Foreword |
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xiii | |
Council on Ethical and Judicial Affairs |
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xv | |
Artist Acknowledgement |
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xvii | |
Permission to Reprint |
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xviii | |
Principles of Medical Ethics |
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1 | (2) |
Preface to the Opinions of the Council on Ethical and Judicial Affairs |
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3 | (2) |
Preamble to the Opinions of the Council on Ethical and Judicial Affairs |
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5 | (2) |
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1 Patient-Physician Relationships |
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7 | (26) |
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1.1 Responsibilities of Physicians and Patients |
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9 | (7) |
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1.1.1 Patient-Physician Relationships |
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9 | (1) |
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1.1.2 Prospective Patients |
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9 | (1) |
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10 | (1) |
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1.1.4 Patient Responsibilities |
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11 | (1) |
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1.1.5 Terminating a Patient-Physician Relationship |
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12 | (1) |
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13 | (1) |
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1.1.7 Physician Exercise of Conscience |
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14 | (1) |
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1.1.8 Physician Responsibilities for Safe Patient Discharge from Health Care Facilities |
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15 | (1) |
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1.2 Special Issues in Patient-Physician Relationships |
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16 | (17) |
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1.2.1 Treating Self or Family |
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16 | (1) |
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1.2.2 Discrimination and Disruptive Behavior by Patients |
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17 | (2) |
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1.2.3 Consultation, Referral, and Second Opinions |
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19 | (1) |
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19 | (1) |
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20 | (1) |
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1.2.6 Work-Related and Independent Medical Examinations |
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20 | (1) |
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21 | (1) |
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1.2.8 Gifts from Patients |
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22 | (1) |
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1.2.9 Use of Remote Sensing and Monitoring Devices |
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23 | (1) |
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1.2.10 Political Action by Physicians |
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23 | (1) |
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1.2.11 Ethically Sound Innovation in Medical Practice |
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24 | (2) |
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1.2.12 Ethical Practice in Telemedicine |
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26 | (2) |
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28 | (5) |
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2 Consent, Communication, and Decision Making |
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33 | (20) |
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2.1 Informed Consent and Shared Decision Making |
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35 | (5) |
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35 | (1) |
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2.1.2 Decisions for Adult Patients Who Lack Capacity |
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36 | (1) |
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2.1.3 Withholding Information from Patients |
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37 | (1) |
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2.1.4 Use of Placebo in Clinical Practice |
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38 | (1) |
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2.1.5 Reporting Clinical Test Results |
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39 | (1) |
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2.1.6 Substitution of Surgeon |
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40 | (1) |
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40 | (7) |
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2.2.1 Pediatric Decision Making |
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40 | (2) |
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2.2.2 Confidential Health Care for Minors |
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42 | (1) |
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2.2.3 Mandatory Parental Consent to Abortion |
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43 | (1) |
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2.2.4 Treatment Decisions for Seriously III Newborns |
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44 | (1) |
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2.2.5 Genetic Testing of Children |
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45 | (2) |
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2.3 Communication with Patients |
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47 | (6) |
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2.3.1 Electronic Communication with Patients |
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47 | (1) |
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2.3.2 Professionalism in the Use of Social Media |
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48 | (1) |
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2.3.3 Informing Families of a Patient's Death |
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49 | (1) |
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2.3.4 Political Communications |
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49 | (1) |
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2.3.5 Soliciting Charitable Contributions from Patients |
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50 | (1) |
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2.3.6 Surgical Co-Management |
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51 | (2) |
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3 Privacy, Confidentiality, and Medical Records |
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53 | (14) |
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55 | (4) |
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3.1.1 Privacy in Health Care |
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55 | (1) |
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3.1.2 Patient Privacy and Outside Observers of the Clinical Encounter |
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55 | (1) |
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3.1.3 Audio or Visual Recording of Patients for Education in Health Care |
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56 | (1) |
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3.1.4 Audio or Visual Recording of Patients for Public Education |
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57 | (2) |
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3.1.5 Professionalism in Relationships with Media |
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59 | (1) |
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59 | (4) |
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59 | (1) |
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3.2.2 Confidentiality Postmortem |
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60 | (1) |
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3.2.3 Industry-Employed Physicians and Independent Medical Examiners |
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61 | (1) |
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3.2.4 Access to Medical Records by Data Collection Companies |
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62 | (1) |
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63 | (4) |
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3.3.1 Management of Medical Records |
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63 | (1) |
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3.3.2 Confidentiality and Electronic Medical Records |
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64 | (1) |
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3.3.3 Breach of Security in Electronic Medical Records |
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64 | (3) |
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4 Genetics and Reproductive Medicine |
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67 | (14) |
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69 | (3) |
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4.1.1 Genetic Testing and Counseling |
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69 | (1) |
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4.1.2 Genetic Testing for Reproductive Decision Making |
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70 | (1) |
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4.1.3 Third-Party Access to Genetic Information |
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71 | (1) |
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71 | (1) |
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4.2 Reproductive Medicine |
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72 | (9) |
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4.2.1 Assisted Reproductive Technology |
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72 | (1) |
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73 | (1) |
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4.2.3 Therapeutic Donor Insemination |
