ethics Flashcards
compassion
- arises when a person is affected by the suffering or distress of another
- and is moved by a desire to relieve that person’s suffering or distress
honesty
quality of being truthful, open and candid
integrity
- to be whole and complete
- sound in one’s principles and character
- unimpaired and free from corruption
responsibility
- capability of fulfilling duty and obligation to the patient
- quality of being reliable and trustworthy
- closely linked with being accountable
The doctor owes a duty of care to Mr T. Knowing that Mr T’s decision is not in Mr T’s own best interest, the doctor should ensure that the interventions for Mr T will be in Mr T’s best interest.
participation
- take part in something; share something in common
- to engage in a partnership
- do these things willingly
empathy
ability to understand and appreciate another person’s feelings, experience and needs
respect
- be considerate and have regard for the patient as a person
- recognise the patient’s personal quality and intrinsic worth
- foster patient’s control over their lives and refrain from carrying out unwanted interventions
demonstrated by actively protecting patients’ rights, incl right to info
sensitivity
- sensitive / mindful towards someone or something
- fine-tuned awareness of the behaviour, feelings and motives of the patient
- alert to other’s responses, circumstances, social and economic support
Inquiring into the reason for Mr T’s decision shows sensitivity for his decision-making capacity, his competency and respects him as a person who have his own preferences, perspectives, rights and freedom of choice.
justice
treat patients fairly and equitable, according to their medical needs with neither prejudice nor preferance
i. fair treatment no discrimination
ii. equal distribution of healthcare resources
autonomy
- acknowledges patient’s right to hold views, make choices and take action for his/her healthcare based on their personal values and beliefs
- doctors need to provide all relevant information required to make an informed decision
Autonomy means to respect patient’s rights to decide for themselves and to help patients make informed decisions and ensure that patient’s decisions are voluntary.
3 components of informed consent
- Disclosure: communication of relevant information
- Capacity / competency: patient’s ability to understand information and foreseeable consequences (including risks/complications, benefits, alternatives, reason for recommended treatment and the result of no treatment)
- Voluntary: patient’s RIGHT to come to a decision freely
beneficence
a. do what is in the patient’s best interests
b. moral obligation to act for the others’ benefits
non-maleficence
do no harm or injury to patient, seek to prevent harm
i. negligent -> careless or unreasonable risk of harm upon another
ii. provide a proper standard of care that minimises risk of harm
iii. medical competence
Gillick competence
21/22 Pros MEQ
Gillick competence relates to an individual possessing sufficient maturity and understanding to consent to treatment.
Gillick competence only applies to minors agreeing to treatment (e.g. when parents refuse), not to minors refusing treatment
4 features of ethics of care
18/19 Pros MEQ
- Focuses on how, & how well, the human needs of particular people are attended to
- Sees people as relational & interdependent
- Considers moral issues within family & other social relationships
- Respects the particular (relationship) claims that arise within actual human relationships
- Regards emotions & relational capabilities as important for understanding what is good
Caring supports the professional attribute of responsibility by ensuring that the proper standard of care is given to the patients. It also supports sensitivity by recognising that people have different perspectives about what is good care for themselves.
What is patient empowerment?
18/19 Pros MEQ
- Defined as helping patients discover & use their own innate ability to gain mastery over their disease
- acknowledges that patients have the ability to make informed decisions & set behavioural goals to make changes of their choosing
ask why he feels that way and provide information about the care that he must receive and ensure that he
- understands the information
- remembers the information
- weighs the information
- can communicate the decision
5 statutory principles of the MCA
17/18 Pros MEQ
- Assume a person has capacity unless you establish the opposite
- Take all practicable steps to help a person make a decision
- A person has the right to make an unwise decision
- Always act in the person’s best interests
- Choose the less restrictive option
2 stage test for assessing capacity under the MCA
17/18 Pros MEQ
- Is the person suffering from an impairment of brain function?
- If yes, does the impairment cause the person to be unable to make a decision when required?
A person is deemed to be unable to make a decision if they are unable to
- understand the information
- remember the information
- weight the information
- communicate the decision
2 considerations of futility
16/17 Pros MEQ
If an intervention is
- non-beneficial and/or harmful
- not able to achieve goals of care
- likelihood of success of a proposed medical intervention is very small
- patient’s QOL is unacceptable
judgments of futility will require a holistic assessment of Mr Y’s condition, and in a manner that is consistent with the ethical principles of beneficence and non-maleficence. It should not be a unilateral position to be made by Ms M
What is legal duty of care?
15/16 Pros MEQ
A duty of care is a legal obligation imposed on an individual requiring adherence to a standard of reasonable care while performing acts likely to harm others.
It exists when a doctor-patient relationship is established.
Medical negligence
15/16 Pros MEQ
Mr Z was owed a duty of care
The duty of care was breached
And as a result of the breach, Mr Z suffered legally defined harm
In cases of medical negligence in Singapore, how is the standard of care measured?
15/16 Pros MEQ
Bolam-Bolitho Test
Doctor is not negligent if he has
- acted in accordance with the practice of a respectable, responsible, reasonable body of professionals
- actions & justification is able to withstand the scrutiny of logic, internal consistency & recent advances, where benefit > harm
