BIOETHICS_WK 6 Flashcards
a chronic, potentially life-threatening condition caused by the
human immunodeficiency virus (HIV). By damaging your
immune system, HIV interferes with your body’s ability to fight
infection and disease
Acquired Immunodeficiency Syndrome
HIV is a sexually transmitted infection (STI). It can also be
spread by contact with infected blood or from mother to child
during pregnancy, childbirth or breast-feeding. Without
medication, it may take years before HIV weakens your
immune system to the point that you have AID
Acquired Immunodeficiency Syndrome
Transmission of HIV
blood
semen
vaginal fluids
breast milk
perinatal events
a particular disease which entirely affects the infected persons
physical appearance
mental
morale
close relatives
social relations
Key population at increased rish of HIV-aids
- injecting drug users (IDU)
- male and female sex workers
- men who have sex with m
Psychosocial Issues Among HIV/AIDS patients
Emotional
Behavioral
Fear
Loss of future and ambitions
Guilt
Grief
Isolation
Resentment at changes in living patterns.
Depression due to absence of a cure, loss of personal control, etc.
Anxiety about prognosis, social, occupational, domestic, and sexual hostility and rejection.
Anger about the helplessness of the situation, unfair fate, others who are infection-free, health care workers, and others who discriminate.
Loss of self-esteem due to rejection, loss of confidence, loss of identity, physical impact of HIV infection, etc.
Obsession due to pre-occupation with health.
Suicidal thoughts and acts
shock, numbness, disbelief, confusion, uncertainty about present and future, denial, guilt,
frequent changes of mood, sadness, and concern about the future.
Emotional
crying, anger expressed verbally and physically, withdrawal, checking the body for signs of
infection/deterioration
Behavioral
f pain, death, disability, loss of functioning, loss of privacy/confidentiality, desertion, etc
Fear
physical attractiveness and potency, sexual relationship, status in
community, independence, control over life, and confidenc
Loss of future and ambitions
behavior that resulted in HIV infection, infecting others, and disrupting the life of others
Guilt
over the loss of health.
Grief
due to social stigma.
Isolation
Screening issues: A conflict between
The necessity to protect the population health in general.
The necessity to protect people as free individuals having rights
Application of the principle of common good
The necessity to protect the population health in general.
respecting patient’s autonomy (privacy & confidentiality)
The necessity to protect people as free individuals having rights
Discrimination results to hesitation to give care, and gossiping
about patient’s extra marital relationship, create a kind of guilty
feeling, grief, depression, fear, anger, suicidal thought, and act of
self isolation and loss of self-esteem in the patien
Stigmatization Follows the Discrimination of HIV Patients
Ethical Responsibilities
respect the dignity of their patients by observing privacy and confidentiality
respect for persons
Beneficence
Justice
The psychiatric interventions for patients with HIV/AIDS are as follows:
Helping the patients changes risky behavior, thus promoting prevention of HIV infection.
- Helping patients during the difficult process of HIV testing (pre- and post-test counselling).
- Helping to establish the diagnosis and treatment of other psychiatric illnesses commonly seen in
patients with HIV. - Implementing psychosocial interventions like psychotherapy, cognitive behavioral therapy,
counselling, etc. - Helping patients, their families, and others in their lives with interpersonal problems related to
HIV/AIDS. - Assisting AIDS patients during the final phase of their illnes
Role of the Nurse in Protecting aids Patients
Nurse as advocate—change agent
Nurse as counsellor, communicator
Active implementer responsible and accountable nurse
Nurse as a comforter
Veracity, fidelity towards HIV patien
Resource allocation is a central part of the decision-making
process in any health care system.
Allocation of Scarce Health Resources
An attempt to answers to concerns about high cost and complaints about
the quality of care are explained by the conditions under which
administrative and care decisions are made on a day-to-day basis
changing the structure of health care system in order to
achieve cost containment
This makes it challenging to meet the medical needs of all
o increased life expectancy and limited health budgets
o continuous physical shortages of resources like donor organ
Allocation of Scarce Health Resources: issues being faced
Increased spending on health care
Health care administrators gear towards profitability
Evaluation for the fairness of allocation for scarce medical
resources
Allocation of Scarce Health Resources: principles relevant for decision-making
Autonomy
Beneficence
Justice
consideration for privacy, individual liberty, and
freedom of choice is usually focused on the individual.
Autonomy
s the overall goal of policy and practice. Usually
interpreted broadly in light of societal, population, or organizational
needs
Beneficence
equity in benefits is the core of public health.
