Ethics - Introduction/Autonomy Flashcards

1
Q

What is ethics?

A
  • Deciding what we should do

- Find reasons for and against

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2
Q

Describe the ethical tree

A
  • Consequences (a decision is right if it brings the best consequences)
  • Duty
  • Virtue (the kind of person you want to be)
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3
Q

What is utilitarianism?

A
  • A form of consequentialism (considering consequences) which states that the right action is that which brings about the maximum overall happiness.
  • All other things being equal, saves the most lives or reduces suffering in the most people.
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4
Q

What is a democratic approach to consequences?

A

Equal weight given to each individual when calculating overall happiness

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5
Q

List the problems with just thinking about concequences

A
  • Some actions are (almost) always wrong
  • Very difficult to be certain of consequences
  • Could justify heinous actions (for the greater good)
  • Irrelevant if the decision maker is a bad person
  • Irrelevant whether a decision is unjust
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6
Q

What are duty based theories?

A
  • Dentological
  • Certain actions are right or wrong irrespective of the consequences
  • Eg. duty to not kill or torture, duty to tell the truth
  • This is simple, as it doesnt require prediction or calculation of consequences
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7
Q

What are the issues with duty?

A
  • How do you decide what is right or wrong?
  • What if moral duties conflict?
  • Absolves the individual from moral responsibility for the consequences, even if the consequences are very bad
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8
Q

What is virtue ethics?

A
  • A virtue is a character trait a human being needs to flourish or live well
  • The best life of a human being consists in the exercise of the virtues e.g. honesty, integrity, wisdom, courage, fairness, compassion
  • Virtues can be nurtured and developed
  • The right course of action is the course that a virtuous individual would take
  • You should not lie, as an honest person would not lie
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9
Q

What is moral identity?

A
  • A sense of the kind of person you want to be
  • An individual’s own moral compass
  • Nurtured through reflection on moral dilemmas and lived experiences
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10
Q

What is moral imagination?

A
  • Recognition and sympathy for the suffering of others

- Respect for others

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11
Q

Define autonomy

A
  • Deciding the direction in which your life should go

- Being free to make your own choices in life

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12
Q

What are the two aspects important in autonomy?

A
  • Instrumental value (we know ourselves better)
  • Intrinsic value (it is our own life)
  • Intrinsic value is more important - a fundamental aspect of being human
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13
Q

Why is intrinsic value of autonomy important?

A

As without free will we do not have moral responsibility

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14
Q

Why may patients make bad health choices?

A
  • The bad health choice may be in their best interest
  • Even if they are wrong about something being in their best interest, they should be able to choose what is done to their body
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15
Q

Why is bodily autonomy different?

A
  • In healthcare, choices will have a direct impact on the individuals body
  • We usually choose how to conduct our lives
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16
Q

How is autonomy respected?

A
  • Enable autonomous choices
  • Range of choices
  • Adequate information
  • Clear explanation
  • No pressure
  • Be non-judgemental
  • Time to consider options
17
Q

Why is respecting autonomy important in medical care?

A
  • Helps doctors give better advice
  • Improve shared decision making
  • Improve confidence
  • Improve trust
  • Improve adherence
18
Q

When are there limits to autonomy?

A

Preventing harm to others

19
Q

Define paternalism

A

Overriding or undermining an individual’s autonomy based on the belief that to do so is in their best interests e.g. withholding bad news or playing down side effects of a treatment

20
Q

Is paternalistic dishonesty sometimes justified?

A
  • Technical information can be difficult to put across
  • Outcomes are uncertain
  • Patients may not be able to handle information, it might cause distress
21
Q

Why is withholding information rarely justified?

A

Consequences:

  • Many patients with a serious illness suspect their diagnosis.
  • Uncertainty causes anxiety
  • Patients may not trust their doctor if they feel she/he is not being honest with them

Duty to respect autonomy:

  • Knowing the diagnosis and prognosis is important for making other important decisions
  • Most patients want to be told their diagnosis

Virtue:
- Honesty is an essential virtue of doctors

22
Q

Is lying worse than withholding the truth?

A

Yes

  • Restricts autonomy more
  • Impossible to tell patients everything
  • Less likely to cause mistrust
  • Moral duty not to lie

No

  • Wrong to assume a patient doesnt want to know
  • Will cause equal mistrust
  • If the intention is the same then morally equivalent
  • Moral duty not to withhold info important to the patient