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KMID : 1025620130160030323
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Korean Journal of Medical Ethics
2013 Volume.16 No. 3 p.323 ~ p.345
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A Social Contracts-Based Approach to Medical Ethical Decision-Making: Approach by Diachronic Formation of Medical Professional Responsibility
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Lee Hyo-Jean
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Abstract
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The normative principles of medical ethics are classified into two categories: traditional ethical theo-ries (utilitarianism and deontological ethics) and empirical principles like the Hippocratic Oath. Each of these two streams of medical ethics has strengths and limitations. This article presents social contract theory as a new approach to understanding medical ethics. On this view, medical professions are based on social contracts for protecting patients from therapists with no licenses. These social contracts con-sist of hyper-norms, general or whole social contracts, regulations, stewardships and personal contracts. Medical professionals and medical societies both must uphold all of the social responsibilities (includ-ing legal liability) of these contracts. In order to strengthen the observance of these social contracts, this article proposes a process of medical ethical decision-making based on social contracts. Additionally, to reduce patient-physician conflicts, this article identifies the appropriate decision-making participants and argues for the necessity of hierarchical clinical ethics committees.
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KEYWORD
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contracts, social responsibility, decision making, licensure, clinical ethics committees
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