The emergency department is a place of challenging ethical dilemmas and littletime and resources to solve them. Ethical Dilemmas in Emergency Medicineprovides invaluable information, perspectives, and solutions to common ethi-cal dilemmas in emergency medicine. It addresses important topics seen in theemergency department, including triage, medicolegal issues, privacy and con-fidentiality, social media, difficult patients, minors, research, patient safety,disasters, suicide, and end-of-life issues.
The accompanying educational modules provide a unique educationalopportunity for resident and staff education on ethical issues in emergencymedicine. Featuring twenty-three layers of ethical dilemmas in emergencymedicine, along with corresponding multimedia resources, including mediapresentations, case-based discussions, and multiple-choice questions, thisbook is an invaluable resource for residents in training as well as practicingphysicians.
Catherine Marco, MD, FACEP, is a professor at Wright State University in theDepartment of Emergency Medicine. She has been active in the education,research, and writing arenas. She has written numerous research manuscriptsand book chapters on medical ethics, resuscitation, and pain management.
Raquel M. Schears, MD, MPH, FACEP, is a full-time clinician and scholar atthe Mayo Clinic. Currently, she is an associate professor in the Department ofEmergency Medicine. Dr. Schears has written peer-reviewed articles, taught inseveral residency programs, and has conducted clinical research. Her publica-tions reveal career interests in the ethical dilemmas of life-sustaining interven-tions, including advance directives, organ donation and informed consent.
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First published 2015
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A catalog record for this publication is available from the British Library.
Library of Congress Cataloging in Publication DataEthical dilemmas in emergency medicine / [edited by] Catherine Marco,
Raquel Schears.p. ; cm.
Includes bibliographical references and index.isbn 978-1-107-43859-0 (alk. paper)
I. Marco, Catherine A., editor. II. Schears, Raquel, editor.[DNLM: 1. Emergency Medicine – ethics. 2. Patient Rights – ethics. WB 105]
rc86.95174.2′96025–dc23 2015020960
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Professor and ChairmanDepartment of Emergency MedicinePerelman School of MedicineChief, Emergency Services University of Pennsylvania Health SystemPhiladelphia, [email protected]
kelly bookman, md, facep
Associate ProfessorSchool of MedicineUniversity of ColoradoAurora, [email protected]
Perelman School of MedicineUniversity of PennsylvaniaPhiladelphia, [email protected]
arthur r. derse, md, jd, facep
Director, Center for Bioethics and Medical HumanitiesProfessor of Bioethics and Medical Humanities, andProfessor of Emergency MedicineMedical College of WisconsinMilwaukee, [email protected]
Co-Chairman and Professor of Emergency MedicineRuth and Harry Roman Emergency Department, Department of EmergencyMedicineCenter for Healthcare Ethics, Burns and Allen Research InstituteCedars-Sinai Medical CenterLos Angeles, [email protected]
Associate ProfessorDepartment of Emergency MedicineExecutive DirectorOffice of Global HealthThe Ohio State University’s Wexner Medical CenterColumbus, [email protected]
Clinical ProfessorDepartment of Emergency MedicineThe University of MichiganAnn Arbor, MichiganPast PresidentThe American College of Emergency PhysiciansRisk Advisor, The Emergency Physicians Medical GroupAnn Arbor, [email protected]
Director, Emory Palliative Care CenterRoxann Arnold Professor in Palliative CareAssociate ProfessorDepartment of Emergency MedicineEmory University School of MedicineAtlanta, [email protected]
kartik rao, do
Department of Emergency MedicineWright State UniversityDayton, [email protected]
Assistant ProfessorDepartment of Public Health and Preventive MedicineDepartment of Emergency MedicineUniversity of ToledoCollege of MedicineToledo, [email protected]
richard rothman, md, phd
Johns Hopkins UniversitySchool of MedicineDepartment of Emergency MedicineBaltimore, [email protected]
Huntsville Hospital Emergency PhysicianMedical Director for Advanced Care Planning and End of Life EducationProgramsClinical Assistant ProfessorInternal MedicineUAB School of MedicineHuntsville CampusBirmingham, [email protected]
The practice of emergency medicine is a complex mission. Successfulpractice includes emergency stabilization, patient assessment, diagnostictests, and medical interventions. The Accreditation Council for GraduateMedical Education and the American Board of Emergency Medicine haveestablished the Emergency Medicine Milestone Project, a framework forassessment of residents in training in twenty-three milestones, fromEmergency Stabilization to Teamwork.
In this complicated environment, ethical dilemmas frequently arise.The complex, time-pressured environment makes the assessment andmanagement of ethical dilemmas challenging. Thus, a study of ethicalissues and principles guiding their application in the clinical environmentis essential.
This book includes twenty-three chapters, analogous to the twenty-three Emergency Milestones, and in respect to the specialty ofEmergency Medicine, the twenty-third recognized medical specialty bythe American Board of Medical Specialties. Each chapter addresses animportant ethical topic in emergency medicine, including issues, contro-versies, and a summary of Ethics Takeout Tips. Available online areeducational modules for use in teaching ethical principles at any level. Itis our hope that this book will serve as a valuable resource to emergencyproviders and educators.
The editors wish to thank the authors, who have dedicated their time andexpertise to the education and application of principles of medical ethics tothe practice of emergency medicine.