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74 | (1) |
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4.2.4 Third-Party Reproduction |
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75 | (2) |
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4.2.5 Storage and Use of Human Embryos |
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77 | (1) |
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4.2.6 Cloning for Reproduction |
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78 | (1) |
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79 | (2) |
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5 Caring for Patients at the End of Life |
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81 | (14) |
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5.1 Advance Care Planning |
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83 | (2) |
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85 | (1) |
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5.3 Withholding or Withdrawing Life-Sustaining Treatment |
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86 | (2) |
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5.4 Orders Not to Attempt Resuscitation (DNAR) |
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88 | (2) |
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5.5 Medically Ineffective Interventions |
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90 | (1) |
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5.6 Sedation to Unconsciousness in End-of-Life Care |
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91 | (1) |
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5.7 Physician-Assisted Suicide |
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92 | (1) |
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93 | (2) |
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6 Organ Procurement and Transplantation |
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95 | (14) |
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97 | (7) |
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6.1.1 Transplantation of Organs from Living Donors |
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97 | (2) |
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6.1.2 Organ Donation after Cardiac Death |
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99 | (1) |
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6.1.3 Studying Financial Incentives for Cadaveric Organ Donation |
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100 | (1) |
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6.1.4 Presumed Consent and Mandated Choice for Organs from Deceased Donors |
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101 | (1) |
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6.1.5 Umbilical Cord Blood Banking |
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102 | (1) |
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6.1.6 Anencephalic Newborns as Organ Donors |
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103 | (1) |
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6.2 Organ Transplantation |
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104 | (2) |
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6.2.1 Guidance for Organ Transplantation from Deceased Donors |
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104 | (1) |
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6.2.2 Directed Donation of Organs for Transplantation |
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105 | (1) |
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6.3 Special Issues in Organ Procurement and Transplantation |
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106 | (3) |
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6.3.1 Xenotransplantation |
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106 | (3) |
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7 Research and Innovation |
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109 | (24) |
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7.1 Physician Involvement in Research |
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111 | (5) |
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7.1.1 Physician Involvement in Research |
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111 | (1) |
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7.1.2 Informed Consent in Research |
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112 | (1) |
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7.1.3 Study Design and Sampling |
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113 | (1) |
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7.1.4 Conflicts of Interest in Research |
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114 | (2) |
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7.1.5 Misconduct in Research |
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116 | (1) |
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7.2 Disseminating Research Results |
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116 | (3) |
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7.2.1 Principles for Disseminating Research Results |
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116 | (1) |
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7.2.2 Release of Data from Unethical Experiments |
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117 | (1) |
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7.2.3 Patents and Dissemination of Research Products |
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118 | (1) |
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7.3 Special Issues in Research |
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119 | (4) |
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7.3.1 Ethical Use of Placebo Controls in Research |
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119 | (2) |
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7.3.2 Research on Emergency Medical Interventions |
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121 | (1) |
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7.3.3 International Research |
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122 | (1) |
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7.3 A Maternal-Fetal Research |
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123 | (10) |
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7.3.5 Research Using Human Fetal Tissue |
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124 | (1) |
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7.3.6 Research in Gene Therapy and Genetic Engineering |
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125 | (1) |
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7.3.7 Safeguards in the Use of DNA Databanks |
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126 | (2) |
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7.3.8 Research with Stem Cells |
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128 | (1) |
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7.3.9 Commercial Use of Human Biological Materials |
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129 | (1) |
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7.3.10 Expanded Access to Investigational Therapies |
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130 | (3) |
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8 Physicians and the Health of the Community |
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133 | (18) |
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8.1 Routine Universal Screening for HIV |
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135 | (1) |
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8.2 Impaired Drivers and Their Physicians |
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136 | (1) |
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8.3 Physicians' Responsibilities in Disaster Response and Preparedness |
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137 | (1) |
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8.4 Ethical Use of Quarantine and Isolation |
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138 | (1) |
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8.5 Disparities in Health Care |
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139 | (1) |
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8.6 Promoting Patient Safety |
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140 | (1) |
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8.7 Routine Universal Immunization of Physicians |
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141 | (1) |
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8.8 Required Reporting of Adverse Events |
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142 | (1) |
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8.9 Expedited Partner Therapy |
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143 | (1) |
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8.10 Preventing, Identifying, and Treating Violence and Abuse |
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144 | (1) |
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8.11 Health Promotion and Preventive Care |
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145 | (2) |
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8.12 Ethical Physician Conduct in the Media |
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147 | (1) |
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8.13 Physician Competence, Self-Assessment, and Self-Awareness |
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148 | (3) |
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9 Professional Self-regulation |
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151 | (34) |
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153 | (2) |
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9.1.1 Romantic or Sexual Relationships with Patients |
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153 | (1) |
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9.1.2 Romantic or Sexual Relationships with Key Third Parties |
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153 | (1) |
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9.1.3 Sexual Harassment in the Practice of Medicine |
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154 | (1) |
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9.2 Physician Education and Training |
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155 | (6) |
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9.2.1 Medical Student Involvement in Patient Care |
