ETHICS IN MEDICINE   University of Washington School of Medicine
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Additional Readings

This reading list is arranged alphabetically by Bioethics Topics. These references are intended to serve as a resource for your research and writing. For many of these topics, you will also want to consult good general references in ethics:
  • Jonsen AR, Siegler M, Winslade WJ. Clinical Ethics. 6th edition. New York: McGraw-Hill; 2006.
  • Reich WT ed. Encyclopedia of Bioethics. Revised Edition. New York: Simon Schuster and MacMillan; 1995.

Use the alphabet menu to go to the general area of your topic title or scroll to find a specific title. Clicking on a topic title will take you to that specific topic.


bulletAdvance Care Planning & Advance Care Directives

  • Barnard D. Living with doubt. American Journal of Bioethics 2010;10(4):27-28.
  • Chochinov HM. Dignity Therapy: Final Words for Final Days. New York, NY; Oxford, UK University Press, 2011.
  • Detering KM, Hancock AD, Reade MC, Silvester W. The impact of advance care planning on end of life care in elderly patients: a randomized controlled trial. British Medical Journal 2010; 340: c1345.
  • Doukas DJ, Hardwig J. Using the family covenant in planning end-of-life care: obligations and promises of patients, families, and physicians. Journal of the American Geriatrics Society 2003 Aug;51(8):1155-8.
  • Dresser R. Advance directives. Implications for policy. Hastings Center Report 1994; 24: S2-5.
  • El-Jawahri A, Podgurski LM, Eichler AF, Plotkin SR. Temel JS, Mitchell SL, Cang Y, Barry MJ, Volandes AE. Use of video to facilitate end-of-life discussions with patients with cancer: a randomized controlled trial. Journal of Clinical Oncology 2010; 28(8): 305-310.
  • Fagerlin A, Schneider CE. Enough. The failure of the living will. Hastings Center Report 2004; 34(2): 30-42.
  • Hammes BJ, Rooney BL. Death and end-of-life planning in one Midwestern community. Archives of Internal Medicine 1998;158(4): 383-390.
  • Hickman SE, Nelson CA, Moss AH, Hammes BJ, Terwilliger A, Jackson A, Tolle SW. Use of the Physician Orders for Life-Sustaining Treatment (POLST) paradigm program in the hospice setting. Journal of Palliative Medicine 2009; 12(2): 133-41.
  • Levi BH, Green MJ. Too soon to give up: re-examining the value of advance directives. American Journal of Bioethics 2010; 10(4): 3-22.
  • Pearlman R, Cole W, Patrick D, Starks H, Cain K. Advance care planning: eliciting patient preferences for life-sustaining treatment. Patient Education and Counseling 1995; 26:353-361.
  • Pearlman R, Starks H, Cain K, Cole W, Rosengren D, Patrick D. Your Life Your Choices--planning for future medical decisions: how to prepare a personalized living will. Available at:
  • Sabatino CP. The evolution of health care advance planning law and policy. Milbank Quarterly 2010; 88(2): 211-239.
  • Silveira MJ, Kim SYH, Langa KM. Advance directives and outcomes of surrogate decision-making before death. New England Journal of Medicine 2010; 362:1211-1218.
  • Stein J. The ethics of advance directives: a rehabilitation perspective. American Journal of Physical Medicine & Rehabilitation 2003 Feb; 82(2): 152-7.
  • Sudore RL, Fried TR. Redefining the “planning” in advance care planning: preparing end-of-life decision making. Annals of Internal Medicine 2010; 153(4): 256-261.
bulletBreaking Bad News
  • Back AL, Trinidad SB, Hopley EK, Arnold RM, Baile WF, Edwards KA. What patients value when oncologists give news of cancer recurrence: Commentary on specific moments in audio-recorded conversations. Oncologist. 2011;16(3):342-350.
  • Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP. SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer. Oncologist. 2000;5(4):302-11.
  • Campbell TC, Carey EC, Jackson VA, Saraiya B, Yang HB, Back, AL, Arnold RM. Discussing prognosis: Balancing hope and realism. Cancer Journal. 2010;16(5):461-466.
  • Fujimori M, Akechi T, Morita T, Inagaki M, Akizuki N, Sakano Y, Uchitomi Y. Preferences of cancer patients regarding the disclosure of bad news. Psycho-Oncology. 2007;16(6):573-581.
  • Martins RG, Carvalho IP. Breaking bad news: Patients’ preferences and health locus of control. Patient Education and Counseling. 2013;92(1):67-73.
  • Von Gunten CF, Ferris FD, Emanuel LL. The patient-physician relationship. Ensuring competency in end-of-life care: communication and relational skills. Journal of the American Medical Association. 2000 Dec 20;284(23):3051-7.

