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Ethics and the Medical Record
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
IN RESPONSE:
These two letters are linked by the observation that my proposal to create a special section in the medical record for ethical concerns is only a preliminary step toward making moral issues more central to the care of the ill. I heartily concur with that judgment and hope that such an addition might be part of a more comprehensive reevaluation of how to better identify and address patient's ethical issues. Drs. Drehmer, White, and Schuster appropriately identify crucial educational interventions and rewards that would, if widely adopted, reenforce the empathy of health care providers. Aside from such measures, a philosophical reorientation is also required. By asserting other guiding principles (1, 2) to balance the role of autonomy in medical ethics (3), the general fiduciary responsibilities of physicians for their patients would be enhanced. Fundamental to that responsibility is helping to identify moral questions and then to assist patients in finding responsible answers. This is the rationale of my proposal.
Dr. Baumgartner either misunderstood me or has identified an ambiguity: In emphasizing the lacuna of addressing ethical concerns of more ordinary cases, I did not mean to ignore those that are obviously morally laden. Transplantation and reproduction technologies bring with them, by their very nature, obvious moral issues, which must be directly addressed. These require no special attention in the sense of being identified; indeed, if anything, they require greater attention.
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
