The study of ethics has been defined as the way of understanding and examining the moral life (Beauchamp and Childress, Principles of Biomedical Ethics, 4th ed., 1994), and as the study of standards of conduct and moral judgment (Webster's Dictionary). The Hippocratic Oath has been revered as one of the oldest codes of medical ethics. More recently, the American Medical Association (AMA) Code of Ethics (earliest version from 1847) and American College of Emergency Physicians (ACEP) Code of Ethics (1997) have provided guidance to emergency physicians in application of ethical principles to clinical practice. Most ethical codes address common features, such as beneficence (doing good), nonmalfeasance (primum non nocere, or "do no harm"), respect for patient autonomy, confidentiality, honesty, distributive justice, and respect for the law. Ethical dilemmas may arise when there is a seeming conflict between two ethical principles or values. Ethical dilemmas may be resolved by various means, including individual physician judgment, additional information gathering, meetings with health care professionals, patients, and families. In some circumstances, the involvement of the institutional ethics committee or the judicial system may be sought. Several ethical situations related to emergency medicine are explored in this chapter.
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