bulletComplementary Medicine
  • Astin JA. Why patients use alternative medicine. Journal of the American Medical Association. 1998; 279:1548-1553.
  • Complementary and Alternative Medicine in the United States; Committee on the Use of Complementary and Alternative Medicine by the American Public. Retrieved from:
  • Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States - Prevalence, Costs and Patterns of Use. New England Journal of Medicine. 1993; 328: 246-252.
  • Ernst E. Complementary medicine: Implications for informed consent in general practice. British Journal of General Practice. 2004; February: 82-83.
  • Kimmelman J. The therapeutic misconception at 25: Treatment, research, and confusion. Hastings Center Report. 2007; 37(6): 36-42.
  • Miller FG, Emanuel EJ, Rosenstein DL, Straus SE. Ethical issues concerning research in complementary and alternative medicine. Journal of the American Medical Association. 2004; 291(5): 599-604.
  • Sugarman J. Informed consent, shared decision-making, and complementary and alternative medicine. Journal of Law, Medicine & Ethics. 2003; 31: 247-250.
  • Tilburt JC, Curlin FA, Kaptchuk TJ, Clarridge B, Bolcic-Jankovic D, Emanuel EJ, Miller FG. Alternative Medicine Research in Clinical Practice: A US National Survey. Archives of Internal Medicine. 2009; Apr 13; 169(7): 670-677.
    • Boyte WR, Blackston JW, Douglas S, Crook ED. Caring for adolescent family members of physician colleagues. The American Journal of the Medical Sciences 2002; 323: 49-53.
    • Clark PA. Confidentiality and the physician-patient relationship -- ethical reflections from a surgical waiting room. Medical Science Monitor 2002; 8: SR31-34.
    • Clayton EW. Ethical, legal, and social implications of genomic medicine. The New England Journal of Medicine 2003; 349: 562-569.
    • Diaz A, Neal WP, Nucci AT, Ludmer P, Bitterman J, Edwards S. Legal and ethical issues facing adolescent health care professionals. The Mount Sinai Journal of Medicine 2004; 71: 181-5.
    • Freedman B. Violating confidentiality to warn of a risk of HIV infection: ethical work in progress. Theoretical Medicine 1991;12: 309-23.
    • Green SA. The ethical limits of confidentiality in the therapeutic relationship. General Hospital Psychiatry 1995;17: 80-4.
    • Sankar P, Mora S, Merz JF, Jones NL. Patient perspectives of medical confidentiality: a review of the literature. Journal of General Internal Medicine. 2003; 18: 659-669.
    • Sobel R. The HIPAA Paradox: the privacy rule that’s not. Hastings Center Report 2007; 37: 40-50.
    • Waz W. The need to know: disclosure of information to pediatric patients. Ethics and Medicine 2010; 26: 75-79.
bulletCross-Cultural Issues and Diverse Beliefs
  • Bowman K. What are the Limits of Bioethics in a Culturally Pluralistic Society. Journal of Law and Medical Ethics 2004; 32(4): 664-669.
  • Carrese JA, Rhodes LA. Western bioethics on the Navajo Reservation: benefit or harm? JAMA 1995; 274: 826-9.
  • Diekema DS. Revisiting the Best Interest Standard: Uses and Misuses. Journal of Clinical Ethics 2011; 22(2): 128-133.
  • Gupta VB, Willert J, Pian M, Stein MT. When Disclosing a Serious Diagnosis to a Minor Conflicts with Family Values. Journal of Developmental and Behavioral Pediatrics 2008; 29(3): S100-S102.
  • Jecker NS, Carrese JA, Pearlman RA. Caring for patients in cross-cultural settings. Hastings Center Report 1995; 25: 6-14.
  • Gyamfi C, Gyamfi MM, Berkowitz RL. Ethical and medicolegal considerations in the obstetric care of a Jehovah's Witness. Obstetrics and Gynecology 2003 Jul; 102(1): 173-80.
  • Learman LA, Kuppermann M, Gates E, Nease RF Jr, Gildengorin V, Washington AE. Social and familial context of prenatal genetic testing decisions: are there racial/ethnic differences? American Journal of Medical Genetics 2003 May 15; 119C(1): 19-26.
  • Lapine A, Wang-Cheng R, Goldstein M, Nooney A, Lamb G, Derse AR. When cultures clash: physician, patient, and family wishes in truth disclosure for dying patients. Journal of Palliative Medicine 2001Winter; 4(4): 475-80.
  • Paasche-Orlow M. The ethics of cultural competence. Academic Medicine 2004 Apr; 79(4): 347-50.
  • Sayeed S, Padela A, Naim MY, Lantos JD. A Saudi family making end-of-life decisions in the PICU. Pediatrics 2012 Apr; 129(4): 764-768.
  • Quest TE, Franks NM. Vulnerable populations: cultural and spiritual direction. Emergency Medicine Clinics of North America 2006 Aug; 24(3): 687-702.

bulletDifficult Patients

  • Friedman EA. Must we treat noncompliant ESRD patients? Seminars in Dialysis.  2001 Jan-Feb;14(1):23-7.
  • Shapiro J, Lie D. Using literature to help physician-learners understand and manage "difficult" patients. Academic Medicine.  2000 Jul;75(7):765-8. 
  • Rianthavorn P, Ettenger RB, Malekzadeh M, Marik JL, Struber M. Noncompliance with immunosuppressive medications in pediatric and adolescent patients receiving solid-organ transplants.  Transplantation. 2004 Mar 15;77(5):778-82
  • Brennan TA, Lee TH. Allergic to generics. Annals of Internal Medicine.  2004 Jul 20;141(2):126-30. 

bulletDo-Not-Resuscitate (DNR) Orders

  • American Heart Association (AHA). 2010 American Heart Association Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010: 122[18 suppl 3]; S640-908.
  • Bishop J, Brothers K, Perry J, et. al. Reviving the conversation around CPR/DNR. American Journal of Bioethics. 2010:10(1); 61-67.
  • Blinderman CD, Krakauer EL, Solomon MZ. Time to revise the approach to determining cardiopulmonary resuscitation status. JAMA. 2012: 307(9); 917-918.
  • Burns JP, Edwards J, Johnson J, Cassem NH, Truog RD. Do-not-resuscitate order after 25 years. Critical Care Medicine. 2003: 31(5); 1543-50.
  • Burns J, Truog R. Futility: A concept in evolution. Chest. 2007: 132; 1987-1993.
  • Frader J, Kodish E, Lantos JD, et. al. Ethics rounds symbolic resuscitation, medical futility, and parental rights. Pediatrics. 2010: 126; 769-772.
  • Garza AG, Gratton MC, Solomone JA, et. al. Improved patient survival using a modified resuscitation protocol for out-of-hospital cardiac arrest. Circulation. 2009: 119; 2597-2605.
    Meaney P, Nadkarni V, Kern K, et. al. Rhythms and outcomes of adult in-hospital cardiac arrest. Critical Care Medicine. 2010: 38(1); 101-108.
  • Quill TE, Arnold R, Back AL. Discussing treatment preferences with patients who want “everything”. Annals of Internal Medicine. 2009: 151(5); 345-350.
  • Washington State Medical Association. Physicians Orders for Life Sustaining Treatment. Retrieved August 13, 2013 from

