Ever since the arrival of the first colonists to the new world, the issue of how best to care for vulnerable, sick, and dying patients has been a central preoccupation of medicine. As the era of the healing art gave way to the era of evidence-based medicine, many of the traditional craft and spiritual traditions that guided physicians, practitioners, and patients have been replaced or incorporated by clinical research, evidence-based medicine, and an increasingly specialized professional culture. However, the focus on evidence and specialization has not been accompanied by a change in the moral impulse that leads to the care and comfort of the dying, the comfort of the dying, and the care of the living. From the time of Hippocrates through the mid-twentieth century, the practice of medicine has been guided by a set of ethical principles that remain a fundamental part of the profession today. In this article, two important American physicians, J.P. DeLeon and Henry Beecher, provide a concise, general overview of the history of ethics in medicine, focusing on how ethical theory has been used to shape the practice of medicine. The authors argue that physicians must always be guided by the fundamental moral imperative to provide the best possible care for their patients; that one must always keep in mind the patient's emotional and spiritual needs, and that all medical care must be patient-focused. The authors also question whether the shift to a more evidence-based or cost-conscious culture as reflected in the paradigm shift of the past 50 years can be seen as a return to the older, more traditional model of caring that represents the best of medical ethics. The authors conclude by discussing the challenge of balancing competing obligations, such as privacy and confidentiality, ethical and medical aspects of care, social justice, and overall efficiency and cost-consciousness in the delivery of modern health care. The authors conclude by offering a variety of resources to further the discussion and debate on these issues within the profession.
The leader of an academic department is often the most visible and best-known person in the department. Yet we know little about how the experience of leadership may influence health professionals. This research builds on my experience in our department and on my previous work. We have a broad range of research topics across a number of specialties. This research will provide insight into the leadership styles of department chairs and leaders, including individual and collective leadership. It will also explore the influence of leadership strategies and leadership styles on clinical practice.
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