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Semin Med Pract 
2008 ;11:36-42
Clinical ethical decision making: the four topics approach
Schumann JH, Alfandre D

Although ethical practice is a core competency of clinical training, there is no well-established pathway to developing the skills needed to address these issues with confidence. This article is the second in a series using common clinical scenarios to illustrate how to apply a systematic approach to managing ethical dilemmas. The authors present a case that raises the ethical question of whether life-sustaining dialysis should be withdrawn. This is followed by an analysis of the facts of the case using the four topics approach to data gathering and decision making in ethically difficult situations.

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