The twelve essays in this stimulating volume, written by health care professionals and others working with the important issue of institutional ethics, focus on the world of academic health centers and provide rich, informed commentaries on significant problems integral to the character and work of those centers. Daniel Steiner demonstrates how the viability of independent research may be threatened by university liaisons with industry. Donald Frederickson traces the history of the National Institutes of Health response to the ethical challenges in clinical investigation and fetal research. Edmund Pellegrino recommends ways in which health-related institutions may translate their concern into action. Robert Coles examines the tensions between institutional and personal values in a very provocative way. Other directions are explored by essayists Roger Bulger, Stephen Toulmin, H. Tristram Engelhardt, Kim Dunn, Mitchell Rabkin, James Haughton, Lawrence Green, and the editors themselves.
Every essay in this wide-ranging collection reveals the implications and effects of institutional values. The end result is a clear picture of conflicts of values: ethical, social, economic, ethnic, cultural, and pedagogic. Integrity in Health Care Institutions points out the need for a deliberate attempt to sort out the values of institutions and, when they are fully and clearly displayed, to use priorities as a guide to satisfying the obligations of academic health centers to those who work within their walls; to the patients, students, scientists, and teachers they serve; and to society in general.
Physicians and nurses, hospital and university administrators, attorneys, sociologists, and everyone concerned about the moral interaction between institutions and individuals will want to read this book.