The two most controversial ends of life decisions are those in which physicians help patients take their lives and when the physician deliberately and directly intervenes to end the patients’ life upon his request. These are often referred to as voluntary euthanasia and physician assisted suicide. Voluntary euthanasia and physician assisted suicide have continued to be controversial public issues. This controversy has agitated the minds of great thinkers including ethicians, physicians, psychologists, moralists, philosophers even the patient himself. Hence the physician, patient, the public and policy makers have recently had to face several difficult questions. Is it morally right to end the life of the patients? Is there any moral difference at all between Voluntary euthanasia and physician assisted suicide? Should a terminally ill patient be allowed to take his life and should the medical profession have the option of helping the patient die. Should voluntary euthanasia and physician assisted suicide be legalised at all? And what actually will be the legal and moral implications if they are allowed. In a bid to find a lasting solution to these moral problems and questions has led to two different strong positions viz opponents and proponents of voluntary euthanasia and physician assisted suicide. The centre of my argument in this work is not to develop new general arguments for or against voluntary euthanasia and physician assisted suicide but to make a critical ethical comparative analysis of voluntary euthanasia and physician assisted suicide. This is the focus of my work. The sole aim of this work is neither to solely condemn nor to support voluntary euthanasia and physician assisted suicide but to critically analyze the two since we live in a world of pluralism.

In the contemporary society, with the disintegration of political authoritarianism and the rise of democratic equality thoughts, as well as the flourishing information and popularity of medical knowledge, patients¡¦ autonomous consciousness and consumerist consciousness thus arise. In this information society, the boundless Internet brings a huge amount of information, and enables the general public to actively enrich themselves with professional medical knowledge, to have a online discussion with others, or to provide online support to each other. Such moves will transform the physician-patient relationship from the traditional ¡§professional led¡¨ interaction to different types of interaction, and hence the relationship between a physician and a patient generally deviates from the social hierarchy system in the past. Medical knowledge is no longer something that the physician can monopolize and enjoy exclusively. Accordingly, several types of physician-patient relationship have been developed. While the information revolution is generally striking the medical profession, in response to the future development and change in the medical field, some assistance should be given to medical students and practitioners to continuously learn new knowledge and new technology, as well as grasp and develop proper communication ability in this rapidly changing information age to build a solid foundation for their future role as a physician. Therefore, it leads to the author¡¦s query about ¡§what competence should a physician possess¡¨ to effectively manage the ¡§new physician-patient relationship management in the information society¡¨ mechanism, which becomes the motivation of making an in-depth study. It is hoped that the literature review and the in-depth interview in this study could help find out the way that physicians and patients ¡§adjust¡¨ to each others in these new types of physician-patient relationship in the information society. Moreover, physicians have to understand that only by improving the effect of their physician-patient relationship management can they create a win-win result under a harmonious physician-patient relationship.

A philosophical and scientific eclectic, Dr. Friedrich Hoffmann (1660-1742) brought together the wisdom of ancient writers with the new science and philosophy of his day. In the Medicus Politicus (The Politic Physician) (1738) he applied his concepts to medicine and medical ethics. The Medicus Politicus contains the lecture notes of Hoffmann as first professor of medicine at the University of Halle. The work is divided into three parts: the personal characteristics required by the new politic physician; the physician's relationship with other members of the medical community (often competitors); and the patient-physician relationship. This dissertation provides the first comprehensive English-language philosophical analysis and commentary on this work. It addresses two issues found in the Medicus Politicus: Hoffmann's model for the new physician and the medical ethics required in the patient-physician relationship. The political, intellectual and religious upheavals of the Long Eighteenth Century inform the work of Hoffmann. Physicians were not yet considered professionals and competed with the untrained. The new Hoffmannian physician would change that and would develop the personal qualities that were found in the professions of theology and law. Specifically, the Hoffmannian physician would be moral, rational and clinically competent. Hoffmann provided two independent but harmonious foundations to justify these requirements: one theological and one rational. Specifically, Hoffmann was an enthusiastic Pietist, a Natural Law theorist and an evidence-based scientist. His applied ethics is one of the most complete systems ever found in the medical clinical setting as it addresses each stage of the healing process. The focus of the patient-physician relationship is trust and trustworthiness. The physician is trustworthy when he is compassionate and competent. Patient and physician work together towards a mutual goal of the patient's healing. The judgments of both patient and physician are directed by prudence--seeking that which preserves society and individuals. This very mature concept of the ethics of the patient-physician relationship founded on trust and trustworthiness is the basis of modern concepts of patient, fiduciary trust, medical ethics and medicine as a profession. / text

Thesis (Ph. D.)--West Virginia University, 2009. / Title from document title page. Document formatted into pages; contains xiv, 157 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 110-121).