    small bulletDuring Anesthesia and Urgent Procedures
  • Jackson SH, Van Norman G.  Goals and values directed approach to informed consent in the “DNR” patient presenting for surgery—more demanding for the anesthesiologist?  Anesthesiology 1999; 990:901-5
  • Troug RD, Waisel DB, Burns JP.  DNR in the OR:  A goal-directed approach.  Anesthesiology 1999; 990:289-95
  • Waisel DB, Burns JP, Johnsons JA, Hardart GE, Troug RD.  Guidelines for perioperative do-not-resuscitate policies.  Journal of Clinical Anesthesia.  2002; 14:467-73
  • Ross LF.  Do not resuscitate orders and iatrogenic arrest during dialysis:  should “no” mean “No”?  Seminars in Dialysis.  2003; 16:395-8
  • Stevenson LW.  Rites and responsibility fo rresuscitations in heart failure:  tread gently on the thin places.  Circulation. 1998; 98:619-22
  • Tulsky JA, Chesney MA, Lo B.  How do medical residents discuss resuscitation with patients?   Journal of General Internal Medicine. 1995; 10:436-41
bulletEnd-of-Life Issues
  • Lynn J. An 88-year old woman facing the end of life. JAMA 1997;277: 1633-1640.
  • Brody H, Campbell ML, Faber-Langendoen K, Ogle KS. Withdrawing intensive life-sustaining treatment--recommendations for compassionate clinical management. NEJM 1997;336:652-657.
  • Quill TE, Byock IR. Responding to intractable terminal suffering: the role of terminal sedation and voluntary refusal of food and fluids. ACP-ASIM End-of-Life Care Consensus Panel. American College of Physicians-American Society of Internal Medicine. Annals of Internal Medicine. 2000 Mar 7;132(5):408-14.
  • Arnold RM, Kellum J. Moral justifications for surrogate decision making in the intensive care unit: implications and limitations. Critical Care Medicine. 2003 May;31(5 Suppl):S347-53.
  • Cimino JE.  A clinician's understanding of ethics in palliative care: an American perspective.Critical Reviews in Oncology/Hematology. 2003 Apr;46(1):17-24. 
bulletEthics Committees and Ethics Consultation
  • American Society for Bioethics and Humanities. Core Competencies for Health Care Ethics Consultation 2nd edition, 2010 (available through the American Society for Bioethics and Humanities—see website below).
  • Dubler NN, Webber MP, Swiderski DM, and the Faculty and the National Working Group for the Clinical Ethics Credentialing Project. Charting the Future: Credentialing, Privileging, Quality, and Evaluation in Clinical Ethics Consultation. Hastings Center Report2009;39(6): 23-33.
  • Eiser AR, Schade SG, Anderson-Shaw L, Murphy T. Electronic communication in ethics committees: experience and challenges. Journal of Medical Ethics. 2001 Apr;27 Suppl 1:i30-2. 
  • Fox E, Bottrell MM, Berkowitz KA, Chanko BL, Foglia MB, Pearlman RA. IntegratedEthics: an innovative program to improve ethics quality in health care. Innovation Journal: the Public Sector Innovation Journal. 2010;15(2):article 8, 1-36.
  • Lo B. Behind closed doors: promises and pitfalls of ethics committees. New England Journal of Medicine. 1987;317:46-49
  • Opel DJ, Brownstein D, Diekema DS, Wilfond BS, Pearlman RA. Integrating ethics and patient safety: the role of clinical ethics consultants in quality improvement. Journal of Clinical Ethics. 2009;20(3):220-7.
  • Schneiderman LJ, Gilmer T, Teetzel HD, Dugan DO, Blustein J, Cranford R, Briggs KB, Komatsu GI, Goodman-Crews P, Cohn F, Young EW. Effect of ethics consultations on nonbeneficial life-sustaining treatments in the intensive care setting: a randomized controlled trial. Journal of the American Medical Association. 2003 Sep 3;290(9):1166-72.
  • Spike J, Greenlaw J. Ethics consultation: high ideals or unrealistic expectations? Annals of Internal Medicine. 2000 Jul 4;133(1):55-7.
  • Back AI, Arnold RM. Dealing with Conflict in Caring for the Seriously Ill: ‘It was Just Out of the Question’. Journal of the American Medical Association 2005; 293:1374-1381.
  • Dominic JC & J Savulescu. Knowing when to stop: futility in the ICU. Current Opinion in Anesthesiology 2011, 24:160-165.
  • Moratti, S. The development of ‘medical futility’: towards a procedural approach based on the role of the medical profession. Journal of Medical Ethics. 2009; 35:369-372.
  • Quill TE, Arnold R, Back AL. Discussing Treatment Preferences with Patients Who Want Everything. Annals of Internal Medicine. 2009; 151:345-9.
  • Rubin, S. When Doctors Say No: the Battleground of Medical Futility. Bloomington, Indiana: Indiana University Press, 1998.
  • Schneiderman LJ, Jecker NS, Jonsen AR. Medical futility: its meaning and ethical implications. Annals of Internal Medicine. 1990; 112:949-54.
  • Schneiderman LJ, Jecker NS, Jonsen AR. Medical futility: responses to critiques. Annals of Internal Medicine. 1996; 125:669-74.
  • Schneiderman LJ, Jecker NS. Wrong Medicine, 2nd Edition. Baltimore: Johns Hopkins University Press, 2011.
  • Texas Health and Safety Code, Annotated, sec.166.046 (West 2006).
  • Truog RD. Is it Always Wrong to Perform Futile CPR? New England Journal of Medicine. 2010;362(6): 477-479.


