NIH: Office of Disease Prevention

Medicine: Mind the Gap

Gaps (and Gasps!) in Medical-Ethical Reasoning: From Ethical Theory to Medical Practice

Heidi Malm, Ph.D.
Professor of Philosophy and Bioethics
Loyola University Chicago

Thursday, October 29, 2009
Building 50 Conference Room
NIH Campus | Bethesda, Maryland


About the Seminar

Good healthcare practice and policy cannot be developed on the basis of scientific evidence alone. Also essential are value-laden or “moral” judgments which, for example, prioritize some endpoints over others (e.g., quality of life over quantity of life), and sanction some means of achieving those endpoints but prohibit others (e.g., Is informed consent always necessary? May harm be caused to some in order to prevent greater harm to others?).

This presentation demonstrated how the methods that contemporary ethical theorists use to develop, test and apply moral judgments are similar to the methods that medical scientists use to develop, test and apply their evidence. It examined several flaws, cognitive biases, and under-appreciated distinctions within medical-ethical reasoning (each of which has a sibling in scientific reasoning) that give rise to gaps between ethical theory and medical practice. The discussion dealt with medical-ethical issues involving the prevention of harm, including cancer prevention, public health, and pandemic planning.

About Heidi Malm

Heidi Malm is Professor of Philosophy at Loyola University Chicago. Her areas of specialization include ethical theory, bioethics and the philosophy of law. Her academic research focuses on ethical issues involving autonomy and the prevention of harm, with a current focus on issues within the field of preventive medicine and law. She has published on the topics of killing vs. letting die, legal paternalism, medical screening, bad Samaritan laws and the duty to aid, consent and the law on rape, and surrogate motherhood, and her articles have appeared in a variety of high-profile journals including Ethics, The Hastings Center Report, Law and Philosophy, American Journal of Bioethics and Philosophy & Public Affairs. A recent article Dr. Malm co-authored, Ethics, Pandemics, and the Duty to Treat, appeared in the American Journal of Bioethics (2008), received much fanfare and is frequently cited. The article addresses the very timely topic of the healthcare workers' duty to treat in times of pandemics; matters of interest to academicians and practitioners in medicine, law, philosophy, public health, and government.

Dr. Malm also works on issues related to ethics and preventive medicine, in particular, ethical issues related to medical screening for diseases such as cancer, as well as the furthering of evidence-based medicine. She has served as the bioethicist on several committees for the National Institutes of Health and has been an invited speaker at numerous schools of medicine and public health, including Harvard, Johns Hopkins, and Northwestern.

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