Bioethics in Public Health Flashcards
What are the 4 bioethical principles?
- autonomy
- non-malficience
- beneficience
- justice
What is autonomy?
the right or condition of self government
What are elements of autonomy?
- Obtaining informed consent for treatment
- facilitating and supporting patients’ choices regarding treatment options
- allowing patients to refuse treatments
- disclosing comprehensive and truthful information, diagnoses, and treatment options to patients
- maintaining privacy and confidentiality
What is informed consent?
Informed consent is respecting a person’s autonomy to make personal choices based on the appropriate appraisal of information about the actual or potential circumstances of a situation
Importance of informed consent?
- Assess risk benefit ratio
- Reduce misunderstandings/confusion
- Protects researcher from legal issues
- Observes the right of autonomy (self-rule)
Elements of informed consent?
- Threshold elements (preconditions)
- Competence (to understand and decide)
- Voluntariness (in deciding) - Information elements
- Disclosure (of material information)
- Recommendation (of a plan)
- Understanding (comprehension) - Consent elements
- Decision (in favor of a plan)
- Authorization (of the chosen plan)
What is non-maleficence?
The obligation to do no harm
- Non-maleficence is the maxim or norm that one ought not to inflict evil or harm
What is beneficencnce?
To do good
- The principle of beneficence consists of performing deeds of “mercy, kindness, friendship, charity and
the like”
What is paternalism?
The deliberate overriding of a patient’s opportunity to exercise autonomy because of a perceived obligation of beneficence
- usually applied by governments e.g. Use Police power
What are the roles of beneficence?
- 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.
What is justice?
refers to fairness, treating people equally (equality) and without prejudice, and the equitable distribution (equity) of benefits and burdens, including assuring fairness in biomedical research
What is distributive justice?
refers to the fair allocation of resources, whereas social justice represents the position that benefits and burdens should be distributed fairly among members of a society, or ideally that people in a society should have the same rights (human rights), benefits, and opportunities.
What is an ethical dilemma?
is a situation in which an individual is compelled to choose between two actions that will affect the welfare of a
sentient being, and both actions are reasonably justified as being good, neither action is readily justified as being good, or the goodness of the actions is uncertain.
Main social issues with ethical implications involved in the Tuskegee experiment?
- Justice
- equality
- rights
- discrimination (only blacks)
- lie/deception
- lack of respect
- loss of trust
What are the bioethical principles were violated by the Tuskegee study?
- Autonomy
- there was no informed consent - Justice
- unequal treatment with others
- Not given treatment for syphilis when
actually it was available - Non-maleficence
- Harm of study participants by spinal tap without anaesthesia - Beneficence
- not giving the participants the available treatment - Truth telling
- Lie that they were treating participants for ‘Bad blood’ - unfair subject selection
Ethical principles for conducting clinical or biomedical research?
- Value – aimed at the enhancement of health knowledge - the research should provide information on how to tackle the ailment under study.
- Independent review - unaffiliated individuals must review the research periodically.
- Informed consent - potential participants ought to be made aware of the research, and their consent sought.
- Respect for enrolled subjects - subject’s rights as autonomous beings ought to be respected and protected
- Scientific validity - the research must be scientifically rigorous.
- Fair subject selection - scientific objectives rather than vulnerability ought to be considered.
- Favourable risk-benefit ratio - risk in research must be minimized and benefit enhanced.
Elements required for international research?
- Social or scientific value
- Favorable risk benefit ratio
- Fair-subject selection
- Independent review
- Informed consent
- Respect for potential and enrolled subjects
What is public health law?
A form of public health policy that integrates concepts from law, medicine, health care and public health
What are the roles of public health law?
- Provides the legal basis for public health practice
- Creates a mission for PH authorities
- Assigns the functions
- Specify manner in which PH professional exercise their authority
What is the rule of human rights in public health?
Human rights are a set of entitlements under international law
1. Privacy and confidentiality
2. Autonomy to participate in health-related decisions
3. Adequate quality of basic amenities i.e. food, housing
4. Communication
5. Choice of medical providers
6. Respect for the dignity of persons, including the rights to security and freedom from discrimination
