BY: THOMAS C. LAWRY
Mr. Lawry is president, Verus, Bellevue, WA.
These are, to paraphrase Charles Dickens, both the best and the worst of times on the Web. They are the best of times because the Web provides clinicians and healthcare managers with a vast array of useful, easily accessed information. They are the worst of times because much of that information is badly organized. There are thousands of Web listings on any given topic, but even the most comprehensive search engine can locate no more than one-sixth of them.
In this column I want to focus on Web sites that deal with ethics. Ethical considerations — ranging from those surrounding clinical decisions to those concerning management issues like pricing and compliance — are a daily part of healthcare leadership. A subject that traces its roots to the ancient Greek philosopher Hippocrates has, in our time, gone digital.
The following are some of the best bioethical resources.
Bioethics for Beginners This site, which can serve as a primer for anyone wishing to learn about the field, includes an introduction to bioethics and a listing of bioethical resources. It is sponsored by the Center for Bioethics, University of Pennsylvania, Philadelphia.
Bioethicsline This site searches the premier database of the National Library of Medicine, Bethesda, MD, for ethical, legal, and public policy issues related to healthcare and biomedical research. The database comprises more than 53,000 records, including journal articles, monographs, newspaper articles, and legal documents. It also offers resources in law, religion, social sciences, and philosophy. Each document is accompanied by linked titles, notes on the sources, and directions for ordering abstracts and further information.
This site provides information on a variety of issues ranging from genetics to assisted suicide. It also offers the American Journal of Ethics & Medicine, as well as an online bioethics bookstore.
Center for Ethics and Professionalism This site provides access to the fourth edition of the American College of Physicians' Ethics Manual, policy documents developed to accompany end-of-life care and ethics case studies, and articles about ethical issues. The site is sponsored by the American College of Physicians-American Society of Internal Medicine.
CHAusa The site of the Catholic Health Association (CHA), St. Louis, provides association members with numerous resources on bioethics, ethics, and health policy issues; with directories of theologians, ethicists, and ethics centers; with a collection of materials on corporate responsibility; and with an interactive education in the role of leadership in organizational integrity.
Ethics and Medics This monthly newsletter, which provides a Catholic perspective on moral issues in health and life sciences, is sponsored by the National Catholic Bioethics Center, Boston.
Guidance for Institutional Review Boards and Clinical Investigators The U.S. government requires institutional review boards for any federally funded organization conducting research that involves human subjects. This site, sponsored by the Food and Drug Administration, advises such organizations on the protection of their human research subjects.
MedEthEx Online This site provides a series of exercises enabling users to improve both their knowledge of medical ethics and their skills in communicating with patients and patients' families about ethical issues. The site includes an interactive ethics program developed at the MCP Hahnemann School of Medicine, Philadelphia. The program's cases, which simulate encounters between patients and therapists, challenge the user to choose appropriate courses of action.
National Reference Center for Bioethics Literature This specialized collection of materials on bioethics — which includes a comprehensive bibliographic listing of topics, teaching resources, and links to other Web resources — is sponsored by the Kennedy Institute for Bioethics, Georgetown University, Washington, DC, and the National Library of Medicine, Bethesda, MD.
Resources for General Ethics
The following sites deal with broader ethical issues.
Applied Ethics in Professional Practice
This site is a resource for ethics education, including ethics training in the workplace. The site's "Case of the Month Club" is interactive: Viewers can vote on the suggested solutions provided for each case study, or they can write in their own solutions. General information on ethical decision making is also included. The site is sponsored by the Professional Engineering Practice Liaison Program, University of Washington, Seattle.
Codes of Ethics Online Project This site provides an index of the official codes of ethics for more than 850 professional societies, healthcare organizations, corporations, government agencies, and academic institutions. Users can browse the index either by employing the subject category or by using keywords to search the full text of the codes. The site is sponsored by the Center for the Study of Ethics in the Professions, Illinois Institute of Technology, Chicago.
The Ethics Connection This site provides "strategies to heighten ethical awareness and improve ethical decision making." It includes ethics news, a list of ethics publications, and an interactive forum for the discussion of ethical issues. It is sponsored by the Markkula Center for Applied Ethics at Santa Clara University, Santa Clara, CA.
Hippias This peer-reviewed search engine provides access to philosophy-related resources on the Web. The site can be used to search for resources pertaining to a wide variety of ethical topics. It is cosponsored by the University of Evansville, Evansville, IN, and Earlham College, Richmond, IN.
Theological Resources on the Web This site, maintained by the Woodstock Theological Center at Georgetown University, Washington, DC, provides links to theological resources.
I would like to thank the following ethicists for reviewing this column and suggesting additions to it: Bridget Carney, PhD, director of ethics, PeaceHealth, Bellevue, WA; Tobias Meeker, director, ethics program, St. John's Health System, Springfield, MO; Sisters of Mercy Health System, St. Louis; Thomas C. Hooyman, PhD, vice president, theology and ethics, Catholic Health Initiatives, Denver.
Contact Tom Lawry at 4628 175 Ave., SE, Bellevue, WA 98006; phone: 425-643-7117; fax: 206-643-0302.
BIOETHICAL RESOURCES AND GENERAL ETHICS SITES ON THE WEB
Bioethics for Beginners
Center for Ethics and Professionalism
Ethics and Medics
Guidance for Institutional Review Boards and Clinical Investigators
National Reference Center for Bioethics Literature
Applied Ethics in Professional Practice
Codes of Ethics Online Project
The Ethics Connection
Copyright © 1999 by the Catholic Health Association of the United States
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