  • Clayton EW. Ethical, legal, and social implications of genomic medicine.
    The New England Journal of Medicine.  2003 Aug 7;349(6):562-9.
  • Greely HT. Informed consent and other ethical issues in human population genetics. Annual Review of Genetics.  2001;35:785-800. 
  • Surbone A. Ethical implications of genetic testing for breast cancer susceptibility. Critical Reviews in Oncology/Hematology. 2001 Nov;40(2):149-57.
bulletHIV and AIDS
  • Fenton KA, Peterman TA. HIV partner notification: taking a new look. AIDS 1997;11(13):1535-46.
  • Gostin L, Ward J, Baker A. National HIV case reporting for the United States: a defining moment in the history of the epidemic. NEJM 1997;337:1162-7.
  • Parsa M, Walsh MJ Ethics seminars: HIV testing, consent, and physician responsibilities.  Academic Emergency Medicine.  2001 Dec;8(12):1197-9. 
  • Lo B, Wolf L, Sengupta S. Ethical issues in early detection of HIV infection to reduce vertical transmission. Journal of Acquired Immune Deficiency Syndromes.  2000 Dec 15;25 Suppl 2:S136-43.              
  • Scarrow SE.  Obstetrical delivery of the HIV-positive woman: legal and ethical considerations. Obstetrical & Gynecological Survey. 2001 Mar;56(3):178-83. 
  • Keshavjee S, Weiser S, Kleinman A. Medicine betrayed: hemophilia patients and HIV in the US. Social Science & Medicine. 2001 Oct;53(8):1081-94. 
bulletInformed Consent
  • Brody H. Transparency: informed consent in primary Care. Hastings Center Report. 1989;19(5):5-9.
    Meisel A, Kuczewski M. Legal and ethical myths about informed consent. Archives of Internal Medicine. 1996;156(22):2521-6.
  • Kim SY, Appelbaum PS, Jeste DV, Olin JT. Proxy and surrogate consent in geriatric neuropsychiatric research: update and recommendations. The American Journal of Psychiatry. 2004 May;161(5):797-806.
  • Committee on Bioethics. Informed consent, parental permission, and assent in pediatric practice. Pediatrics1995 Feb;95(2):314-317.
  • Cooper SP, Heitman E, Fox EE, Quill B, Knudson P, Zahm SH, MacNaughton N, Ryder R. Ethical issues in conducting migrant farmworker studies. Journal of Immigrant Health. 2004 Jan;6(1):29-39.
  • Council on Ethical and Judicial Affairs of the American Medical Association. Performing procedures on the newly deceased. Academic Medicine. 2002 Dec;77(12 Pt 1):1212-6.
  • Easton RB, Graber MA, Monnahan J, Hughes J. Defining the scope of implied consent in the emergency department. The American Journal of Bioethics. 2007 Dec;7(12):35-38.
  • Report on the Council of Ethical and Judicial Affairs. Withholding Information from Patients. American Medical Association. Retrieved from:
  • Santen SA, Hemphill RR, McDonald MF, Jo CO. Patients' willingness to allow residents to learn to practice medical procedures. Academic Medicine. 2004 Feb;79(2):144-7.
  • Whitney SN, McCullough LB. Physician’ silent decisions: because patient autonomy does not always come first. The American Journal of Bioethics. 2007 July;7(7):33-38.
  • Wynia MK. Routine Screening: Informed consent, stigma, and the waning of HIV exceptionalism. The American Journal of Bioethics. 2006 July;6(4):5-8.
  • Zawistowski CA, Frader JE. Ethical problems in pediatric critical care: consent. Critical Care Medicine. 2003 May;31(5 Suppl):S407-10.

small bullet in the Operating Room

  • Wilson RF. Unauthorized practice: teaching pelvic examination on women under anesthesia. Journal of the American Medical Women's Association.  2003 Fall; 58(4):217-20; discussion 221-2.
  • Kahler DM, Davis W.  Inability to obtain formal informed consent in the face of a standard surgical indication. The Journal of Bone and Joint Surgery. American Volume 2001 Jan;83-A(1):142-3. 
bulletInterdisciplinary Team Issues
  • Shannon SE. The roots of interdisciplinary conflict around ethical issues. Critical Care Nursing Clinics of North America 1997;9:13-27.
  • Cashman S, Reidy P, Cody K, Lemay C. Developing and measuring progress toward collaborative, integrated, interdisciplinary health care teams. Journal of Interprofessional Care. 2004 May;18(2):183-96. 
  • Abreu BC, Zhang L, Seale G, Primeau L, Jones JS. Interdisciplinary meetings: investigating the collaboration between persons with brain injury and treatment teams. Brain Injury. 2002 Aug;16(8):691-704.
  • Liberman RP, Hilty DM, Drake RE, Tsang HW. Requirements for multidisciplinary teamwork in psychiatric rehabilitation.  Psychiatric Services.  2001 Oct;52(10):1331-42.
  • Sommers LS, Marton KI, Barbaccia JC, Randolph J. Physician, nurse, and social worker collaboration in primary care for chronically ill seniors.  Archives of Internal Medicine.  2000 Jun 26;160(12):1825-33.
bulletLaw and Medical Ethics

