ethical case analysis Flashcards
Ethical dilemmas in healthcare can be resolved by drawing on —– by using —— and —-
- ethical reasoning skills
- using ethical analysis and argument
—— means when itrequires one to clarify clinically relevant and applicable concepts and use them with consistent meaning.
ethical analysis
—— means when you requires one to use clearly formulated ideas in suggesting reasons that support a conclusion that should guide clinical judgement, decision-making and behaviour.
ethical argument
methods of ethical reasoning includes:
- 4quadrant method
- 4 principles
- who’s ethics ?
-BMA method - principle of double effect
- conceptual analysis
- using case studies
four principles methods ( related to ethics )
- non-maleficnes
- beneficent
- justice
- autonomy
this leads to : judgment and decision by speficifcation which means when you add content to your analysis of a case from specific case and also its done by balancing which is finding reasons about which moral norms should prevail
the BMA electric method states :
- recognise the situation as one that raise am ethical issue
- break down the Delima into the components parts
- seek additional info including patient viewpoint
- identify any relevant legal or professional guidance
if the issue is resolved: you will be able to justify your reasons
if your issue is not resolved you subject the dilemma into critical analysis and if its still not resoldved you If there is an unresolvable conflict or the law is unclear, it may be necessary to seek a court declaration
the four question approach is:
- what do we know
- what do we want to know
- what are we able to do
( and then u ask the 4th question depending on the variation what ought to be done )
four quadrant method includes
- medical indication
- patient preferences
- quality of life
- contextual features
thePrinciples of Beneficence and Nonmaleficence is applied to :
medical indication as:What is the patient’s medical problem? Is the problem acute? chronic? critical? reversible? emergent? terminal?
What are the goals of treatment?
In what circumstances are medical treatments not indicated? What are the probabilities of success of various treatment options?
In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided?
respect of autonomy is a principle used in —-
patient preference as:
Has the patient been informed of benefits and risks, understood this information, and given consent?
Is the patient mentally capable and legally competent, and is there evidence of incapacity?
If mentally capable, what preferences about treatment is the patient stating? If incapacitated, has the patient expressed prior preferences?
Who is the appropriate surrogate to make decisions for the incapacitated patient? 6. Is the patient unwilling or unable to cooperate with medical treatment? If so, why?
principles of beneficence , non-maleficence and autonomy are used in:
quality of life
What are the prospects, with or without treatment, for a return to normal life, and what physical, mental, and social deficits might the patient experience even if treatment succeeds?
is in which quadrant method
quality of life
Who is the appropriate surrogate to make decisions for the incapacitated patient? 6. Is the patient unwilling or unable to cooperate with medical treatment? If so, why?
is in which method
patient preference
1- On what grounds can anyone judge that some quality of life would be undesirable for a patient who cannot make or express such a judgment
2- Has the patient been informed of benefits and risks, understood this information, and given consent?
3-Are there biases that might prejudice the provider’s evaluation of the patient’s quality of life? What ethical issues arise concerning improving or enhancing a patient’s quality of life? Do quality-of-life assessments raise any questions regarding changes in treatment plans, such as forgoing life-sustaining treatment?
4-What are plans and rationale to forgo life-sustaining treatment?
5-What is the legal and ethical status of suicide?
1 and 3 - quality of life
2-patient preference
4 and 5 - quality of life
Principles of Justice and Fairness refers to —-
contextual features as:
- Are there professional, interprofessional, or business interests that might create conflicts of interest in the clinical treatment of patients?
- Are there parties other than clinicians and patients, such as family members, who have an interest in clinical decisions?
- Are there financial factors that create conflicts of interest in clinical decisions?
-Are there problems of allocation of scarce health resources that might affect clinical decisions?
