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Community Health > Ethics > Flashcards

Ethics Flashcards

1
Q

consequentialism

A

end justifies the means (the morally right action is one that gives rise to the best consequences or outcomes)

 John Stuart Mill

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2
Q

give 3 types of consequentialism

A

utilitarianism
egoism
alturism

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3
Q

utilitarianism

A

the best course is the one that promotes most happiness/ pleasure and absence of pain for all (lesser of two evils)

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4
Q

egoism

A

the best course is whats best for you (may be positive, negative, neutral for others)

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5
Q

altruism

A

the best course is whats best for others well-being

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6
Q

deontology

A

duty based theories.
duty of care to each other
there are fundamental rules and duties to follow, and as such certain acts are seen as wrong no matter the consequences

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7
Q

moral absolutism

A

certain acts are good or bad, irrespective of intent or consequences

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8
Q

kantian

A

one must act from duty, and it is the motives of the decision maker, rather than the consequences of the action that make something right or wrong

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9
Q

contemporary approach (deontology)

A

centre on ‘permissible harm’
(can divert a train to save 5 but kill 1*, but cant kill 1 to harvest organs for 5)
*some harm inevitable anyway

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10
Q

four principles

A

autonomy
beneficence
non-maleficence
justice

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11
Q

autonomy

A

freedom for patient to choose and advocate for their own health

(Problem: mental health, pregnant, children )

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12
Q

beneficence

A

what is considered in the patients best interests

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13
Q

non-maleficence

A

balance actions benefits against harm

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14
Q

justice

A

equity and avoiding discrimination at both an individual and societal level

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15
Q

dynamism

A

situations are almost always dynamic, a decision taken at one time may not be appropriate at a later stage

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16
Q

clinical truth

A

contextual, circumstantial, and personal

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17
Q

objective truth

A

reality

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18
Q

Formula of universal law (Kant)

A

could you live in a world where everyone acted this way

19
Q

Formula of humanity (kant)

A

don’t treat people as a means to an end (don’t use people)

20
Q

virtue ethics

A

Compassion, patience, kindness, fidelity - characteristics

Assume person of good character will always act in right way …?

21
Q

+vs and -ves of virtue ethics

A

 +ve
• Whole person taken into account
• Centres ethics on the person and what it means to be a human
 -ve
• No help in moral dilemma
• Virtues not clear
• Virtues dependent on culture they are devised in

22
Q

ethics in practice

A 
Candour
	open and honest
	disclose errors
	Ethical, regulatory (GMC 2013), contractory (NHS), statutory 
Consent
Capacity
Confidentiality 
Communication
23
Q

what are 2 types of uncertainty

A

objective

subjective

24
Q

2 types of objective uncertainty

A

aleatory - cant know anymore

epistemic - don’t know anymore

25
Q

2 types of subjective uncertainty

A

ethical - i don’t know what i should know

choice - i dont now what i want to know

26
Q

what does the GMC state about whistle blowing

A

‘ you must make the care of your patients your first concern’

27
Q

Seedhouse grid – 4 layers:

A
  1. Autonomy (innermost layer – consider first)
  2. Beneficence , truth (+ non-maleficence)
  3. Balance pt. and society
  4. External considerations and law
    (outmost layer)
28
Q

Complexity theory

A

consider connectedness of living world

 Connectivity and interdependence – how the behaviour of one individual affects others
 Co-evolution – adaption/ changes of one aspect on another – doctor and pt. co-evolve
 Far from equilibrium – essential for pt. surviving and flourishing
 History – pt. and doc influence by prev
 Feedback – increase returns
 Self-organisation, emergence, creation of new order – Gestalt principle

29
Q

Four quadrant approach

A

Medical indications

  • Beneficence and non-maleficence
  • Review tx/ diagnosis

Patient preferences
- Autonomy

Quality of life
- Beneficence and non-maleficence

Contextual features

  • Loyalty and fairness
  • Encounter Inc. family, law, insurance
30
Q

Conscientious objection

A

can opt out of providing procedure because of personal beliefs AS LONG AS no direct/ indirect discrimination, harassment of individual pt./group
Abortion act 1967:

31
Q

consent (x3)

A

voluntary
informed
capacity

32
Q

negligence (x3)

A

duty of care
breached
resulting in harm

33
Q

test for whether duty of care was breached

A

Bolam test - did dr act as majority of peers would have acted

34
Q

what does consent guard against

A
  • Exploitation

* Medical paternalism

35
Q

what are 3 forms of consent

A

implied (hold out arm for vaccine)
written
oral

36
Q

capacity

A

understand
retain
decide
communicate decision

37
Q

which bears most weight, living will or LPA?

A

Hierarchy:

  • Living will
  • Lasting power of attorney
  • Court of protection
  • Deputy court of protection
  • Doctors
  • (relatives/ patients do not make decisions)
38
Q

when can you break confidentiality

A 
o	Judge
o	Police and criminal evidence act 
o	Pt. consent
o	Other involved in pt. care
o	Coroner
o	Police – RTA and terrorism
39
Q

what act does confidentiality come under

A

Data protection act 1998

40
Q

when may someone lack capacity

A

o Unconscious
o Lack understanding
o Severe learning difficulties

(mental capacity act 2005)

41
Q

what treatment can you give under mental health ac 1983?

A
  • Only enforce treatment for mental health problems e.g. depression, not for medical procedures
42
Q

what does the Mental capacity act 2005 state (3 things)

A
  • A person must be presumed to have capacity unless it is established that he lacks capacity.
  • An act done, or a decision made, under this Act for or on behalf of a person who lacks capacity must be done, or made in his best interests.
  • Capacity must be honoured even if unreasonable
43
Q

what law does negligence come under

A

law of tort

Community Health (4 decks)

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