19.1 Bioethics in care of patients with advanced illness

Question 1

What is an approach to analyze ethical dilemma

Answer 1

Acquisition of relevant information
Assessment
Plan

Question 2

What are the 4 categories of relevant information to be acquired in an ethical dilemma? (4 box method)

Answer 2

Medical indications
Patient preferences
Patient QOL
Contextual/external factors (e.g. family, religion, economy, resource allocation)

Question 3

Name 4 ethics principles in medicine

Answer 3

Autonomy
Beneficence
Non-maleficence
Justice

Question 3

What does patient autonomy refer to (universally)?

Answer 3

Negative right autonomy (i.e. right to refuse to treatment)

Question 4

What is moral distress - for HCP? What does it contribute to (name 3)?

Answer 4

Moral distress = negative emotions/attitudes that arise in response to one’s perceived involvement in a situation that one perceives to be morally undesirable

Contributes to: job dissatisfaction, burnout and attrition

Question 5

Name 3 ways to address moral distress

Answer 5

Collect/share information to understand rationale behind decisions

Self regulation - clinicians have boundaries and know what they’re responsible for

Ethical competence

Moral resilience

Self-awareness - of one’s own values and biases

Being able to sit with suffering and know who is suffering