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MED 105- MEDICAL ETHICS > 7. HUMAN RIGHTS AND DIGNITY IN CARE > Flashcards

7. HUMAN RIGHTS AND DIGNITY IN CARE Flashcards

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USMLE® Step 1 flashcards
1
Q
  1. What is the Universal Declaration of Human Rights?
A
  • it is a series of articles that sets certain standards to
    define the rights of all human beings
  • it was signed in 1948
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2
Q
  1. What is Article 1 of the Universal Declaration of Human Rights?
A
  • all human beings are born free and equal in dignity
    and rights
  • they are endowed with reason and conscience
  • they should act towards one another in a spirit of
    brotherhood
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3
Q
  1. What is dignity?
A
  • it is when we show respect to someone
  • it is the view point that a person is an individual being
    that deserves respect
  • the respect of one’s human rights
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4
Q
  1. What is meant by dignity in care?
A
  • this refers to treating patients as individuals
  • patients are entitled to respect
  • they are entitled to autonomy, privacy and self-worth
  • this refers to ensuring that the patient does not feel
    dehumanised based on their illness
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5
Q
  1. What happens when a patient’s rights are compromised?
A
  • they feel that their autonomy is not respected
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6
Q
  1. What do Human Rights refer to?
A
  • they refer to respect for the person and their dignity
  • human rights and moral rights are complementary
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7
Q
  1. What do Legal Rights reflect?
A
  • they reflect the doctor’s duties
  • they reflect the doctor’s obligation towards protecting
    citizens
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8
Q
  1. What does Dignity in care refer to?
A
  • it refers to treating patients as individuals
  • these patients are entitled to their own respect,
    autonomy, privacy and self worth
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9
Q
  1. Who developed the 4 Principles of Health Care in Ethics?
A
  • Tom Beauchamp and James Childress
  • they were developed in the 1979 book:
    “Principles of Biomedical Ethics”
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10
Q
  1. What do the 4 Principles of Health Care in Ethics provide to medical practitioners?
A
  • they provide guidelines to make decisions
  • this is useful for facing complicated situations involving
    patients
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11
Q
  1. What are the 4 Principles of Health Care Ethics?
A
  1. Autonomy
  2. Beneficence
  3. Non-Maleficence
  4. Justice
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12
Q
  1. What is the framework of Principles?
A
  • they are general norms
  • they leave considerable room for judgement in many
    cases
  • they are not a precise action guide
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13
Q
  1. What is Autonomy?
A
  • it revolves around self rule and self determination
  • it is the ability to think, to decide and to act
    on the basis of your own thoughts and decisions
  • it is the ability to do the above mentioned freely and
    independently
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14
Q
  1. How does Autonomy perceived in Health Care?
A
  • a medical practitioner cannot impose treatment on an
    individual for whatever reason
  • health practitioners need to help and support patients
    in coming to their own decisions
  • health practitioners need to respect and follow those
    decisions
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15
Q
  1. In the domain of Health care, what forms can respecting a patient’s autonomy take?
A
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16
Q
  1. Read through this case.
    Are there any limits to the patient’s autonomy?
A
  • the patient is not in absolute capacity
  • this is due to the fact that he may have sustained a
    brain injury
  • this can damage his reasoning and cloud his clarity
  • he has the necessity for treatment
  • he is a risk to others
    (he could have an infectious disease)

NB:
- the patient does have the right to refuse treatment
- the doctor may have to make the decision for the
patient is the patient is in a comma or not capable to
do so

17
Q
  1. What is Beneficence?
A
  • this refers to the moral importance of doing good to
    others
    (your patients)
  • it is about taking actions to benefit and promote the
    welfare of other people
18
Q
  1. What is Beneficence according to Beauchamp and Childress?
A

