Heart 2009;95:885-887
VIEWPOINT
Do cardiologists and cardiac surgeons need ethics? Achieving happiness for a drug user with endocarditis
1 Royal United Hospital, Bath, UK
2 Bristol Heart Institute, Bristol, UK
Dr A K Nightingale, Department of Cardiology, Bristol Heart Institute, Marlborough Street, Bristol BS2 8HW, UK; angus.nightingale{at}uhbristol.nhs.uk
Ethical dilemmas are commonplace in clinical cardiology. There has been a recent focus on ethical behaviour of cardiologists and debate about resource allocation and cost-effectiveness of new technologies. The case of an intravenous drug addict, with native aortic valve endocarditis complicated by a cerebral abscess and severe aortic regurgitation, is presented to illustrate some common ethical and moral dilemmas. The predominant theories in medical ethics, including the "Four-Principles Approach," is discussed, and a model to translate these ethical theories into a clinical decision-making tool is presented.
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