1001. Ethics and politics in medicine

Question 1

What makes up ethics?

Answer 1

1. Principles
2. Values
3. Honesty
4. Standards and rules of behaviour that guide the decisions

Question 2

What are the four principles of ethics?

Answer 2

1. Respect for autonomy: promote right to self-determination (confidentiality, informed consent, promote capacity)
2. Non-maleficence (avoidance of harm)
3. Beneficence (do good)
4. Justice (fairness/ equity, equal treatment, non-discrimination, individual vs population (rationing, limits to autonomy))

Question 3

What practices should a Dr do to uphold their ethical standards?

Answer 3

• Non-judgemental approach
• Not imposing personal views and respecting patient’s views
• Confidentiality
• Not exceeding your competency
• Fitness to practice

Question 4

What are the GMC duties of a Dr?

Answer 4

• Make care of patient your first concern
• Treat every patient politely and considerately
• Respect patient’s dignity and privacy
• Listen to patients and respect their views
• Give patients information in a way they can understand
• Respect rights of patients to be fully involved in decisions about their care
• Keep professional skills and knowledge up to date
• Recognise limits of professional competency (yours)
• Be honest and trustworthy
• Respect and protect confidential information
• Make sure your personal beliefs do not prejudice your patient’s care
• Act quickly to protect patients from risk if you have a good reason to believe that you or a colleague may not be fit to practice
• Avoid abusing your position as a doctor
• Work with colleagues in the ways that best serve patient’s interests

Question 5

What are the professionalism standards of a Dr?

Answer 5

1. not imposing your personal views and respect patient’s views
2. confidentiality
3. not exceeding your competency
4. fitness to practice

Question 6

What is a Dr’s duty of candour?

Answer 6

• Be open and honest with patients when something goes wrong with a patients treatment or care which causes, or has the potential to cause harm or distress
• If you are unsure of the consequences immediately seek the advice of an appropriate senior colleague to peer review your view and subsequently tell the patient (or the patients advocate, carer or family) when something has gone wrong even if the patient is not aware or has not complained
• You must apologise to the patient and offer an appropriate remedy or support to put matters right (if possible) and explain fully the short and long term effects of what has happened
• This duty requires you to be open and honest with all parties as well as any relevant organisations such as your employer, practice principal or the Health Authority of Board; you must take part in reviews and investigations when requested.
• You must raise concerns when appropriate if you believe a patients best interests potentially have been or actually have been compromised.
• As a doctor or a student you should encourage other peers and colleagues to be open and honest; you must not stop someone who has concerns from raising concern

Question 7

What are some policies in Britain that aim to influence health?

Answer 7

• Smoking Ban (Health Act of 2006); can’t smoke in closed public spaces or NHS grounds
• Alcohol taxation increase
• Ban of advertisement of fast food
• Sugar tax
• Legal drinking age
• Change in smoking packaging
• Ban on smoking in cars with children <18
• Child care support
• Minimum wage
• Early life: health checks, vaccination programmes, pre-natal and post-natal follow ups, childcare for free, repeat prescriptions, emergency appointments for children, free school meals in P1-p3

Question 8

What do health policies aim to influence?

Answer 8

• Sanitation and immunisation
• Housing
• Human safety
• Famine
• Education
• Poverty/ social inequality
• Health and safety

Question 9

What actions do a government take to promote health?

Answer 9

• Legislation/policies on smoking/alcohol
• Improvements in housing
• Provision of health education
• Health and safety laws
• Traffic/transport legislation/policies

Question 10

What causes variables in public health?

Answer 10

1. Democracy
2. International rivalry
3. Civil conflict
4. Ethno-religious cleavages
5. Income inequality
6. Rapid urbanisation
7. Level of educational attainment
8. Level of economic development

Question 11

What lifestyle factors influence health?

Answer 11

• Active vs sedentary
• Diet
• Obesity
• Alcohol consumption
• Smoking
• Sexual health
• Illicit drugs