Abstract:

This article provides a brief survey of medical ethics in the United States. It begins with a short sketch of issues in theoretical medical ethics, but the article's primary focus is on applied medical ethics. The discussion of applied medical ethics begins with a review of important norms of clinical ethics which are generally accepted in the United States. These settled norms include:(1) decision - making for competent patients should be shared.(2) Competent patients have a right to refuse medical treatment, including life - sustaining treatment.(3) Decision - making for incompetent patients can be approximated by advance directives and/or surrogate decision - makers.(4) Surrogate decision - making for incompetent patients should be based on the substituted judgment and/or best interests standards. In addition, the following areas of continuing controversy are discussed: medical futility, the moral authority of advance directives, physician assisted suicide and active euthanasia ("mercy killing"), the standard of death, living related organ donation, AIDS, reproductive technology, genetic technology, cost containment, and access to health care. The article ends with a brief discussion of ethical issues related to research with human subjects in the United States.

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