bulletMaternal/Fetal Conflict
  • Mattingly SS. The maternal-fetal dyad: exploring the two patient obstetrical model. Hastings Center Report 1992;22(1):13-18.
  • Harris LH.  Obstet Gynecol. 2000 Nov;96(5 Pt 1):786-91.
    Rethinking maternal-fetal conflict: gender and equality in perinatal ethics.
  • Dickens BM, Cook RJ. Ethical and legal approaches to 'the fetal patient'.
    International Journal of Gynaecology and Obstetrics. 2003 Oct;83(1):85-91. 
  • Oduncu FS, Kimmig R, Hepp H, Emmerich B.  Cancer in pregnancy: maternal-fetal conflict.  Journal of Cancer Research and Clinical Oncology.  2003 Mar;129(3):133-46. Epub 2003 Mar 18. 
  • Hilfiker D. Facing our mistakes. NEJM 1984; 310:118-122.
  • Leape LL. Error in medicine. JAMA 1994; 272: 1851-1857.
  • Wu A, Cavanaugh TA, McPhee SJ, Lo B, Micco GP. To tell the truth: ethical and practical issues in disclosing medical mistakes to patients. Journal of General Internal Medicine 1997; 12: 770-775.
  • Kapp MB. Medical mistakes and older patients: admitting errors and improving care. Journal of the American Geriatrics Society. 2001 Oct;49(10):1361-5. 
  • Rosner F, Berger JT, Kark P, Potash J, Bennett AJ. Disclosure and prevention of medical errors. Committee on Bioethical Issues of the Medical Society of the State of New York.  Archives of Internal Medicine.  2000 Jul 24;160(14):2089-92. 
  • Hall JK.  Legal consequences of the moral duty to report errors.  JONA'S Healthcare Law, Ethics and Regulation.   2003 Sep;5(3):60-4. 
  • Crook ED, Stellini M, Levine D, Wiese W, Douglas S. Medical errors and the trainee: ethical concerns.   The American Journal of the Medical Sciences.  2004 Jan;327(1):33-7. 
  • Hevia A, Hobgood C.  Medical error during residency: to tell or not to tell.  Annals of Emergency Medicine.  2003 Oct;42(4): 565-70.
bulletNeonatal ICU Issues
  • Carter BS, Sandling J. Decision making in the NICU: the question of medical futility. Journal of Clinical Ethics 1992;3(2):142-3;discussion 143-5.
bulletParental Decision Making
  • Committee on Bioethics, American Academy of Pediatrics. Informed consent, parental permission, and assent in pediatric practice. Pediatrics 1995; 95: 314-317.
  • Diekema DS. Parental Refusals of Medical Treatment: The Harm Principle as Threshold for State Intervention. Theoretical Medicine & Bioethics 2004; 25: 243-264.
  • Diekema DS and the Committee on Bioethics, American Academy of Pediatrics. Responding to Parental Refusals of Immunization. Pediatrics 2005; 115: 1428-1431.
  • English A, Shaw FE, McCauley MM, Fishbein D. Legal Basis of Consent for Health Care and Vaccination for Adolescents. Pediatrics. 2008; 121: S85-S87.
  • Hanisco CM. Acknowledging the Hypocrisy: Granting Minors the Right to Choose Their Medical Treatment. New York Law School Journal of Human Rights 2000; 16: 899-932.
  • Miller VA, Drotar D. Discrepancies between mother and adolescent perceptions of diabetes-related decision-making autonomy and their relationship to diabetes-related conflict and adherence to treatment. Journal of Pediatric Psychology 2003; 28(4): 265-74.
  • Ross LF. Children, Families and Health Care Decision-making. New York: Oxford University Press, 1998.
  • Sher EJ. Choosing for Children: Adjudicating Medical Care Disputes between Parents and the State. New York University Law Review 1983; 58: 157-206.


  • Back AL, Wallace JI, Starks HE, Pearlman RA. Physician-assisted suicide and euthanasia in Washington State. Patient requests and physician responses. JAMA. 1996;275(12):919-925.
  • Back AL, Starks H, Hsu C, Gordon JR, Bharucha A, Pearlman RA. Clinician-patient interactions about requests for physician-assisted suicide: a patient and family view. Arch Intern Med. 2002;162(11):1257-1265.
  • Battin, MP. The Least Worst Death. Oxford: Oxford University Press, 1994.
  • Cohen JS, Fihn SD, Boyko EJ, Jonsen AR, Wood RW. Attitudes toward assisted suicide and euthanasia among physicians in Washington State. N Engl J Med. Jul 14 1994;331(2):89-94.
  • Dobscha SK, Heintz RT, Press N, Ganzini L. Oregon physicians' responses to requests for assisted suicide: A qualitative study. J Palliative Med. 2004;7(3):451-461.
  • Emanuel, L. Facing requests for physician-assisted suicide: Toward a practical and principled clinical skill set. JAMA 1998; 280(7):643-647.
  • Ganzini L, Nelson HD, Schmidt TA, Kraemer DF, Delorit MA, Lee MA. Physicians' experiences with the Oregon Death with Dignity Act. N Engl J Med. 2000;342(8):557-563.
  • Ganzini L, Nelson HD, Lee MA, Kraemer DF, Schmidt TA, Delorit MA. Oregon physicians' attitudes about and experiences with end-of-life care since passage of the Oregon Death with Dignity Act. JAMA. 2001;285(18):2363-2369.
  • Quill T, Arnold RM. Evaluating requests for hastened death. Fast Fact #156. J Palliat Med.  2008:11(8):1151-52.
  • Quill T, Arnold RM. Responding to a request for hastening death. Fast Fact #159. J Palliat Med.  2008:11(8):1152-53.
bulletPhysician-Patient Relationship
  • Brock DW, Wartman SA. When competent patients make irrational choices. NEJM 1990; 322: 1595-9..
  • Clark NM, Nothwehr F, Gong M, et al. Physician-patient partnership in managing chronic illness. Academic Medicine 1995; 70: 957-9.
  • Emanuel EJ, Emmanuel LC. Four models of the physician-patient relationship. JAMA. 1992;267:323-9.
  • Halpern J.  What is clinical empathy? Journal of General Internal Medicine.  2003 Aug;18(8):670-4.
  • Illingworth R. What does 'patient-centred' mean in relation to the consultation? The Clinical Teacher. 2010 Jun;7(2):116-20. doi: 10.1111/j.1743-498X.2010.00367.x.
  • Post SG, Puchalski CM, Larson DB.  Physicians and patient spirituality: professional boundaries, competency, and ethics. Annals of Internal Medicine. 2000 Apr 4;132(7):578-83. 
  • Teal CR, Street RL. Critical elements of culturally competent communication in the medical encounter: A review and model. Social Science & Medicine. 2009 Feb;68(3):533-43.
bulletPrenatal Diagnosis
  • Evans MI, Krivchenia EL, Yaron Y. Screening.  Best Practice & Research. Clinical Obstetrics & Gynaecology. 2002 Oct;16(5):645-57. 
  • Schimpf MO, Domino SE.  Implications of the Human Genome Project for obstetrics and gynecology.  Obstetrical & Gynecological Survey.  2001 Jul;56(7):437-43. 
  • Robertson JA. Extending preimplantation genetic diagnosis: medical and non-medical uses.  Journal of Medical Ethics. 2003 Aug;29(4):213-6. 
  • Blumenthal D. Doctors in a wired world: can professionalism survive connectivity? The Milbank Quarterly. 2002; 80(3): 525-46, iv.
  • Chervenak FA, McCullough LB. Neglected ethical dimensions of the professional liability crisis. American Journal of Obstetrics and Gynecology. 2004 May; 190(5): 1198-200.
  • Collier R. Professionalism: How payment models affect physician behaviour. Canadian Medical Association Journal. 2012; 184(12): E645-E646.
  • Cruess RL, Cruess SR. Teaching medicine as a profession in the service of healing. Academic Medicine. 1997; 72: 941-952.
  • Doukas, D.J. Where is the Virtue in Professionalism. Cambridge Quarterly in Healthcare Ethics. 2003; 12: 147-154.
  • Inui, T.S. A Flag in the Wind: Educating for Professionalism in Medicine. Association of American Medical Colleges. 2003
  • Medical Professionalism in the New Millenium: A Physician Charter. Annals of Internal Medicine. 2002;136: 243-246.
  • Panush RS. Not for sale, not even for rent: Just say no. Thoughts about the American College of Rheumatology adopting a code of ethics. The Journal of Rheumatology. 2002 May; 29(5): 1049-57.
  • Welling RE, Boberg JT. Professionalism: lifelong commitment for surgeons. Archives of Surgery. 2003 Mar; 138(3): 262-4; discussion 264.

