Clinical realities and moral dilemmas: Contrasting perspective from academic medicine in Kenya, Tanzania and America
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Date
1999
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Volume Title
Publisher
Daedalus
Abstract
Physians in university hospitals in Africa face a funda
mental moral crisis: hospitals are overwhelmed by pa
tients dying from AIDS, and physicians have few re
sources to respond. In such settings, not only do physicians face
very specific moral dilemmas?how to ration scarce resources
and acquire costly medications, how to inform families that a
child is HIV positive?but the very moral foundations of medi
cine as a scientific and caring profession are called into ques
tion. Practicing medicine and training new physicians in such
settings produce profound ethical dilemmas.
On the surface, the situation in teaching hospitals in North
America could hardly be more different. Resources for high
technology medical practice are abundant, though not unlim
ited. Physicians and medical students see a wide range of dis ease conditions and manage patients with diverse prognoses.Ethical dilemmas about when to provide or withhold care and
how to involve patients in decision making are present, but at
a different level.
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Keywords
Clinical realities, Moral dilemmas, Kenya, Tanzania and America
Citation
Good, M.J.D., Mwaikambo, E., Amayo, E. and Machoki, J.M.I., 1999. Clinical realities and moral dilemmas: Contrasting perspectives from academic medicine in Kenya, Tanzania, and America. Daedalus, 128(4), pp.167-196.