title: Do cardiologists and cardiac surgeons need ethics? Achieving happiness for a drug user with endocarditis.
abstract: Ethical dilemmas are commonplace in clinical cardiology. There has been a recent focus on ethical behaviour of cardiologists and debate about resource allocation and cost-effectiveness of new technologies. The case of an intravenous drug addict, with native aortic valve endocarditis complicated by a cerebral abscess and severe aortic regurgitation, is presented to illustrate some common ethical and moral dilemmas. The predominant theories in medical ethics, including the "Four-Principles Approach," is discussed, and a model to translate these ethical theories into a clinical decision-making tool is presented.
authors.affiliation: Department of Cardiology, Bristol Heart Institute, Bristol, UK. angus.nightingale@uhbristol.nhs.uk
authors.forename: D I
authors.initials: DI
authors.lastname: Bromage
authors.forename: D J
authors.initials: DJ
authors.lastname: McLauchlan
authors.forename: A K
authors.initials: AK
authors.lastname: Nightingale
mesh_terms: D001022:Aortic Valve Insufficiency / Q000601:surgery; D001922:Brain Abscess / Q000150:complications; D002309:Cardiology / Q000941:ethics; D003657:Decision Making; D004697:Endocarditis, Bacterial / Q000601:surgery*; D028663:Ethical Theory; D019918:Heart Valve Prosthesis Implantation / Q000941:ethics*; D006801:Humans; D008297:Male; D013203:Staphylococcal Infections / Q000601:surgery; D015819:Substance Abuse, Intravenous / Q000150:complications*; D013903:Thoracic Surgery / Q000941:ethics; D055815:Young Adult