Ethical and Legal Considerations



Ethics are the standards that societies, organizations, and professions establish to define expectations for behavior among members of that group. They broadly define right from wrong and create expectations of appropriate behavior. Laws, regulations, and policies are used to more clearly define ethical behavior and to impose sanctions for wrongful actions. This chapter will describe established ethical and legal principles that anesthetists should consider when acting appropriately and professionally within their practice. Because laws, regulations, and policies differ among states and within institutions, anesthetists must familiarize themselves with the proper policies where they practice.


Advance Directive Health Care Decision Persistent Vegetative State Medical Futility Health Care Agent 
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Suggested Reading

  1. American Medical Association. Code of Medical Ethics Current Opinions with Annotations, Chicago: American Medical Association.
  2. American Society of Anesthesiologists: Perioperative DNR Orders to Limit Resuscitation. Syllabus on Ethics, American Society of Anesthesiologists.
  3. Annas GJ, Densberger, JE. Competence to refuse medical treatment: Autonomy versus Paternalism, 15 Toledo L. Rev. 1984; 561 at 568.Google Scholar
  4. Appelbaum P, Grisso T. Assessing Patients’ Capacities to Consent to Treatment. N Engl J Med. 1988; 319:1635–8.PubMedCrossRefGoogle Scholar
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  8. Hoehner P. Ethical Management of the Elderly Patient. Chapter 4. Geriatric Anesthesiology. 2nd Edition. 2008.Google Scholar
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  10. Norman GV. Do-not-resuscitate Orders During Anesthesia and Urgent Procedures. Ethics in Medicine. Seattle Washington: University of Washington School of Medicine 1998.Google Scholar
  11. Pollock, SG. Life and Death Decisions: Who Makes Them and by What Standards? 47 Rutgers L. Rev. 1989; 505.Google Scholar
  12. Post LF, Blustein J, Dubler NN. 1999. The doctor-proxy relationship: An untapped resource Journal ofLaw, Medicine & Ethics 27(1):5–12. Prendergast TJ. 2001.Google Scholar
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Relevant Statutes and Case Law

  1. Patient Self-Determination Act, 42 USCA §1395cc(f), 1992.Google Scholar
  2. Health Care Decisions Act; Section 5, Subtitle 6, Maryland Annotated Code; Health GeneralGoogle Scholar
  3. Faya v. Almaraz, 329 Md. 435; 620 A.2d 327 (1993).Google Scholar
  4. Mohr v. Williams, 95 Minn. 261, 104 N.W. 12 (Minn. 1905).Google Scholar
  5. McQuitty v. Spangler, et al., 410 Md. 1; 976 A.2d 1020 (2009).Google Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Anesthesiology and Critical Care Medicine, A5W-588Johns Hopkins School of MedicineBaltimoreUSA
  2. 2.Legal Department, Johns Hopkins Health System CorporationJohns Hopkins Bayview Medical CenterBaltimoreUSA

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