ethical questions Flashcards
should the NHS fund treatment for smokers?
Yes: -NHS has a duty of care to all patients regardless of cause under the constitutional value ‘Everyone counts’
- numerous other lifestyle choices have an influence on our health e.g. heavy drinking, eating unhealthily, driving, not wearing mask in pandemic so if the NHS refuses treatment for smokers the same should apply to these people, which would ultimately remove the majority of the very population that is funding the NHS in the first place
- smoking is more common amongst lower socioeconomic groups so refusing them treatments could only serve to worsen existing health inequalities
- smokers contribute financially to the health service to the same extent as non-smokers by paying tax
No:-the NHS has limited resources and funding, so those who cannot have prevented their condition should be prioritised (e.g. genetic disorders)
-Unconditional treatment of smokers may encourage people to carry on practising smoking
should we use animals for testing products/drugs?
YES: -contributes to life-saving treatments for humans and animals as we share many diseases e.g. blood disorders, cancers and diabetes
-in vitro studies for medical treatment have limitations as they do not allow observation of complex interactions which occur in vivo
NO: -conditions animals are kept in do not promote good animal welfare -> unethical e.g. primates deprived of socialisation opportunities which can lead to behavioural problems, reduced space availability may lead to fighting
Should doctors strike?
FOR:-poor working conditions (e.g. long hours) will have a direct influence on the doctors performance which in turn can have negative effects on patient care, so in the long term strikes can actually benefit if they bring about the required change
-many other professions have the right to strike e.g. teachers and so doctors should have the same rights as others
AGAINST: -violates beneficence and non-maleficence as patient care is being compromised since many appointments/procedures would have to be delayed/cancelled as a result of less staff
-not fair for patients and other healthcare staff as they are having to bare the burden of a strike for no fault of their own
-After considering both sides of the argument, my personal view is that it is important for doctors to get justice and ensure they can provide the best quality of care but striking is not the preferred option to do this e.g. liaising directly with the government through the BMA could be tried first
should doctors prescribe alternative medicine/ homeopathy?
-medical treatments that are used instead of traditional (mainstream) therapies
AUTONOMY: patient has the right to make their own decisions about their healthcare, if they want to try out an alternative therapy and it does not present harm, doctors cannot stop them
BENEFICENCE: sometimes even the act of taking a drug which they believe will work can improve their wellbeing, and thus is in their best interest to take it (consequentialism)
NON-MALEFICENCE: many alternative medicines are not well regulated and may even be harmful when used in combination with other medications the patient is taking e.g. St John’s Wort, a herbal remedy for depression which interacts negatively with other drugs such as birth control pills and statins, reducing their efficacy -> could put patient in danger
JUSTICE: alternative medicines can be expensive and a waste of money since they often do not have scientific evidence of efficacy and safety and so funding should not be wasted on this
Should doctors treat family/friends?
YES:-if the condition is trivial it would be easier and less time consuming for them
- the individuals’ condition could get worse in that time
- could reduce burden on the NHS as it will reduce the number of patients coming in
- you may know them better than a doctor who has never met them before so you may have deeper insight into their concerns, exceptions and problems
NO:-the personal connection could bring bias into the doctor’s judgement, they may want to avoid important intimate examinations or may subconsciously downplay some diagnoses that such as cancer
-also a patient may purposefully withhold some info as they may be uncomfortable sharing this with someone they know e.g. a 16-year-old girl not disclosing that she is sexually active to a family member/friend, this may be harmful as the doctor may prescribe a medication which interacts negatively with birth control pills
Should we have a sugar tax?
YES: -NHS would have to spend less money on sugar related health problems such as diabetes and obesity which would save a lot of money, staff and time
-May incentivise food companies to produce lower cost, lower sugar alternatives
NO:-In practise, companies could swap out sugar with equally harmful ingredients such as fats and sweeteners which come with health problems of their own
- a sugar tax would disproportionally affect people with lower income, further widening the equality ga
- reduces the autonomy of consumers to spend their money on whatever they want, could be seen as paternalism
Should the NHS be privatised?
PROS: -competition between private companies could lead to lower healthcare costs whilst still receiving a high standard of care
- the cost of healthcare could deter people from coming to A&E with more trivial problems that could be seen in a GP etc -> reduce waiting times
- could allow more patient autonomy with drugs, which private company they choose, which doctor is treating them etc
CONS:-healthcare could become commercialised and profit focussed because of competition instead of focussed on patient best interests, goes against beneficence
- widens wealth inequality gap and discriminates against lower income families
- puts poorer individuals at risk as if they can’t afford healthcare, they may be more at harm from diseases, violates non-maleficence
UK approach
+ve: -UK was first country in the world to begin the vaccine roll out
-one of the top country globally for viral sequencing, allowing early detection of new variants to rapidly deploy additional support to areas where variants of concern have been prevalent
- ve: -Lack of testing when elderly patients were discharged from hospitals back into care homes early on in the pandemic & lack of PPE and testing for care home staff
- Not locking down fast enough, by locking down just a week earlier in March 2020, an estimated 20,000 lives could have been saved
should the covid vaccine be made compulsory?
AUTONOMY: no-patients have the right to decide what treatments they take/don’t take, patients with capacity can refuse other treatments so why can’t they decide against vaccination
BENEFICENCE: yes-benefit to wider society as can create herd immunity which can protect vulnerable individuals/those that cannot take vaccines
NON-MALEFICENCE: no-there are some risks associated with the vaccines e.g. blood clots side effect of astrazeneca, although risk is very low the numbers add up when given to a large population
JUSTICE: no-issue of some countries having more stock of vaccines than others, inequalities
Overall, I think the benefits of vaccination to society outweigh the risks of side effects as death from COVID19 is statistically more likely than the risks of serious side effects from the vaccine
telemedicine
- could significantly reduce overall costs of healthcare as resources are redistributed to primary care and patient’s homes, HOWEVER devices can cost a lot, may not be affordable for lower income families (inequality)
- more time efficient for patients as no travel time required HOWEVER may not be time efficient for doctor as it may take longer to diagnose due to the distance/may be more misdiagnoses
- suitable for patients with communicable diseases HOWEVER patients may be reluctant to share important information as there is less privacy in their own home (family member may listen)
- may be a good option for elderly with a lack of mobility HOWEVER they may struggle with technology
AI
currently used for:
- to diagnose diseases from scans e.g. cancer,
- radiotherapy: for creating individualised doses
- virtual nursing: wearable devices that remind
PROS: -could help with staff shortages and alleviate some strain on the healthcare staff
- provides training opportunities for students via simulations so mistakes won’t have detrimental effects
- machines don’t get tired so can operate for longer without breaks than doctors
CONS: -lack of empathy which is essential in building patient-doc trust
- AI can replace jobs -> rise in unemployment
- use of machine introduces a third party, data can be hacked breaching confidentiality
- doctors are better equipped to detect non-verbal signs and subtle cues that help with diagnosis and holistic care
