The intellectual and moral integrity of bioethics: response to commentaries on A case study in unethical transgressive bioethics: \u27Letter of concern from bioethicists\u27 about the prenatal administration of dexamethasone .

In our target article we showed that the Letter of Concern (LoC) fails to meet accepted standards for presenting empirical data for the purpose of supplementing a normative claim and for argument-based normative ethics. The LoC fails to meet the standards of evidence-based reasoning by making false claims, failing to reference data that undermine its key premises, and misrepresenting and misinterpreting the scientific publications it selectively references. The LoC fails to meet the standards of argument-based reasoning by treating as settled matters what are, instead, ongoing controversies, offering “mere opinion” as a substitute for argument, and making contradictory claims. The LoC is methodologically defective and thus a case study in unethical transgressive bioethics. Not withdrawing the LoC will damage the field of bioethics, making this case study in unethical transgressive bioethics important for the entire field

Surgeon-industry relationships: Ethically responsible management of conflicts of interest

AbstractJ Vasc Surg 2002;35:825-6

How do we guarantee trainee professional purity?

In a weekly resident's meeting, the offers of several medical device companies to pay residents for completing their surveys and one endovascular company to pay for chief residents to attend a weekend conference about their products at an expensive resort are brought up. They ask for your approval. As residency director, you should:AAllow them to complete the surveys but not attend the conference.BAllow them to attend the conference but not complete the surveys.CAllow both activities.DDisallow both activities.EDiscuss the context of the activities

Business dealings with a patient: Money never sleeps

Mr M.O. Gul returned for his postoperative visit today after you successfully repaired a leaking abdominal aortic aneurysm. Mr Gul owns most of the cable networks in the state, making him a billionaire. He realizes that he met the bearded reaper and walked away because of your skills. He is pioneering a new technology that will make current Wi-Fi obsolete. Unexpectedly, he offers you the opportunity to invest with the expectation of huge returns. M.O. personally guarantees you will not lose money. What should you do?AInvest. No questions asked.BDo not invest. It is unprofessional.CDo not invest without consulting with your attorney.DDo not invest. You have already been paid for services rendered.EInvest provided you forego future medical relationships with M.O. as the attending physician

Is “your only hope” medical treatment choice really a choice?

An elderly gentleman, from Scandinavia, Mr K. R. Plunk, with a soon-to-be lethal disease, has come to see you because you are the world's expert in complex aneurysm surgery and his is a case for the books. He has multiple comorbidities; the most concerning is his cardiopulmonary functioning. You have only operated on a few patients who are at this level of risk. He has been told repeatedly you are his only hope, which is literally true. A cure would pair one of the “biggest operations” with one of the frailest patients. You have been on an invincible roll and have decided to give it a shot, if he agrees. What is the most ethical informed consent in this case?A.Standard informed consent is appropriate.B.Ethically adequate informed consent cannot be given in this case.C.Informed consent must include the possible long-term intensive care unit fears.D.Consult your risk management group.E.Emphasize realism and futility in informed consent

Medical expert witness litmus

Several years ago, Dr G. Breaking was the foremost proponent of a new surgical procedure, which was named after him. At a recent national meeting, he discussed a paper that modified the procedure and criticized the presenter's revisions as dangerous—risking increased paralysis. GB's unedited comments were published last month in the specialty's leading journal. Today, an attorney called the office representing a surgical patient who suffered paralysis after undergoing the modified procedure. GB has unremittingly avoided involvement in litigation. The plaintiff's attorney asks him to serve as an expert witness against the surgeon. What should GB do? ARefuse involvement because the medical tort system is a farce.BExplain that opinions expressed in his published critique represented intellectual jousting.CClaim that he is too busy and decline to be involved.DAgree to review the records objectively.ETestify and establish a Web page advertising further availability as a plaintiff's witness

Ethics of re-hearsing procedures on a corpse

You are the attending surgeon of a homeless pedestrian who sustained multiple injuries when struck by a car. He died soon after being brought to the emergency department. It is late in the evening. A first-year resident and a medical student have been helping with the failed attempt at resuscitation. The emergency department is empty, except for your case. A central line kit lies on the bed, opened but not used. The junior resident asks your permission for herself and the student to practice the technique of subclavian cauterization and tracheal intubation on the fresh cadaver to get a “feel” for the procedures. There is no medical simulation for these procedures at your medical center. The best ethical response is: ATell them to go ahead and practice.BThey can only practice intubation because it leaves no external wounds.CYou should supervise them yourself to assure educational benefit.DThey should wait until you get permission from the medical examiner.EThe present case is not appropriate for educational purposes