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155 | (1) |
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9.2.2 Resident and Fellow Physicians' Involvement in Patient Care |
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155 | (2) |
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9.2.3 Performing Procedures on the Newly Deceased |
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157 | (1) |
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9.2.4 Disputes between Medical Supervisors and Trainees |
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157 | (1) |
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9.2.5 Medical Students Practicing Clinical Skills on Fellow Students |
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158 | (1) |
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9.2.6 Continuing Medical Education |
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159 | (1) |
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9.2.7 Financial Relationships with Industry in Continuing Medical Education |
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159 | (2) |
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161 | (2) |
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9.3.1 Physician Health and Wellness |
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161 | (1) |
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9.3.2 Physician Responsibilities to Colleagues with Illness, Disability, or Impairment |
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162 | (1) |
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9.4 Peer Review and Disciplinary Action |
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163 | (4) |
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9.4.1 Peer Review and Due Process |
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163 | (1) |
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9.4.2 Reporting Incompetent or Unethical Behavior by Colleagues |
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164 | (1) |
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9.4.3 Discipline and Medicine |
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165 | (1) |
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9.4.4 Physicians with Disruptive Behavior |
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166 | (1) |
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9.5 Physician Involvement in Health Care Institutions |
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167 | (2) |
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9.5.1 Organized Medical Staff |
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167 | (1) |
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167 | (1) |
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168 | (1) |
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9.5.4 Civil Rights and Medical Professionals |
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168 | (1) |
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9.5.5 Gender Discrimination in Medicine |
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168 | (1) |
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9.6 Physician Promotion and Marketing Practices |
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169 | (9) |
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9.6.1 Advertising and Publicity |
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169 | (2) |
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9.6.2 Gifts to Physicians from Industry |
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171 | (1) |
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9.6.3 Incentives to Patients for Referrals |
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172 | (1) |
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9.6.4 Sale of Health-Related Products |
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172 | (1) |
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9.6.5 Sale of Non-Health-Related Goods |
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173 | (1) |
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9.6.6 Prescribing and Dispensing Drugs and Devices |
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174 | (1) |
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9.6.7 Direct-to-Consumer Advertisement of Prescription Drugs |
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174 | (1) |
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9.6.8 Direct-to-Consumer Diagnostic Imaging Tests |
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175 | (2) |
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9.6.9 Physician Self-Referral |
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177 | (1) |
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9.7 Physician Interactions with Government Agencies |
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178 | (7) |
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178 | (1) |
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9.7.2 Court-Initiated Medical Treatment in Criminal Cases |
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179 | (1) |
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9.7.3 Capital Punishment m |
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180 | (2) |
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9.7.4 Physician Participation in Interrogation |
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182 | (1) |
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183 | (2) |
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10 Interprofessional Relationships |
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185 | (12) |
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10.1 Ethics Guidance for Physicians in Nonclinical Roles |
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187 | (1) |
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10.1.1 Ethical Obligations of Medical Directors |
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187 | (1) |
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10.2 Physician Employment by a Nonphysician Supervisee |
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188 | (1) |
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189 | (1) |
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190 | (1) |
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10.5 Allied Health Professionals |
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190 | (1) |
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10.6 Industry Representatives in Clinical Settings |
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191 | (1) |
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10.7 Ethics Committees in Health Care Institutions |
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192 | (2) |
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10.7.1 Ethics Consultations |
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193 | (1) |
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194 | (3) |
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11 Financing and Delivery of Health Care |
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197 | (18) |
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11.1 Access to Health Care |
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199 | (4) |
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11.1.1 Defining Basic Health Care |
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199 | (1) |
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11.1.2 Physician Stewardship of Health Care Resources |
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199 | (2) |
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11.1.3 Allocating Limited Health Care Resources |
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201 | (1) |
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11.1.4 Financial Barriers to Health Care Access |
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202 | (1) |
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11.2 Health Care Organizations and Physician Practice |
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203 | (7) |
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11.2.1 Professionalism in Health Care Systems |
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203 | (2) |
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11.2.2 Conflicts of Interest in Patient Care |
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205 | (1) |
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11.2.3 Contracts to Deliver Health Care Services |
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205 | (1) |
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11.2.3.1 Restrictive Covenants |
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206 | (1) |
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11.2.4 Transparency in Health Care |
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207 | (1) |
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11.2.5 Retainer Practices |
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207 | (1) |
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11.2.6 Mergers between Secular and Religiously Affiliated Health Care Institutions |
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208 | (2) |
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210 | (5) |
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11.3.1 Fees for Medical Services |
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210 | (1) |
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11.3.2 Fees for Nonclinical and Administrative Services |
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211 | (1) |
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11.3.3 Interest and Finance Charges |
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211 | (1) |
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212 | (3) |
Guide to the Use of Annotations |
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215 | (2) |
Annotations |
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217 | (1) |
Principles of Medical Ethics |
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217 | (60) |
Opinions of the Council on Ethical and Judicial Affairs |
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277 | (232) |
Concordance |
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509 | (10) |
Index of Cases |
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519 | (10) |
Index of Articles |
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529 | (60) |
Index |
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589 | |