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1. Foundations of Medicine > Ethics > Flashcards

Ethics Flashcards

1
Q

What is Ethics?

A

Involves study of morality (i.e. study of good and/or the right)

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2
Q

What features does an ethical judgement have?

A

1) PRESCRIPTIVE (tells you what the right thing to do is)

2) JUSTIFIED THROUGH REASONING

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3
Q

How can we approach ethical problems?

A
  1. What kind of person should we be?
  2. What should I do?
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4
Q

What is Virtue Ethics?

A

Being a virtuous person

Focuses on excellence on character, ensuring one lives the best life overall
(i.e. achieves flourishing)

MEAN between two opposing vices

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5
Q

Examples of Virtues

A

Courage - mean between recklessness and cowardice

Generosity - mean between wastefulness and meanness

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6
Q

What is Consequentialism?

A

Act in such a way to benefit the most people - producing best consequences

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7
Q

What is utilitarianism?

A

Best known consequentialist theory

RIGHT action produces greatest happiness (or pleasure) for the greatest number (principle of utility)

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8
Q

What are the different types of utilitarianism?

A
  1. Act utilitarianism
  2. Rule Utilitarianism
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9
Q

What is Act Utilitarianism?

A

Considering the consequences of each specific act

Looks at benefit for that singular action

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10
Q

What is Rule Utilitarianism?

A

Formulates rules (which will govern acts) that seek to produce the best consequences

Looks at WIDER impacts - what would happen if we kept applying this action generally

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11
Q

What is Deontology?

A

Fulfilling moral duties

(duty, obligation, responsibility

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12
Q

What is narrative ethics?

A

Describes a variety of approaches, which focus particularly on the patient’s story

Helps us understand human (moral) life by focusing on communication, perspectives and relationships

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13
Q

How is demand for healthcare increasing?

A
  • ageing population with more chronic illness
  • medicalisation (increasing remit of healthcare)
  • increased consumer demand
  • technological advances making more possible
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14
Q

Why is resource availability not keeping up with demand?

A

Staff shortages & low recruitment in some areas

Inadequate funding to meet demand

CCG’s choosing to cut/reduce some services

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15
Q

How do prioritise & ration?

A

Must determine
- who/what to treat first, and why
- what if anything to cut/limit, and why

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16
Q

What stages do we make decisions?

A
  • Nationally
  • Locally
  • Individually
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17
Q

How do we prioritise & ration nationally?

A

NICE; DH; PHE

Public Health campaigns targeting specific issues; certain treatments approved

18
Q

How do we prioritise & ration locally?

A

CCG; NHS Trusts; Practices

Withdrawing/limiting IVF funding; strategic focusing of services

19
Q

How do we prioritise & ration individually?§

A

CLINICIANS

Which treatments to offer; referral decisions

20
Q

What is Distributive Justice?

A

Distribution of goods in accordance with the principle of justice

21
Q

How can we achieve distributive justice?

A

Consequentialism, Equality, Egalitarianism, Aristotelean, Rawlsian

22
Q

What is Equality & Egalitarianism?

A

All persons are equal in their fundamental worth and therefore entitles to be treated equally

23
Q

How does equality & egalitarianism relate to Distributive Justice?

A

UNJUST to give one person access/opportunity but not another person, because both persons are of equal worth

24
Q

What is the Aristotelean Principle?

A

‘Persons in equal circumstances should be treated equally, persons in unequal circumstances should be treated unequally’

25
Q

What is non-relevant criteria?

A

CANNOT influence / change

e.g. race, sex, mental or physical disability

26
Q

What is relevant criteria?

A

CAN influence

e.g. health behaviour or lifestyle

27
Q

What are protected characteristics?

A

Some criteria UK law prohibits (Equality Act 2010) from being used to discriminate between persons

-> age, disability, gender reassignment, marriage & civil partnership, pregnancy & maternity, race, religion & belief, sex, sexual orientation

28
Q

What is a Rawlsian (egalitarian) Thought?

A

Thought Experiment that ensures just distrubution

28
Q

What is a Rawlsian (egalitarian) Thought?

A

Thought Experiment that ensures just distribution of goods, ensuring that the greatest benefit goes to the least advantaged

29
Q

What are sources of the Law?

A
  • Acts of Parliament
  • Court Rulings (superiors courts - e.g. Supreme Court)
  • European Union (EU)
  • European Convention on Human Rights (ECHR): also directly part of English Law, following Human Rights Act 1998
30
Q

What are branches of Law related to Medicine?

A

Medical Law is its OWN branch of law, but drawn on various others, such as
- criminal law (punishment)
- civil law (compensation)

31
Q

What is the role of the GMC?

A

To protect, promote, & maintain the health & safety of the public by ensuring proper standards in the practise of medicine

32
Q

Why do we use GMC guidance?

A
  • Broad Principles of GOOD practise
  • Ethically based, consistent with law
  • Framework for doctors to exercise professional judgement
  • Serious or persistent failure could lead to action
33
Q

Why do we maintain a patient’s confidence?

A
  • keeping a promise
  • respecting autonomy
  • more people will trust healthcare professionals
  • patients will disclose medical history
  • healthcare/research will best flourish
34
Q

What happens if you fail to comply with confidentiality?

A

Injunction (stopping disclosure)

Financial Compensation (‘damages’)

35
Q

When can you break confidentiality?

A
  • Patient consents to disclosure
  • Disclosure is required by the law
  • Disclosure is in the public interest
36
Q

What is Patient Consent?

A

If patient has ‘mental capacity’, consent is guiding principle to breaking confidentiality

37
Q

What are the types of consent?

A

EXPRESS CONSENT (needed, to employers & insurance companies)

IMPLIED CONSENT (records are secure but may be able to share)

38
Q

What happens to consent if the patient lacks ‘mental capacity?

A

‘Best interests’ is guiding principle

Effort would be made to get relevant consent, but break if exceptional & justifiable

39
Q

Why can you break confidentiality if required by the law?

A

May be required by statute or court

e.g. notifying authorities of certain communicable diseases (list of notifiable diseases)

e.g. copying with legal/disciplinary proceedings

40
Q

Why can you break confidentiality in the public interest?

A

IN public interest, not OF interest

e.g. disclosing in case of alcoholic surgeon OR serious crime committed

e.g. MAINTAINING for HIV statuses of doctors

1. Foundations of Medicine (4 decks)

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