Ethics Flashcards
Pillars of medical ethics?
Beneficence - doing good
Non maleficence - not doing harm
Autonomy (respectinga patients right to self-determination)
Justice (ensuring fairness)
Infectious disease or STD?
Confidentiality should be respectedthisinstance is a bit tricky, in this case where failure to disclose will put another person at risk of infection, a doctor should try their best to convince the patient. Although there is no law saying that you must tell any partners about STDs its still highly recommended you do so. If the patient wants to keep anonymity there are sexual health clinics that can notify partners and ex-partners for the patient without telling them who they are.According to the GMC, ‘there can be a public interest in disclosing information to protect individuals or society from risks of serious harm, such as from serious communicable diseases or serious crime’. Therefore, if you think that the woman is in severe danger, you can take the matter into your own hands.
What is gillick competency?
used to assess whether a child is mature enough to consent to treatment
There is no set of defined questions to assess Gillick competency. Professionals need to consider several things when assessing a child’s capacity to consent, including:
the child’s age, maturity and mental capacity
their understanding of the issue and what it involves - including advantages, disadvantages and potential long-term impact,alternative options
how well they understand any advice or information they have been given
What if a child doesn’t want their parents knowing about the decisions they’re making
You should always encourage a child to tell their parents or carers about the decisions they are making. If they don’t want to do this, you should explore why and, if appropriate, discuss ways you could help them inform their parents or carers. For example, you could talk to the young person’s parents or carers on their behalf.
If the young person still wants to go ahead without their parents’ or carers’ knowledge or consent, you should consider the Gillick and Fraser guidelines.
However, if a young person refuses treatment which may lead to their death or severe permanent harm…
their decision can be overruled.
What are the Fraser Guidelines?
The Fraser guidelines apply specifically to advice and treatment about contraception and sexual health. They may be used by a range of healthcare professionals working with under 16-year-olds
Child protection concerns
Underage sexual activity is a possible indicator of child sexual exploitation and children who have been groomed may not realise they are being abused.
Sexual activity with a child under 13 should always result in a child protection referral.
If a young person presents repeatedly about sexually transmitted infections or the termination of pregnancy this may be an indicator of child sexual abuse or exploitation.
Patients who refuse treatment
Inform the patient of the benefits
Inform of the risks of not undergoing treatment
ask why theyre refeusing treatment and try to alleciate any concerns they ahve
You must respect a competent patient’s decision to refuse an investigation or treatment, even if you think their decision is wrong or irrational. You may advise the patient of your clinical opinion, but you must not put pressure on them to accept your advice. If, after carrying out an assessment, you believe the patient lacks the capacity to make a decision about their treatment you should act in their best interests
Abortion
For: In the case of rape, good
Could cause damage to the mothers mental health or physical health
Could be the most loving thing to do if the baby is going to be born with deformities or is going to be born into a household where they cannot afford it.
Some argue, that when abortions take place - it’s not a fully developed baby you’re terminating, it’s simply a cluster of cells
Against: Killing potential life
Euthanasia
For: Allowing people to die with dignity is kinder than forcing them to live and suffer
Because of autonomy, competent patients should be allowed to choose to die, in order to end their suffering
Against: Alternative treatments are available such as palliative care and drugs to relieve pain
Slippery slope-Opening the doors to voluntary euthanasia could lead to and involuntary euthanasia, by giving doctors the power to decide when a patient’s life is not worth living. In the Netherlands in 1990 around 1,000 patients were killed without their request.
Introduction of euth could lead to some healthcare providers thinking “whats the pount of spending all this time and effort and equipment resources on these patients when theres another option” which isn’t a good way to think and doctors should always try their best to treat their patients. This way of thinking could lead to
Euthanasia becoming a cost-effective way to treat the terminally ill
