Ethics Flashcards
Name the four key ethical principles related to medicine
Autonomy
Non-maleficience
Beneficiene
Justice
Describe the ethical principle ‘autonomy’
self:rule - the capacity to make reasoned decsisions and act on them
Describe the ethical principle ‘non-malificence’
First do no harm
Descibe the ethical principle ‘beneficience’
Make the care of your patient your first concern
Describe the ethical principle ‘justice’
Fairness - respect for rights
Name the 3 principle ethical theories
Virtue ethics
Duty (deotology) ethics
Consequentialism (ethics)
a) Describe virute ethics
b) who created it?
a) An action is right if, and only if, it is what a virtuous agent would do in the circumstance
Balance between two extremes
b) Aristotle
a) Describe duty (deontological) ethics
b) Who created it?
a) An action is right if, and only if, it is in accord with a moral rule or principle
Morality is a matter of adhering to fixed standards, of performing duties
b) Immanuel Kant
a) Describe consequentialism (utiltarianism)
b) Who created it?
a) An action is right if, and only if, it promotes the best consequnce
Ends justify means
Outcomes are what matter
Promote ‘greatest happiness for the greatest number’
b) John Stuart Mill
Discuss the origin of values
- Bernard Williams (1929-2003)
- Thick concepts: descriptive + normative e.g., rude, kind, sympathetic, violent
- Thin concepts: moral judgement over facts e.g., good, bad, right, wrong
Discuss the role of doctor’s decisions over patient’s
Greater knowledge of medical facts
- But not invariably: sometimes a doctor can be wrong
- Sometimes the patient will know more than the doctor
Greater accuracy of hypotheses
- Familiar with the date and how to apply it
- Greater aptitude for interpretation
Doctors can participate in their patients’ value judgements and will invariably have their own values - developed throughout time
Ensure you base your decision on your medical judgement (facts) + the patient’s values primarily
a) When is an argument valid?
b) Does a valid argument need to have a true conclusion?
c) What is the technical term for validity
a) An argument is valid when if the premises are true then the conclusion MUST be true
b) No
c) Truth perservation
Int terms of facts and values, what should your care/decisions involve?
Involve both facts and values - the patient’s as well as your own
What do clinicians tend to significantly underestimate about patient’s?
- Patient’s willingness to undergo toxic treatments to improve length/QoL
- Desire of patients to have full information even if they dont act on it or believe it
Why are animals used?
- Creation and breeding of genetically modified animals (mainly mice)
- Basic research (how it works)
- Regulatory testing
- Research that translates animal-human
- Protection of natural environment
- Preservation of animal species
Is the use of animal research still necessary? Provide a reason for both sides including the necessity argument and compartive moral value argument
No
- Not virtuous and morally acceptable
Yes
- Potential benefits to humans justifies it
- Necessity argument: In-vitro or in-silico investiagtions cannot replicate the function of complex living systems
- The comparative moral value argument: Human wellbeing is paramount, and it is even less morally acceptable to experiment on human
What are issues with paying and using human subjects
- Paying research subjects risks selecting for the neediest, vulnerable groups (economic coercion)
- Many do regard people as having more moral worth than other animals
Describe the 3 principles of replacement, reduction and refinement of the animal welfare ethical reviews boards (AWERBS) of using animals for animl research
- Ensure that, wherever possible, a scientifically satisfactory method or testing strategy, not involving the use of live animals is used instead
- Use a minimum amount of animals without compromising the objectives of the project.
- Ensure breeding, accommodation, and care, methods of prcedures procedures and eliminating are reduced to the minimum of any possible pain, suffering, distress or lasting harm to the animals.
Describe factors of consideration in animal research
- How important is the possible result?
- How likely are there to be benefits?
- Possible benefit vs certain harm
- Act certainty v omission possibility: animals will surely suffer by the act, humans might suffer without research
- 92% of drugs shown safe and effective in animals fail in human trials
In the past there has been problems when it comes to experimenting on humans. Describe 3 situations in history where humans have been use
- Tuskegee syphilis experimennt
- 1932-1972, US
- 399 African americans with untreated syphilis monitored for 40 years
- Told that they would be getting free medical care
- Not told of their diagnosis - given placebos rather than experiment
- HeLa cell line
- African american woman’s cancer cell growth culture after she had died
- Conset from her or her family never sought
- Total mass of HeLa cells > 50 million tonnes
- Still in use today
- Nazi experiments on prisoners
- Nazis claimed not to see some people as fully human but still used for medical research
- Denial of humanity
- Indifference to suffering
- Some experimental results still in use today
List the five “rules” of ethical (human) research
- Obtain informed conset
- Minimise risk of harm of partcipants’
- Protect anonymity and confidentiality
- Be transparent to subjects (avoid deception)
- Respect participants’ right to withdraw
What are the reasons for con compulsion (compulsive) vaccinations?
- Autonomy - individuals right to choose or parents’ right to make treatment decisions for their children
- Fear of “other kinds of hrm” - Blood-clot paranoia around Oxford-AstraZeneca Covid vaccine,Wakefield MMR scandal
- Distrust of medical profession
- Distrust of ‘big pharma’
- Vehemence (sometime violent) of some ant-vaxxers
What are the reasons for pro compulsion (compulsive) vaccinations?
- Beneficience- good for the individual
- Consequentialism (Ulitarian) - “herd immunity” leads to general reduction in suffering
- Non-malificence - unvaccinated individuals are at risk of harm
- Justice - compromising herd immunity by refusing to bevaccinated or vaccinate one’s child is not fair to others
What are some hard problems for parents when it comes to vaccinating their child?
- Harm vs benefit - will the vaccine harm/benefit my child?
- Knowledge vs belief - “do you know that the vaccine is safe?”
- Individual vs population vs patient autonomy - “why should I put my child at risk for the sake of this ‘herd immunity’”
