It is estimated that up to thirteen percent of hospital admissions result from the adverse effects of diagnosis or treatment, and that almost seventy percent of iatrogenic complications are preventable. The obligation to do no harm has been central to medical conduct since ancient times, yet iatrogenic illness has now come to be recognized as a significant risk factor in health care delivery. This book integrates history, philosophy, medical ethics and empirical data to examine the concept and phenomenon of medical harm. Issues covered include appropriateness of care, acceptable risk and practitioner accountability, and the book concludes with recommendations for limiting iatrogenic harm. Essential reading for medical ethicists, physicians and those involved in health care policy and administration, this stimulating and highly readable book will be of interest to all providers of health care, and many of their patients.
Acknowledgements; Introduction; Part I:: 1. Divided loyalties:: harm to the profession vs. harm to the patient; 2. Medical epistemology, medical authority and shifting interpretations of beneficence and non-maleficence; 3. Medical harms and patients rights:: the democratization of medical morality; Part II:: 4. The moral basis of medicine:: why do no harm?; 5. Due care as a specification of the duty to do no harm; 6.Conceptual and ethical dimensions of medical harm; Part III:: 7. From hospitalism to nosocomial infection control; 8. Adverse effects of drug treatment; 9. Unnecessary surgery; 10. The concept of appropriateness in patient care; 11. Recommendations for limiting iatrogenic harm; Appendix; Bibliography; Index.
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