Thesis (M.S.)--University of Michigan, 1992.

Thesis (M.S.)--University of Michigan, 1992.

This research sought to identify the determinants of nonuse and high use of physician services and assess whether or not patterns of nonuse and high use changed over time. The population of interest was a group of elderly unmarried women who participated in the Longitudinal Retirement History Survey from 1969 to 1979. Andersen and Newman's (2) health care services utilization model served as the conceptual framework for this research. Of specific interest was the relationship between age strata and health care behavior. Age proved to be a stratifying variable within the health care delivery system. Over the ten year survey period, the health care behavior of preretirement and postretirement nonusers and high users differed significantly. A decline in nonuse was also associated with the transition years. This finding could be attributed to the "near poor" becoming eligible for Medicare. In any event, these data show that utilization of physician services is likely to increase among some unmarried women in their middle 60's.

There is a paucity of information about the various factors that influence the selection of primary care physicians. Also, the relative significance of these factors is not known, making it difficult to properly address ways to improve the information flow to patients when they select a primary care physician.

Introduction: I am a general practitioner in solo practice in Athlone. I work closely with a qualified nursing sister. Many of the patients we attend to have non-insulin dependent diabetes mellitus. Aim: To implement change in the management of our patients with diabetes by developing a protocol for future improved care. Objective: To assess the quality of care provided to patients with (NIDDM), by a doctor - nurse team in private general practice. Method : The study was quantitative and qualitative and consisted of 3 sections : 1) an internal audit based on the retrospective examination of patients' medical records, 2) a questionnaire which was administered to determine patients' knowledge of their disease and 3) a focus group interview which centred around patients' experience of the disease and feelings about the service provided. The interview was audio taped. Findings: Problem areas identified were sub-optimal record keeping; poor attendance and infrequent eye and foot examinations; patients' knowledge of their disease was limited; certain aspects of doctor-patient and patient-family relationships that may impact negatively on care; fears and anxieties relating to the disease and perceptions oflocus of control as external.

Physician Assistant (PA) students undergo a rigorous educational curriculum consisting of both clinical and didactic instruction to prepare them for their role as a general health care provider. In order to complete training as a general health care provider PA students must learn a wide array of general medical knowledge and clinical skills so that they are able to use their judgment and skills in any area of practice or specialty. More specifically, PAs are expected to identify and effectively treat pediatric disorders that are within the knowledge and skills obtained during their qualified education. In medicine, perhaps the most important diagnostic tool is the ability to properly perform an effective physical examination. Historically, within PA program curricula, methods to optimize performance of a pediatric physical examination have been poorly represented. The pediatric population is unique in that the approach to the patient, as well as the techniques used to gain cooperation from the patient, may change drastically through normal child development. Having a wide array of techniques and skills to comfort and engage the pediatric patient is critical in performing the physical exam. Formal training in this area will better prepare PA students for any setting in which a pediatric patient will be encountered and enable them to deliver effective pediatric care. The objective of this project is to develop a curriculum that will focus on a mastery of skills needed to successfully perform a pediatric physical exam. The proposed curriculum will educate PA students in an understanding of age-appropriate strategies to be used while examining pediatric patients from birth through to mid-childhood (8-years old) that will meet the expectations of current pediatric practices. A literature review provides the basis for the curriculum. The curriculum will be integrated at the end of the PA student’s didactic curriculum, prior to beginning their clinical rotations. Assessment will include a needs assessment for the curriculum, gauging the comfort of students performing the pediatric physical exam, and preparedness of the students for their pediatric clerkship. Student success will be evaluated through a pre and post-test comparison, clinical skills evaluation, as well as a questionnaire surveying student comfort level and knowledge of strategies with the standard curriculum in comparison to student comfort level and knowledge of strategies after specialized training with the newly developed curriculum. It is predicted that the new curriculum will better prepare PA students for their pediatric clerkship and practice.