bulletPublic Health Ethics

  • Anderson E. What is the point of equality? Ethics 1999;109(2):287-337.
  • Armstrong GL, Conn LA, Pinner RW. Trends in infectious disease mortality in the United States during the 20th century. JAMA 1999;281(1):61-6.
  • Arras JD, Fenton EM. Bioethics and human rights: access to health-related goods. Hastings Center Report 2009;39(5):27-38.
  • Asada Y. Health Inequality: Morality and Measurement (University of Toronto Press 2007
  • Association of Schools of Public Health USA. Available at, accessed March 14, 2014.
  • Bayer R. The ethics of blinded HIV surveillance testing. American Journal of Public Health 1993;83(4): 496-497.
    • AIDS, privacy, and responsibility. Daedalus 1989(Summer):79-99.
    • Ethical and social policy issues raised by HIV screening: the epidemic evolves and so do the challenges. AIDS 1989;3(3):119-24.
  • Bayer R, Moreno JD. Health promotion: ethical and social dilemmas of government policy. Health Affairs 1986;5(2):72-85.
  • Bernheim RG, Childress JF, Melnick A, Bonnie RJ. Essentials of Public Health Ethics (Burlington, MA: Jones & Bartlett Learning 2013).
  • Blacksher E. Carrots and sticks to promote healthy behavior: a policy update. Hastings Center Report 2008;38(3):13-16.
  • Blacksher E. Children’s health inequalities: ethical and political challenges to seeking social justice. Hastings Center Report 2008;38(4):28-35.
  • Blacksher E. Redistribution and Recognition: pursuing social justice in public health. Cambridge Quarterly of Health Care Ethics 2012;21:320-331.
  • Brock D. Broadening the bioethics agenda. Kennedy Institute of Ethics Journal 2000;10(1):21-38.
    Childress JF, Faden RR, Gaare RD, et al. Public health ethics: mapping the terrain. Journal of Law, Medicine & Ethics 2002;30: 170-178.
  • Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health, Final Report. Geneva: World Health Organization 2008.
  • Daniels N. Four unresolved rationing problems: a challenge. Hastings Center Report 1994;24(4):27-29.
  • Daniels N, Sabin J. The ethics of accountability in managed care reform. Health Affairs 1998;17(5): 50-64.
  • Daniels N. Just Health (Cambridge: Cambridge University Press 2008).
  • Dankwa-Mullen et al. Moving toward paradigm-shifting research in health disparities through translational, and transdisciplinary approaches. American Journal of Public Health 2010;100:S19-S24.
  • Fraser N, Honneth A. Redistribution or Recognition: A Political-Philosophical Exchange. New York: Verso 2003.
  • Frieden TR, Dietz W, Collins J. Reducing childhood obesity through policy change: acting now to prevent obesity. Health Affairs 2010;29(3):357-363.
  • Frohlich KL, Potvin L. The inequality paradox: The population approach and vulnerable populations. American Journal of Public Health 2008;98(2):1–6.
  • Geiger HJ. Racial and ethnic disparities in diagnosis and treatment: A review of the evidence and a consideration of cause. In: Smedley BD, Stith AY, Nelson AR, eds. Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare. Washington, D.C.: Institute of Medicine 2003.
  • Hurst SA. Just care: should doctors give priority to patients of low socioeconomic status? Journal of Medical Ethics 2009;35:7-11.
  • Institute of Medicine. The Future of Public Health Washington D.C.: The National Academies Press 1988.
  • Israel B, et al. Review of community-based research: assessing partnership approaches to improve public health. Annual Review of Public Health 1998;19:173-202.
  • Jones CP, Jones CY, Perry GS, Barclay G. Addressing the social determinants of children’s health: a cliff analogy. Journal of Health Care for the Poor and Underserved 2009;20(4):1-12.
  • Kass N. An ethics framework for public health. American Journal of Public Health 2001;91(11): 1776-1782.
  • Link BG, Phelan JC. Social conditions as fundamental causes of disease. Journal of Health and Social Behavior 1995; extra issue:80-94.
  • Link BG. Epidemiological sociology and the social shaping of population health. Journal of Health and Social Behavior 2008;49:367-84.
  • Mackenbach JP, Politics is nothing but medicine at a larger scale: reflections on public health’s biggest idea. Journal of Epidemiology and Community Health 2009;63(3):181-184.
  • Marchand S, Wikler D, Landesman B. Class, Health, and Justice. Milbank Quarterly 1998;76(3):449-67.
    Marmot MG, Bell R. Action on Health Disparities in the United States: Commission on Social Determinants of Health. JAMA 2009;301(11):1169-1171.
  • McGinnis JM, P. Williams-Russo, and J.R. Knickman, The Case for More Active Policy Attention to Health Promotion. Health Affairs 2002;21(2):78-93.
  • Mechanic D. Disadvantage, inequality, and social policy. Health Affairs 2002;21(2):48-59.
  • Mill JS (1859) On Liberty. In: Collini S, ed. On Liberty and Other Essays. Cambridge: Cambridge University Press 1989, p. 13.
  • Murtagh L, Ludwig DS. State intervention in life-threatening childhood obesity. JAMA 2011;306(2):206-207.
    Nuffield Council on Bioethics. Public Health: Ethical Issues. London: Nuffield Council on Bioethics 2007. Available at:
  • Opel DJ et al. Characterizing providers’ immunization communication practices during health supervision visits with vaccine-hesitant parents: a pilot study. Vaccine. 2012 Feb 8:30(7)1269-75.
  • Organisation for Economic Cooperation and Development (2012) Obesity update 2012., accessed March 14, 2014.
  • Pearson SD, Lieber SR. Financial penalties for the unhealthy? Ethical guidelines for holding employees responsible for their health. Health Affairs 2009;28(3):845-852.
  • Pellegrino ED. Health promotion as public policy: the need for moral groundings. Preventive Medicine 1981;10:371-78.
  • Powers M, Faden R. Social Justice: The Moral Foundation of Public Health and Health Policy. New York: Oxford University Press 2006.
  • Public health, ethics, and equity, eds. Anand S, Peter F, Sen A. (Oxford University Press 2006).
  • Reiser SJ. Responsibility for personal health: a historical perspective. Journal of Medicine and Philosophy 1985;10(1):7-17.
  • Rifkin S. Health planning and community participation. World Health Forum 1986;7(2):156-162.
  • Roberts MJ, Reich MR. Ethical analysis in public health. Lancet 2002;359: 1055-1059.
  • Robertson A, Minkler M. New health promotion movement: a critical examination. Health Education Quarterly 1994;21(3):295-312.
  • Robertson A. Critical reflections on the politics of need: implications for public health. Social Science Medicine 1998;47(10):1419-1430.
  • Upshur REG. Principles for the justification of public health intervention. Canadian Journal of Public Health 2002;93(2):101-103.
  • Wallerstein N, Bernstein E. Introduction to community empowerment, participatory education and health. Health Education Quarterly 1994;21(2):141-148.
  • Wallerstein, N. What is the evidence on effectiveness of empowerment to improve health?, Health Evidence Network Reports, 2006. WHO REgional Office for Europe, Copenhagen, DK.
  • Wallerstein N, Duran B. Community-based participatory research contributions to intervention research: the intersection of science and practice to improve health equity. American Journal of Public Health 2010;100:S40-S46.
  • Wikler DI. Persuasion and coercion for health: ethical issues in government efforts to change life-styles. Milbank Memorial Fund Quarterly Health and Society 1978;56(3):303-38.
  • Wikler D, “Personal and Social Responsibility for Health,” in Public health, ethics, and equity, eds. Anand S, Peter F, Sen A (Oxford University Press 2006), p. 115.
  • Williams DR, et al. Moving upstream: how interventions that address the social determinants can improve health and reduce disparities. Journal of Public Health Management Practice 2008;Supplement:S8-S17.
  • Wilson J (2009) Towards a Normative Framework for Public Health Ethics and Policy. Public Health Ethics 2(2): 184-194.
  • Woolf SH, Braveman P. Where health disparities begin: the role of social and economic determinants-And why current policies may make matters worse. Health Affairs 2011;30(10):1852-5.
  • World Medical Association. World Medical Association Statement on Health Promotion 1995. Available at:, accessed March 14, 2014.
  • Yarborough et al. Relationships hold the key to trustworthy and productive translational science: recommendations for expanding community engagement in biomedical research. Clinical Translational Science 2012;6:310-313.
  • Young IM. Justice and the Politics of Difference. Princeton, NJ: Princeton University Press 1990.

