Block 1 VLE Flashcards
What are values?
Claims about, or expressions of, things like: Preferences Attitudes Emotions Aesthetic appreciation
What is values based practice?
A process that supports clinical decision making where complex and conflicting values are in play
Define facts
Claims about the world that have been, or can in principle be, verified by empirical methods
How would you assess facts?
Use empirical methods to determine the truth of factual statements
How would you assess values?
Moral theories:
1) Consequentialism/utilitarianism
2) Deontology
3) Virtue ethics
Describe the 3 key ethical theories
Key ethical theories:
Consequentialism/utilitarianism
- Consequentialism: assess the moral value of anything in terms of that thing’s outcomes or impact upon the world
- Need to provide and defend and account of:
a. The relevant good,
b. method of quantification,
c. how to rightness will be determined - Utilitarianism: aim for the best balance b/w benefit and harm; most effective use of resources
Deontology
- Rules govern actions and we have a duty to abide by them regardless of cost
- Respect autonomy
Virtue ethics
- Focuses on the character of the person (the doctor/professional?), not their actions
- A right act is the action a virtuous person would do in the same circumstances
- Not “what should I do?” but “what kind of person should I be?”
Key principles
1. Respect for autonomy e.g. informed consent
2. Beneficence – acting in the patient’s best interests
3. Consequentialism e.g. weighing patient’s interests against benefit of
training the student?
Application to clinical situations
PPP – remember when analyzing an ethical question
1. Principles - autonomy, beneficence, consequentialism
2. Particulars (context/facts of the case)
3. Perspectives (of all those involved or affected by the case e.g. patient
family, med student, dr, other patients)
What are the 3 elements needed for consent?
1) Competence/capacity
2) Information
1. Sufficiently inform patient considering:
1. Patient needs/wish
2. Patients’ Existing knowledge
3. Nature of condition
4. Complexity of treatment/risks
5. GMC requires you to give info on diagnosis/prognosis,
potential risks/benefit, alternative treatment including option not to treat.
3) Voluntariness
1. Consent given freely without coercion
2. Potential pressure from employers, relative, insures
What are the 4 things needed to establish capacity?
• Assessment based on ability to make a specific decision at a time it needs to be made
• Unable if they cannot do 1 or more of:
1. understand the information given to them that is relevant to
the decision
2. retain that information long enough to be able to make the
decision
3. use or weigh up the information as part of the decision-making
process
4. communicate their decision (by any means)
What is the underlying ethical principle that consent is based on?
Autonomy
Who should take consent?
• Dr. undertaking investigation/providing treatment
• If impractical, delegate it to someone who is:
1. Suitably trained and qualified
2. Sufficient knowledge or investigation/treatment, risks involved
3. Understand and agrees to act in accordance with GMC guidance
What are the different types of consent?
- Implied via compliance
- Oral
- Written - only considered evidence of consent. Not considered valid
informed consent document aspects of consent conversation
What are the different types of coercion?
- Explicit
- Implicit
- Power differentials in the patient/doctor r/ship
- Pressure from family
How would a doctor avoid coercion when trying to take consent?
- Talk to patient alone, establish whether there are any external pressures
- Speak to colleagues
- Identify appropriate solutions – e.g. power differentials patient doc
r/ship –> patient can decide to defer to someone else’s expertise - Give patient time/space to make decision instead of rushing them
Outline the ethical principles underpinning of person-centred care
Reasons to practice person-centred care:
- Respect - Recognising the moral value of a person as an autonomous
being. Treating people as ends and not simply as means - Autonomy – Deontological - It underpins the legal and professional
framework that governs the patient doctor relationship. - Dignity – support and promote self-respect
- Care – beneficence, best interest of patient - treat condition but care
for the patient - Consequentialist - consequences
a. Better patient outcomes
b. Fewer complaints
c. Less risk of litigation
d. Increased trust in the medical profession
What does the Human Tissue Act 2004 do?
- regulates removal, storage, use and disposal (scheduled purposes) of human tissues (relevant material) in England, Wales and Northern Ireland
- established a regulatory body: Human Tissue Authority
