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Do cardiologists and cardiac surgeons need ethics? Achieving happiness for a drug user with endocarditis
  1. D I Bromage1,
  2. D J McLauchlan1,
  3. A K Nightingale2
  1. 1
    Royal United Hospital, Bath, UK
  2. 2
    Bristol Heart Institute, Bristol, UK
  1. Dr A K Nightingale, Department of Cardiology, Bristol Heart Institute, Marlborough Street, Bristol BS2 8HW, UK; angus.nightingale{at}


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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  • Competing interests: None.

  • Patient consent: Obtained.