bulletResearch Ethics

  • Candilis PJ, Fletcher KE, Geppert CMA, Lidz CW and Appelbaum PS. A direct comparison of research decision-making capacity: Schizophrenia/schizoaffective, medically ill, and non-ill subjects. 2008. Schizophrenia Research; 99(1-3): 350-358.
  • Diekema DS. Conducting ethical research in pediatrics: a brief historical overview and review of pediatric regulations. Journal of Pediatrics. 2006. Jul;149(1 Suppl):S3-11.
  • Drabiak-Syed K. Lessons from Havasupi Tribe v. Arizona State University Board of Regents: Recognizing Group, Cultural, and Dignitary Harms as Legitimate Risks Warranting Integration into Research Practice. Journal of Health & Biomedical Law. 2010; 6(1): 175-225.
  • Emanuel EJ, Wendler D, Killen J, Grady C. What makes Clinical Research in Developing Countries Ethical? The Benchmarks of Ethical Research. Journal of Infectious Disease. 2004; 189: 930-937.
  • Emanuel EJ, Wendler D, Grady C. What makes clinical research ethical? JAMA. 2000 May 24-31; 283(20):2701-11.
  • Haigh C & Jones NA. An overview of the ethics of cyber-space research and the implication for nurse educators. Nurse Education Today. 2005; 25: 3-8.
  • Ludman EJ, Fullerton SM, Spangler L, Trinidad SB, Fujii MM, Jarvik GP, Larson EB, Burke W. Glad you asked: participants’ opinions of re-consent for dbGap data submission. Journal of Empirical Research on Human Research Ethics. 2010;5(3):9-16.
  • Miller FG, Wendler D, and Swartzman LC. Deception in Research on the Placebo Effect. PLoS Medicine. 2005 September; 2(9): e262. Published online 2005 September 6. doi: 10.1371/journal.pmed.0020262.
  • World Medical Association. Declaration of Helsinki: ethical Principles for Medical Research Involving Human Subjects JAMA. 2013; 310(20): 2191-2194. doi:10.1001/jama.2013.281053.
bulletResource Allocation
  • Bordenheimer T. The Oregon Health Plan - lessons for the nation. NEJM 1997; 337(10): 720-3.
  • Pesik N, Keim ME, Iserson KV. Terrorism and the ethics of emergency medical care. Annals of Emergency Medicine 2001 Jun;37(6):642-6. 
  • Sinuff T, Kahnamoui K, Cook DJ, Luce JM, Levy MM; Values Ethics and Rationing in Critical Care Task Force.  Rationing critical care beds: a systematic review. Critical Care Medicine. 2004 Jul;32(7):1588-97.
  • Donohoe M. Luxury primary care, academic medical centers, and the erosion of science and professional ethics.  Journal of General Internal Medicine. 2004 Jan;19(1):90-4. 
  • Douglas DD.  Should everyone have equal access to organ transplantation? An argument in favor. Archives of Internal Medicine. 2003 Sep 8;163(16):1883-5; discussion 1885.
  • Tauber AI.  A philosophical approach to rationing.  The Medical Journal of Australia.  2003 May 5;178(9):454-6. 
bulletSpirituality and Medicine
  • A Time for Listening and Caring, Spirituality and the Care of the Chronically Ill and Dying,  Christina M. Puchalski,  Oxford Press, 2006 (Hardcover book)

