surgeons (www.cpso.on.ca/Policies/ending.htm) accessed 29 April 2006.
Connelly, J. and Dalle Mura, S. (1988). Ethical problems in the medical office. JAMA 260: 812–15.CrossRefGoogle ScholarPubMed
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Fryer, G. E., Green, L. A., Dovey, S. M., Yean, B. P., and Phillips, L. D. (2003). Variation in the ecology of medical care. Ann Family Med 1:81–9.CrossRefGoogle ScholarPubMed
Jonsen, A. R., Siegler, M., and Winslade, W. (2002). Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine, 5th edn. New York: McGraw-Hill.Google Scholar
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Rogers, W. and Braunack-Mayer, A. (2004). Practical Ethics for General Practice.New York: Oxford University Press, p. 3.Google Scholar
Starfield, B. (1998). Primary Care: Balancing Health Needs, Services, and Technology, 2nd edn, New York: Oxford University Press.Google Scholar

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  • Primary care ethics
  • Edited by Peter A. Singer, University of Toronto, A. M. Viens, University of Oxford
  • Book: The Cambridge Textbook of Bioethics
  • Online publication: 30 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545566.070
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  • Primary care ethics
  • Edited by Peter A. Singer, University of Toronto, A. M. Viens, University of Oxford
  • Book: The Cambridge Textbook of Bioethics
  • Online publication: 30 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545566.070
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Primary care ethics
  • Edited by Peter A. Singer, University of Toronto, A. M. Viens, University of Oxford
  • Book: The Cambridge Textbook of Bioethics
  • Online publication: 30 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545566.070
Available formats
×