Ethical principles Flashcards
What are the 4 key principles in medicine?
- Autonomy
- Justice
- Beneficence
- Non-maleficence
What is autonomy?
Right of competent adults to make informed decisions about their own medical care.
Gives patient the freedom to choose freely, where they are able.
Medical practitioner cannot impose patient on treatment- except cases where individual is deemed to be unable to make decisions- capacity
How is autonomy applied?
Applied in situations involving capacity
Explain medical condition fully, options of treatment, advantages & disadvantages of treatment & alternatives
- Is able able to retain info & arrival at a decision
- Has patient provided informed consent
- Patient needs to be actively involved in diagnosis & treatment
Being coerced into making decision- not consent- should not be respected
What are the limitations of autonomy?
Autonomy is condition- can be lost temporarily- e.g. pain impaired decision making
Patients only have autonomy if they have capacity
Autonomy does not over-rule justice & public interests
What is beneficence?
Act in best interests of patients
-From the viewpoint of objective assessment by health professional
Respecting beneficence & autonomy usually lead to same conclusion- most patients want what’s in their best interest
How is beneficence applied?
Consider all treatment options & rank them in order of most effective
When ranking, chosen treatment should be medically good for patient & suit individuals circumstances.
Consider:
- patients expectations of treatment
personal circumstances- holistic care
-All valid Treatment options- rank (above)
What are the limitations of beneficence?
Beneficence w/out respect for individuals autonomy may lead to actions that are not beneficial as they try to promote well-been against their will
Autonomy & beneficence conflict when competent patient chooses course of action that’s not in their best interest
What is non-maleficence?
Do no harm to patients
How is non-maleficence applied?
Acts as threshold for treatment- if treatment does more harm than good, should not be considered
Potential benefits & harms need to be weighed up to decide what is overall in patients best interest
What are the limitations of non-maleficence?
Most medical treatments have some chance of doing harm- does not mean they should always be avoided
What is justice?
Fair & equitable (not equal) distribution of health resources & opportunity I.e time, money & intensive care beds
Fair treatment of individuals & act in best interests of society as whole
Promotes financial sustainability off health system for society while meeting individual needs of patients
How is justice applied?
Patients in similar situations should have access to same health care
Physicians required to ovoids care based on cost-effective management of limited resources
E.g. cost benefit analysis
What are the limitations of justice?
Can be difficult to deice what is suitable dlstribution because equitable does not mean equal
What is paternalism?
Choosing a course of action in patient’s best interest but w/out patient’s consent
In past, doctor-patient relationship was strongly paternalistic.
Patients view are set aside
- frowned upon
- patient might not be aware of reason for treatment
What is soft paternalism?
Situations where patients capacity & understanding are not known.
Physician justified in intervening urgently on behalf of patient if posing risk to himself.
- may not be possible to assess if patient has capacity
- Sedation or use of restraints may be required- still soft paternalism