    Spirituality in Patient Care, 2nd edition by Harold Koenig, MD (paperback)
    Templeton Foundation Press, 2007

    A Balm for Gilead: Meditations on Spirituality and the Healing Arts
    Primary Author: Daniel P. Sulmasy, University of Chicago, 2006

    Journal of Palliative Medicine
    Volume 12, Number 10, 2009
    ª Mary Ann Liebert, Inc.
    DOI: 10.1089=jpm.2009.0142 A SPECIAL REPORT
    Improving the Quality of Spiritual Care as a Dimension
    Of Palliative Care: The Report of the Consensus Conference
    Christina Puchalski, M.D., M.S., F.A.P.C.,1 Betty Ferrell, Ph.D., M.A., F.A.A.N., F.P.C.N.,2
    Rose Virani, R.N.C., M.H.A., O.C.N.,! F.P.C.N.,2 Shirley Otis-Green, M.S.W., L.C.S.W., A.C.S.W., O.S.W.-C.,2
    Pamela Baird, A.A.,2 Janet Bull, M.A.,1 Harvey Chochinov, M.D., Ph.D., F.R.C.P.C.,3
    George Handzo, M.Div., B.C.C., M.A.,4 Holly Nelson-Becker, M.S.W., Ph.D.,5
    Maryjo Prince-Paul, Ph.D., A.P.R.N., A.C.H.P.N.,6
    Karen Pugliese, M.A., B.C.C.,7 and Daniel Sulmasy, O.F.M., M.D., Ph.D.8

bulletStudent Issues
  • Ardagh M. May we practise endotracheal intubation on the newly dead? Journal of Medical Ethics. 1997; 23: 289-294.
  • Branch W, Pels RJ, Lawrence RS, Arky R. Becoming a Doctor: Critical-Incident Reports from Third-Year Medical Students. NEJM 1993; 329 (15): 1130-2.
  • Christakis DA., Feudnter C.Ethics in a short white coat: the ethical dilemmas that medical students confront. Academic Medicine. 1993; 68: 249-54.
  • Wall LL, Brown D. Ethical issues arising from the performance of pelvic examinations by medical students on anesthetized patients.  American Journal of Obstetrics and Gynecology.  2004 Feb;190(2):319-23. 
  • Rucker L, Shapiro J. Becoming a physician: students' creative projects in a third-year IM clerkship.  Academic Medicine. 2003 Apr;78(4):391-7. 
  • Nora LM, McLaughlin MA, Fosson SE, Stratton TD, Murphy-Spencer A, Fincher RM, German DC, Seiden D, Witzke DB. Gender discrimination and sexual harassment in medical education: perspectives gained by a 14-school study.  Academic Medicine. 2002 Dec;77(12 Pt 1):1226-34. 
  • Clever SL, Edwards KA, Feudtner C, Braddock CH 3rd. Ethics and communication: does students' comfort addressing: ethical issues vary by specialty team? Journal of General Internal Medicine. 2001 Aug;16(8):559-63.
  • Parsons GN, Kinsman SB, Bosk CL, Sankar P, Ubel PA. Between two worlds medical student perceptions of humor and slang in the hospital setting.  Journal of General Internal Medicine. 2001 Aug;16(8):544-9.

bulletTermination of Life-Sustaining Treatment

  • Keown J. Medical murder by omission? The law and ethics of withholding and withdrawing treatment and tube feeding.  Clinical Medicine.   2003 Sep-Oct;3(5):460-3. 
  • Gladsjo JA, Breding J, Sine D, Wells R, Kalemkiarian S, Oak J, Vieira AS, Friedlander SF. Termination of life support after severe child abuse: the role of a guardian ad litem. Pediatrics. 2004 Feb;113(2):e141-5.

bulletTreatment Refusal

  • Knuti KA, Amrein PC, Chabner BA, Lynch TJ Jr, Penson RT. Faith, identity, and leukemia: when blood products are not an option.  Oncologist. 2002;7(4):371-80. 
  • Annas GJ. Forcible medication for courtroom competence--the case of Charles Sell. The New England Journal of Medicine.  2004 May 27;350(22):2297-301. 
  • Meyer JH Jr.  Informed consent, informed refusal, and informed choices.
    American Journal of Obstetrics and Gynecology.   2003 Aug;189(2):319-26.

bulletTruth-telling and Withholding Information

  • Blackhall LJ, Frank G, Murphy S, Michel V.  Bioethics in a different tongue: the case of truth-telling.  Journal of Urban Health.  2001 Mar;78(1):59-71. 
  • Krizek TJ.  Surgical error: ethical issues of adverse events.  Archives of Surgery. 2000 Nov;135(11):1359-66. 
  • Surbone A.  Truth telling.  Annals of the New York Academy of Sciences. 2000 Sep;913:52-62. 
  • Resnik DB.  Ethical dilemmas in communicating medical information to the public.
    Health Policy. 2001 Feb;55(2):129-49. 
  • Garrison A.  Between a rock and a hard place.  JAMA. 2003 Sep 3;290(9):1217-8. 

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