Professional Ethics

Professional ethics, perched on the border between science and humanity, has undergone public scrutiny in modern times. One of the most notable examinations of professional ethics occurred during the Nuremberg trial of Nazi medical atrocities in 1946. In recent years, increasing use of medical technology and the formation of health maintenance organizations have created a new environment in which medical ethics are questioned. "Right to Die" debates and health professionals' sexual misconduct with patients are often in the news. Dr. Bursztajn has written extensively on the subject of professional ethics and it continues to be one of his major areas of interest both in his clinical work and in his work as a forensic psychiatrist.

Administrative bodies struggle with maintaining a balance between protecting the public and liberty interests.

The Importance of Meaningful Informed Consent for Protecting Patients and Clinical Research Subjects

Employment & Ethics

In the workplace, the forensic psychiatrist may be asked to consider whether a claimed disability (e.g., a chronic general illness, such as Chronic Fatigue Syndrome, a chronic pain syndrome, such as Fibromyalgia, or a mental disorder, such as Depression or Obsessive-Compulsive Disorder) is valid and work stress related. Some other frequently asked employment related examination questions are:

  1. Is a claimed impairment subject to the ADA mandate for accommodation?
  2. What is the appropriate organizational response to a sexual harassment claim?
  3. What is the validity and extent of sexual harassment-related damage claims, such as emotional injury or Post-Traumatic Stress Disorder?

As a nationally recognized forensic neuropsychiatric expert, Dr. Bursztajn continues to teach via peer review service, publication, and presenting workshops in recognized professional forums. By way of introduction, see American Psychiatric Association workshop abstract on reducing the risk of dual agency complications by performing objective forensic neuropsychiatric evaluations of work impairment claims independent of ongoing subjectively oriented treatment.

News Articles

Conflicts of Interest

Recent Articles in the News:

Managed Healthcare

Managed health care organizations are more numerous and pervasive today. As they have grown in influence, many patients and professionals have claimed that medical care, while increasing in sophistication, has declined in quality. At the same time, the large-business and third-party aspects of managed care organizations can make medical decision-making an impersonal process, and increase the need for organizations and clinics to exercise joint responsibility with the treating physician for informed patient care.

Elder Care

Unfortunately, nutrition tends to be neglected for the elderly receiving home care as well as institutional care. The following provides some relevant information.

Benefit Denial

Disabilities, including psychiatric disabilities, are controversial reasons for denial of health benefits or health insurance altogether.

Organizational Responsibility & Ethics

Under some circumstances, managed health care organizations are responsible for liability. The AMA also considers the plan medical director as a "physician first."

Organizational Influences on Clinical Decision Making

ERISA

According to the Pocket Guide to Managed Care, "The Employee Retirement Income Security Act (ERISA) is a federal law that governs the rights of employees to employer-sponsored pension and health benefits. It is supposed to protect patients by preempting state laws that regulate or tax employee benefits provided by employers. In theory, ERISA can protect managed care organizations that are sued for (a) Malpractice, (b) Refusal to pre authorize care, and (c) Denying payment through their utilization management process. In practice, ERISA's actual protection of MCOs is variable." (La Puma, J and D Schiedermayer, McGraw Hill,1996. pp 24-25)

Political activity has also recently increased to address the need for patient protection.

Biotechnology

Care for the Dying

Terminally ill patients are often denied certain kinds of medical treatment. While the process of dying is often depressing, such depression is rarely treated. Often, this depression leads to giving up on life rather than the desire to make one's last months feel worthwhile. There are serious ethical and medical considerations in regard to best practice treatment for the terminally ill.

Privacy & Confidentiality

Telemedicine

To obtain Telemedicine: An Overview of Applications and Barriers, contact: Physician Insurers Association of America, 2275 Research Boulevard, Suite 250, Rockville, MD 20850. (301) 947-9000.

Dr. Bursztajn has an active patient care practice and consults to physicians, institutions, judges, and plaintiff and defense counsel nationally.