Justice
Evaluate the fairness of ten allocation principles for scarce medical
resources
sickest first
waiting list
prognosis
behavior
instrumental value
combination of criteria
reciprocity
youngest first, lottery
monetary contribution
information identifiable to any person, including, but not
limited to, information that relate
Personal Information
Personal Information
name
health
finances
education
business
receipt of governmental services
addresses
telephone numbers
social security numbers
driver license numbers
other identifying numbers
any financial identifiers
Refers to both the practice and the study of the activities a
person performs in order to acquire or create, store, organize,
maintain, retrieve, use, and distribute the information needed
to complete tasks and fulfill various roles and responsibili
Personal Information Management
Personal Information Management Issues
reliability, speed, efficiency, and usability of
medical records
increased the ability for
information to be misused, sold, and accessed without an
individual’s consent
Principles related to Personal Information
Autonomy
Fidelity
the capacity to observe and make sense or meaning is central to
one’s ability to make ethical choices and to take moral action
Moral discernment
Principles are necessary for moral discernment
Helps in interpreting important aspects of moral situations
Points towards fulfilling ones duties (like keep secrets, tell the
truth
Principles are absolute and do not allow any legitimate
exceptions, the only morally good act is to obey and refrain the
forbidden action.
Using Principles for moral discernment
There are other principles that are generally applicable, but not
always so.
Principle of autonomy (confidentiality) but may be breeched
(nonmaleficence) due to the demands of justice
Framework for Ethical Discernment
Observe
Deliberate
Act
FOUR PRINCIPLES OF
MORAL DISCERNMENT/ JUDGMENT
Principle of Formal Cooperation
Principle of Material Cooperation
Principle of Lesser Evil
Principle of Double Effect
Conscience
the act by which we apply to our own conduct our knowledge of
good and evil, whether our judgment be correct or incorrect.
Principle of well-formed conscience
▪indicates that people are obligated to inform themselves
about ethical norms, incorporate that knowledge into their
daily lives, act according to that knowledge, and take
responsibility for those actions.
Principle of well-formed conscience
Inform themselves as adequately as possible about the relevant
facts and ethical norms.
Form a morally certain judgment of conscience on the basis of this information.
Act according to this well-informed conscience.
\Accept responsibility for their own actions.
developed a model for ethical decision
making incorporating the nursing process and principles of
biomedical ethics.
▪ Crisham (1985)
The MORAL Decision-Making Model
Massage the dilemma:
Outline options:
Review criteria and resolve:
Affirm position and act:
Look back:
The MORAL Decision-Making strategies
- recognizing personal circumstances,
- anticipating consequences,
- considering others’ perspectives,
- seeking help,
- questioning your own judgment,
- dealing with emotions, and
- examining personal values.
ethical paradox or moral
dilemma
Ethical dilemma
approaches to solve an ethical dilemma
REFUTE THE PARADOX (dilemma):
▪VALUE THEORY APPROACH:
▪ FIND ALTERNATIVE SOLUTIONS:
aimed to
protect human
subjects from
enduring the kind of
cruelty and
exploitation the
prisoners endured
at concentration
camps.
Nuremberg Code
The 10 elements of the
Nuremberg code
- Voluntary consent is essential
- The results of any experiment must be for the greater good of
society - Human experiments should be based on previous animal
experimentation - Experiments should be conducted by avoiding physical/mental
suffering and injury - No experiments should be conducted if it is believed to cause
death/disability - The risks should never exceed the benefits
- Adequate facilities should be used to protect subjects
- Experiments should be conducted only by qualified scientists
- Subjects should be able to end their participation at any time
- The scientist in charge must be prepared to terminate the
experiment when injury, disability, or death is likely to occur
a formal statement developed by the World Medical
Association that provides ethical guidelines that physicians
and other medical research participants should adhere to
when conducting research that uses human subjects.
Declaration of Helsinki
In 1948 the WMA’s Declaration of Geneva issued documents:
- Outline of every physician’s ethical duties (which included
pledges to focus on the health of the patient) and, - Not to use medical knowledge to violate human rights.
a statement of basic ethical principles and guidelines that provide an
analytical framework to guide the resolution of ethical problems that
arise from research with human subjects
Belmort Report
Belmort Created by
National Commission for the Protection of Human
Subjects of Biomedical and Behavioral Research.
▪Advancement in technology does not elicit ethical or moral
issues, but it is the use of technological inventions that raises
these issues.
Current technology
Current technology
Helix and DNA Tests
The Robot Priest
Emotion-Sensing Facial
Recognition
Ransomware
The Textalyzer
AI or “DEEP LEARNING”
SENTENCING SOFTWARE
PREDATORY JOURNALS
THE PSEUDOSCIENCE OF
SKINCARE
PROJECT NIGHTINGALE
one of the largest
private healthcare systems in
the United States, ranking
second in the United States by
number of hospitals
Ascension-
