Ethics Flashcards
What does the world medical association declaration of geneva state
The health of my patient will be my first consideration.
Core ethical principles
- Proportionate and just actions
- accord with ethical standards of civilians
- According to clinical need, impartially and without discrimination
- Shouldnt be involved in punishments
- report violations of ethics and law
- Justify departure from ethical principles or guidelines
Triaging ethics
Recognise and acknowledge its natural to feel some moral obligations. But its only ethical to treat according to clinical need
Rules about shooting
Armed with light weapons for use in their defence or in the defence of the wounded and sick in their charge. Must never use offensively.
What are doctors professional and ethical duties
Preserve life, care for the sick and wounded and reduce suffering
Duty of care under fire
Having to use weapons to protect their patients
Provisions for army medics under international humanitarian law
Wounded and sick protected and respected
No distinction in the treatment of the wounded and sick on anything other than clinical grounds
Care for enemy as you would your own
Nobody should be compelled to disobey medical ethics or refrain from action
What role do military commanders have in medical military ethics
Military commanders are required to support doctors in the fulfilment of their ethical duties and will expect doctors to act in accordance with their professional obligations
How can you address conflicting obligations and loyalties
Adherence to core ethical principles
What if the patient doesnt have capacity
Provide care on the basis of what is in his or her best interests
What if consent is hard to get
If it is an emergency and is secondary to life saving care then its fine to skip
What if there is uncertainty about what the patient wants
It is sensible to assume that the injured person would want to receive appropriate care and treatment
What anxieties should a doctor be aware of in enemy injured
May anticipate ill treatment or fear consequences of non cooperation
How can you make sure consent is good
Make sure it isnt delegated to non military personnel
What do you need to consider about interpreters
That they are from the same cultural or religious background as the patient. You dont want cultural bias
What forms can consent take
Express or implied
What to do if a patient refuses treatment
If they have capacity they are allowed to deny treatment but you should make sure that you explain sensitively so that they dont have lots of anxiety
Can members of the armed forces refuse treatment
They have exactly the same freedom of choice as to the medical treatment they receive as all patients
Is confidentiality maintained after death
yes
Does duty of confidentiality apply equally to members of the army and civilian patients
Yes
When can you breach confidentiality
When the health, security or safety of the unit, the patient or the wider public is at risk
How is competence different in the army
Doctors may be required to provide care for patients across a broader range of competencies than would be required of a practicioner in civilian practise.
If you are told to do something you dont feel competent in what should you do
Seek supervision from a senior or more experienced colleague to ensure the risk to patients is minimised
Should you accept or decline to treat a patient
If you think acting would do more harm than waiting for a senior then you should decline.
What should you do if you are incompetent but the alternative is no treatment
Act in the way which will increase a patients chance of survival or significantly improved outcome
UN principles of detainment
Duty to provide protection of physical and mental health and treatment of disease as if they werent detained
Can a doctor declare a detainee fit for detention, interrogation, questioning or punishment
No. Can declare them unfit based on medical issues but not fit.
Cons of treating civilians
We arent a humanitarian hospital. Can be better to support local hospitals and encourage them to go there
Can you act as an officer not a doctor if you tell someone youre not a doctor anymore
No
Can detainees refuse treatment or examination
Yes
What amounts to unethical practises and abuse
Disproportionate and unjust treatment
If your examination would lead to transfer to a harmful facility what should you do
Refuse to examine
