Construction of a System of Clinical Ethics including Practicable Tools for Case-Examination in Medical Practice

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1. We, philosophers and medics in collaboration, have tried to construct a practicable system of clinical ethics for medics, on the basis of the following two basic ideas. First, medical practice must be premised on a certain value chosen among many possible values, which can be expressed, the longer a life is, and the higher is its quality, the better. Secondly, the medical practice should be a collaboration between medics, the patient, and his/her family.2. As to the ethical principles in medicine, by criticizing and revising the famous four (beneficence, non-maleficence, respect for autonomy, and equality), we have reached the following system.P1 Intend to promote the patient's well-beingR1-1 Intend to make the integrated sum of the patient's QOL as high as possible.R1-2 Don't prevent the patient from leading a full life.P2 Treat the patient as a human being.R2-1 Do medical practice in collaboration with the patient (and his/her family).R2-2 Stand by the patient (and his/her family) in suffering.P3 Justice or equality3. We have constructed a format as a fact sheet for examining a process of shared decision making on the basis of the ethical principles shown above. Also we have constructed a format for examining a narrative that is about the history of a patient and medics that might include some ethical problems. Using these formats, medics become able to analyze appropriately the ethical aspect of their practice.