Ethics

Bioethics for clinicians, revisited

From July 1996 to October 1998 CMAJ published a series of articles discussing important aspects of contemporary bioethics. In October, the journal continued the series with the first of a new set of articles that extend into such previously unvisited terrain as the disclosure of medical error and the determination of brain death. Articles on Aboriginal, Hindu and Sikh, Chinese, Islamic, Jewish and Christian beliefs will explore how cultural perspectives and religious values can affect medical decision-making. CMAJ 2000;163(7):833.

In the first article, researchers discuss the difficulties of applying non-Aboriginal bioethical notions in the context of Aboriginal culture, a context that is itself diverse and pluralistic. The authors describe how values such as holism, autonomy and an emphasis on quality of life may come into play in the health care decisions of Aboriginal patients, and they emphasize the importance of using appropriate communication styles and of understanding the interpersonal and situational dimensions of the decision-making process. CMAJ 2000;163(7):845-50.

Two Victoria authors discuss the cultural and religious traditions of Hindus and Sikhs. Although the two differ profoundly, they both traditionally take a duty-based rather than rights-based approach to ethical decision-making. These traditions also share a belief in rebirth, a concept of karma, an emphasis on the value of purity, and a holistic view of the person that affirms the importance of family, culture, environment and the spiritual dimension of experience. Physicians with Hindu and Sikh patients need to be sensitive to and respectful of the diversity of their cultural and religious assumptions regarding human nature, purity, health and illness, life and death, and the status of the individual. CMAJ 2000;163(9):1167-70.

Manitoba pharmacists get conscience clause

The Manitoba Pharmaceutical Association now allows pharmacists to refuse to provide a prescription if they object to the prescribed drug on moral or religious grounds. Any pharmacist who invokes the conscience clause must still ensure that the customer’s needs are met. Some pharmacists object to dispensing drugs such as the morning-after pill because of their pro-life beliefs. CMAJ 2000;163(3):320.

Copyright 2000 Canadian Medical Association or its licensors