7. HUMAN RIGHTS AND DIGNITY IN CARE Flashcards
1
Q
- 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
2
Q
- 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
3
Q
- 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
4
Q
- 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
5
Q
- What happens when a patient’s rights are compromised?
A
- they feel that their autonomy is not respected
6
Q
- What do Human Rights refer to?
A
- they refer to respect for the person and their dignity
- human rights and moral rights are complementary
7
Q
- What do Legal Rights reflect?
A
- they reflect the doctor’s duties
- they reflect the doctor’s obligation towards protecting
citizens
8
Q
- 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
9
Q
- 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”
10
Q
- 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
11
Q
- What are the 4 Principles of Health Care Ethics?
A
- Autonomy
- Beneficence
- Non-Maleficence
- Justice
12
Q
- 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
13
Q
- 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
14
Q
- 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
15
Q
- In the domain of Health care, what forms can respecting a patient’s autonomy take?
A
16
Q
- 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
- 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
- What is Beneficence according to Beauchamp and Childress?
A
IT IS PERFORMING DEEDS OF:
- mercy
- kindness
- charity
19
Q
- What are the 5 rules of Beneficence?
A
- Protect and defend the rights of others
- Prevent harm from occurring to others
- Remove conditions that will cause harm to others
- Help persons with disabilities
- Rescue persons in danger
20
Q
- What is Beneficence useful for?
A
- it helps to establish a process for ranking the available
treatment options
21
Q
- What 4 questions should a doctor ask themselves when it comes to using beneficence to establish a treatment?
A
- Will this treatment option resolve this patient’s
medical problem? - Is it proportionate to the scale of the medical
problem? - Is this treatment option compatible with this patient’s
individual circumstances? - Is the specific option and its outcomes in line with the
patient’s expectations of treatment?
22
Q
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- What is Justice?
A
- this is a principle that helps Health Professionals make
decisions about:
- time
- money
- clinical resources
35
Q
- What two points are emphasised by the Principle of Justice?
A
- Patients in similar situations should have access to
the same healthcare - 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
- we must take into account the effect of such use of
36
Q
- Look at this example.
What can be said about Justice?
A
- DISTRIBUTIVE JUSTICE:
- this is the fair distribution of resources
- 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
- 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
- What two Principles did John Rawls advocate for in terms of Justice?
A
- Everyone should be given equal liberty
- this is regardless of their adversities
- Differences among people should be recognised
- this is done by making sure the least-advantaged
people are given opportunities for improvement
- this is done by making sure the least-advantaged
NB:
- there should be no self interest from the doctor’s side
when making these decisions
39
Q
- Read through this case.
How do Autonomy and Justice apply to this situation?
A
- 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
- the patients have the right to be given access to
- 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