Bioethics in Nutrition Flashcards
What are the four principles of medical ethics?
Why are they important?
Describe each.
- autonomy
- non-maleficence
- beneficence
- justice
Autonomy:
Respecting the decisions of those who have capacity to make decisions about their own care.
Non-maleficence:
The obligation to not purposely inflict harm on others
Beneficence:
There are two parts to beneficence:
Provide a benefit
Weigh up risk and benefit
Justice:
Fair and equal provision and distribution of benefits, risks, cost and resources
Define the concept and process of ethics.
Ethics are moral principles that govern our behaviour or conduct of our activities.
Ethics is a process of reasoning so that a morally respectable and defensible decision can be reached that protects the best interests of the patient.
Describe and define bioethics
- what are the components of bioethics?
Bioethics is the study of ethical, social, and legal issues that arise in biomedicine and biomedical research.
Bioethics is the ‘natural child’ of scientific and medical progress and is based on the necessity of finding the best balance between the benefits and harms of progress (Calahan, 2020).
Can we? (technical question)
Should we? (moral question)
Bioethics encompasses:
- Medical ethics
- Environmental ethics
- Public health ethics
What are the UKVRN Standards of Ethics, Conduct and Performance (2019)?
All UKVRN Registrants commit that they will adhere to the following AfN Standards of Ethics, Conduct and Performance:
- Prioritize public benefit
- Practice safely and effectively
- Work within own limits
- Communicate appropriately
- Be honest and trustworthy
- Speak up about concerns
- Respect and maintain confidentiality
- Promote professionalism
What are two important perspectives to consider in bioethics?
Individual health perspective:
Maximising the good of individual patients
Importance of principles of beneficence & autonomy
Health policy perspective:
Maximising the good of society rather than individuals
Importance of utilitarianism & justice
What are the different types of moralist?
- relate to a nutrition based ethical dilemma
Duty-based moralist:
- Concerned with the intrinsic merits of a medical decision rather than the consequences.
- Would protect the sanctity of life at all costs.
Nutrition example: would always feed the patient no matter the anticipated outcome on the basis that this is the duty of a doctor.
The goal based moralist (utilitarian):
- Believes the actions consequences are the determinant of whether the action itself is right or not.
- Would justify the mortality/morbidity of a few patients by the potential benefit to the majority of patients.
Nutrition example: would feed when appropriate to do so, or withdraw nutrition, based on the results of a scientific trial.
The rights based moralist:
- The fundamental principle of medical law.
- Would condemn an action if it violated the patients rights.
Nutrition example: would argue that a patient should always be offered nutritional support and if a patient refuses nutrition support this must be respected.
Why is ethics essential in nutrition?
How is ethics in nutrition governed by the AfN?
Nutrition is an extensive profession with diverse specialisms, practised in a wide range of settings. An essential element of nutrition work is to protect and benefit the public.
All AfN registrants (RNutr/ANutr) agree to adhere to the AfN Standards of Ethics, Conduct and Performance.
The AfN Standards of Ethics, Conduct and Performance apply across the field and are intended to guide registrants in their behaviour and work related decisions, to ensure they practise safely, effectively and appropriately.
Core competency 5 (CC5a-CC5f) is also concerned with Professional Conduct.
- Understanding of professional conduct and the Association for Nutrition’s Standards of Ethics, Conduct and Performance.
What are the benefits of having AfN ethical code of conduct?
- Demonstration of our Values
- Protection of Public
- Our responsibility to Clients
- Our responsibility to the Profession
- Our responsibility to Colleagues & other Professions
Explain the role of ethics in nutrition research.
Identify underlying ethical principles
To discuss central ethical concepts associated with conducting research including:
- Informed consent
- Confidentiality
- Scientific integrity
Identify strategies to ensure ethical research related to example studies
What are the research patients’ rights?
- what are the different types of consent?
Participants’ rights:
- to give or refuse consent
- to withdraw from the research
- to confidentiality
- to all relevant information
Types of consent:
Voluntary:
No coercion or undue influence e.g. suggesting participants get involved as a personal favour, offering ‘irresistible’ positive benefits or tokens of appreciation.
Informed:
Merely signing a form is not sufficient. Perhaps get ideas from larger group about what we need to do as researchers to ensure understanding and authentic consent e.g. use of appropriate language – no medical/technical jargon – pitched at the person’s comprehension level, show/demonstrate equipment or procedure, encouraged to ask questions (on more than one occasion) etc…
Competence:
The minimum level of mental capacity and skill in reasoning and rational conduct needed to guide a person’s life according to their own desires, beliefs, and intentions
Who would be considered vulnerable?
People are considered vulnerable when they:
- Are partially or entirely unable to make autonomous decisions to participate
- Have a greater potential of experiencing harm in the research process
- Have little or no status within society
- Are in distress
