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In Clinical Ethics, three clinical ethicists (a Philosopher – Jonsen; a Physician – Siegler; and a Lawyer – Winslade) developed a method to work through difficult cases. The process can be thought of as the “Ethics Workup,” similar to the “History and Physical” skills that all medical students use when learning how to “Workup” a patient’s primary complaints. While this method has deep philosophical roots, clinicians who use this method like the way it parallels thinking through tough medical cases.

Medical Indications All clinical encounters include a diagnosis, prognosis, and treatment options, and include an assessment of goals of care
Patient Preferences The patient’s preferences and values are central in determining the best and most respectful course of treatment.
Quality of Life The objective of all clinical encounters is to improve, or at least address, quality of life for the patient, as experienced by the patient.

Contextual Features All clinical encounters occur in a wider social context beyond physician and patient, to include family, the law, culture, hospital policy, insurance companies and other financial issues.
Directions: Carefully read each scenario describing an ethical dilemma in health care. Select TWO scenarios for which you will write a thorough response to not exceed ONE complete paragraph for each. Responses will vary based on an individual’s cultural upbringing, ideology, and cognitive development of ethical theories and principles. You must be able to support your individual position by applying theory and principle appropriately.
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