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MED 105- MEDICAL ETHICS > 8. APPLYING THE 4 PRINCIPLES > Flashcards

8. APPLYING THE 4 PRINCIPLES Flashcards

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USMLE® Step 1 flashcards
1
Q
  1. Is there a hierarchy with regards to the 4 principles?
A
  • no
  • they are non-hierarchal
  • a doctor is required to take all the principles into
    account when they are applicable to the clinical case
    that is being considered

NB:
- when two or more principles can be considered in the
case, there can be conflict between them

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2
Q
  1. Look at this case.
    How do the 4 Principles apply here?
A
  1. AUTONOMY:
    - the patient dislikes needles
    - the patient does not want the operation
  2. BENEFICENCE:
    • the doctors need to find a solution that would
      prevent kidney failure
    • there is a need to go ahead with the operation
  3. NON-MALEFICENCE:
    • forcing the patient to accept the needle might be
      harmful to them
    • the surgery could cause physical and psychological
      harm
  4. JUSTICE:
    • the patient may start to go into preventable kidney
      failure
    • she will need dialysis
    • this will have a negative impact on patients who
      need the same treatment
    • this would create an extra burden for specialist
      services
    • a financial and physical burden would be placed on
      the patient

NB:
- the doctor needs to make a decision guided by
achieving the best possible benefits for the patient and
society

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3
Q
  1. What are the 5 contributions of the 4 Principles approach?
A
  1. it identifies key principles for ethical and clinical
    practice
  2. Beauchamp and Childress suggest a common
    morality
  3. It draws attention to the values, rights and normalities
    of the underlying moral dilemmas
  4. it reflect’s the doctors duties
  5. it allows for multiple moral considerations
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4
Q
  1. List 3 criticisms of the 4 Principles Approach.
A
  1. IT CAN BE PROBLEMATIC
    • to adhere to the same principles and guidelines for
      different situations
  2. THE PRINCIPLES ARE NON SPECIFIC
    • they appear to simply remind the decision maker of
      considerations that should be taken into account
  3. THERE IS NO AGREED UPON METHOD FOR SOLVING
    CONFLICTS
    • this becomes a problem when two different
      principles conflict about what should be done
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5
Q
  1. How should the 4 Principles approach be treated?
A
  • it should not be treated as a general moral theory
  • it should be treated as an assist when it comes to
    reflecting in moral problems
  • it acts as an assist when it comes to moving towards an
    ethical solution
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6
Q
  1. Does this summary make sense?
A
  • yes
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7
Q
  1. What tools exist for the analysis of Clinical Ethics cases?
A
  • we can analyse ethical dilemmas and case studies
    using ethical theories
    (consequentialism, utilitarianism, deontology, virtue
    ethics)
  • we can use a number of frameworks and practical
    tools to assist in the analysis of a case
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8
Q
  1. Name 3 practical and methodological frameworks we can use to assist in Clinical Case analysis.
A
  1. The Four Principles Approach
  2. The Future Topics approach
  3. The Structured Case Analysis Model
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9
Q
  1. Which Approach is this?
A
  • the Four Principles Approach
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10
Q
  1. What is the Four Topics Approach?
A
  • it is a list of questions to ask yourself when it comes to
    making decisions about the treatment of the patient
  • it is especially useful when the patient denies
    treatment
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11
Q
  1. Who described the Four Topics approach?
A
  • Jonsen
  • Siegler
  • Winslade
  • in 2006
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12
Q
  1. Read over this.
    Do you understand it?
A
  • yes
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13
Q
  1. Read over this.
    Do you understand it?
A
  • yes
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14
Q
  1. What are the 7 steps of the Structured Case Analysis Model?
A
  1. Summarise the Case
  2. State the Moral Dilemma
  3. State the Assumptions being made or to be made
  4. Analyse the case
  5. Acknowledge the justifiable ethical solutions
  6. Lose the ethical solutions that are not justifiable
  7. State the preferred approach with explanation
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15
Q
  1. When we analyse the case in the Structured Case Analysis, what do we analyse it in reference to?
A

WE ANALYSE IT IN REFERENCE TO:
- ethical principles
- consequences
- professional codes
- virtuous health care practices
- the law

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16
Q
  1. According to the World Medical Association Medical Ethics Manual (2015), what are the 6 steps to conducting an Ethical Analysis?
A
  1. Determine whether the issue at hand is an ethical one
  2. Consult Authoritative Sources
    • EG: Medical Association Codes of Ethics and Policies
    • EG: Respected colleagues
  3. Consider Alternative solutions in the light of the:
    • principles
    • duties
    • values
    • likely consequences
  4. Discuss your proposed solution with those whom it
    will affect
  5. Make your decision and act on it
    • be sensitive to others affected
  6. Evaluate your decision
17
Q
  1. Read over this question.
    What should you do?
A

CONSULT CLINICAL ETHICS SUPPORT:
- EG: Clinical Ethics Committees
- EG: Clinical Ethics Consultancy

18
Q
  1. What are Clinical Ethics Committees (CECs)?
A
  • they are multidisciplinary and independent groups
19
Q
  1. What members do Clinical Ethics Committees have?
A
  • different health professionals
    (this makes up majority of the members)
  • members of hospital management
  • members of administration
  • legal members
  • medical ethics academics
  • religious members
  • lay members
20
Q
  1. What is the aim of the Clinical Ethics Committees?
A
  • they aim to provide support for decision making on
    ethical issues
  • these ethical issues arise from several aspects of
    patient care
  • they help to provide discussion and advice about
    complex or controversial cases
  • they do not take over responsibility for a clinical
    decision
  • the responsibility for a clinical decision remains with
    the doctor and the clinical team
21
Q
  1. What are the 3 Primary Functions of the Clinical Ethics Committee?
A
  1. Case Consultation
    (for both urgent and non-urgent cases)
  2. Ethics Education
  3. Policy Development and Review
    (this includes the interpretation of National
    Guidelines)
22
Q
  1. What are some frequent issues for consultations with Clinical Ethics Committees (CECs)?
A
  • the withholding and withdrawing or life sustaining
    treatment
  • consent and capacity
  • refusal of treatment and restraint issues
    (this treatment could save the patients life)
  • pandemic responses
23
Q
  1. Read through this summary.
    Does everything make sense?
A
  • yes
24
Q
  1. Answer the following questions.
A
  • you can answer them verbally or on a piece of paper

MED 105- MEDICAL ETHICS (36 decks)

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