IT IS PERFORMING DEEDS OF:
- mercy
- kindness
- charity

19
Q
  1. What are the 5 rules of Beneficence?
A
  1. Protect and defend the rights of others
  2. Prevent harm from occurring to others
  3. Remove conditions that will cause harm to others
  4. Help persons with disabilities
  5. Rescue persons in danger
20
Q
  1. What is Beneficence useful for?
A
  • it helps to establish a process for ranking the available
    treatment options
21
Q
  1. What 4 questions should a doctor ask themselves when it comes to using beneficence to establish a treatment?
A
  1. Will this treatment option resolve this patient’s
    medical problem?
  2. Is it proportionate to the scale of the medical
    problem?
  3. Is this treatment option compatible with this patient’s
    individual circumstances?
  4. Is the specific option and its outcomes in line with the
    patient’s expectations of treatment?
22
Q
  1. Why is Autonomy vs. Beneficence a complicated topic?
A
  • we have to asses the health professional’s opinion
    against the patient’s own views
  • there is a divergence between medical interest and
    medical benefit
  • there is a divergence between the patient’s best
    interests, their wishes and their preferences
23
Q
  1. How does the best interest of the patient become a broader concept?
A
  • it has to reflect the WHO definition of health
  • this outlines that health is a state of complete physical,
    mental and social well-being
  • the patient’s perspective must be included
24
Q
  1. When does the doctor have to make sole decisions?
A
  • they have to make these decisions if the patient is
    incapable or if they have no family or friends to help
    make the decision for them
25
Q
  1. Read through this case.
    What can be said about Autonomy vs Beneficence?
A

IN EMERGENCY MEDICINE:
- the principle of Beneficence is often given priority over
the principle of respect for patient autonomy
- the doctor has to make the best decision because the
patient is unconscious

26
Q
  1. What is Non-maleficence?
A
  • health professionals should avoid harm on patients
  • most medical treatments have a chance of doing some
    harm
    (such treatments should not always be avoided)
  • the potential benefits, harms and their probabilities
    should be weighed up
  • this should help decide what is in the patient’s overall
    best interests
27
Q
  1. What are some examples of Maleficence in Health Care?
A
  • doctors can cause harm by making the wrong
    judgement based on a lack of information
  • doctors can cause harm by confusing one patient’s files
    with another
28
Q
  1. How can we describe the relationship between Non-Maleficence and Beneficence?
A
  • Health care professionals are encouraged to do good
    (Beneficence)

IF FOR SOME REASON THEY CANNOT:
- they are required to do the least harm
(Non-Maleficence)

29
Q
  1. Read through this case.
    How is this an example of Beneficence?
A
  • the appendix could be successfully removed in situ
  • this would certainly improve the patients life
30
Q
  1. Read through this case.
    How does Non-Maleficence tie into this?
A
  • there is a high risk of infection in a non-sterile
    environment
  • there are low chances of a successful operation
  • there are no other clinical staff or surgical equipment
    available
  • there is no prior experience of doing an appendectomy
    at the roadside
  • not doing the surgery would avoid all the above
    mentioned harm
31
Q
  1. What is a constant standard for Clinical Practice?
A
  • Beneficence
  • Non Maleficence
  • these are in response to a specific situation for a
    specific patient
32
Q
  1. What acts as a threshold for treatment?
A
  • Non Maleficence
  • treatments that cause more harm than good should
    not be considered
  • a high risk factor deduces which treatments are not
    worth while
33
Q
  1. How does Beneficence help with making a treatment decision?
A
  • it helps to consider all the valid treatment options
  • we then prioritise based on this
34
Q
  1. What is Justice?
A
  • this is a principle that helps Health Professionals make
    decisions about:
    - time
    - money
    - clinical resources
35
Q
  1. What two points are emphasised by the Principle of Justice?
A
  1. Patients in similar situations should have access to
    the same healthcare
  2. When it comes to determining the level of care that
    should be available for one set of patients:
    • we must take into account the effect of such use of
      resources on the other patients
36
Q
  1. Look at this example.
    What can be said about Justice?
A
  1. DISTRIBUTIVE JUSTICE:
    • this is the fair distribution of resources
  2. SOCIAL JUSTICE
    • this is also known as Rights Based Justice
    • it focuses on the fact that benefits and burdens
      should be distributed fairly among members of a
      society
    • these resources should be distributed with respect
      for people’s needs and rights
37
Q
  1. What was John Rawls theory of Justice in 1971?
A
  • fairness and equality should be evaluated from a
    position that is free of biases
  • there needs to be an equal access to health care
    services
38
Q
  1. What two Principles did John Rawls advocate for in terms of Justice?
A
  1. Everyone should be given equal liberty
    • this is regardless of their adversities
  2. Differences among people should be recognised
    • this is done by making sure the least-advantaged
      people are given opportunities for improvement

NB:
- there should be no self interest from the doctor’s side
when making these decisions

39
Q
  1. Read through this case.
    How do Autonomy and Justice apply to this situation?
A
  1. AUTONOMY
    • the patients have the right to be given access to
      specialised health services
    • the patient has the right to make the treatment
      decision for themselves
  2. JUSTICE
    • this is the allocation of resources
    • not all treatments can be funded for all patients
    • prioritising the cancer patients will limit the ability of
      the other patients to access healthcare resources

MED 105- MEDICAL ETHICS (36 decks)

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