Ethics & Law Flashcards
Deontological Ethics
- Immanuel Kant
- “an action in and of itself determines moral worth, not the outcome… emphasis is on principles, rules, maxims, and duties”
- just follow the rules and you did the right thing, despite the outcome
Utilitarianism Ethics
- John Stuart Mill
- emphasis is to maximize positive outcomes for all involved
- the greatest good for the greatest number
- action is right if more people benefit from it than are harmed
values
of importance to the individual
morals
doing the right things based on personal and collective values
- collective values of a community or society
- just bc u don’t like cats doesn’t mean that u kick it out of the way
ethics
principles adopted by a group that guide behaviour
autonomy
individual freedom, choice, self-legislation
examples of autonomy in TM
- right to refuse transfusion/products
- patient centered care
veracity
truth-telling, open relationship
examples of veracity in TM
- risks of receiving transfusion (trxns)
- risks of NOT receiving transfusion
beneficence
doing good,, obligation to care for those in need
examples of beneficence in TM
clincally appropriate use of products
non-maleficence
doing no harm, protect those in care
examples of non-maleficence in TM
- screening donors (Hb/age/weight, TD testing)
- compatibility testing
justice
fairness, respect for all
examples of justice in TM
- access to products, availability
- wise use of scarce resources
what is consent?
permission to perform procedure or event to happen
- legal requirements = voluntary, age, capacity, informed, documented
- implied consent = verbal/non-verbal behaviour
- expressed consent = written
examples of consent in TM
- consent form/included in consent for other procedures (eg. major surgery)
- consent can be revoked - patient condition changes, different procedures
we as MLTs are bound by confidentiality
- organization policy (APL)
- professional code of ethics (CSMLS, CMLTA)
- provincial legislation (Health Infomation Act, Health Professions Act, FOIPP)
ex:
- discussing cases in public areas
- rare product use
- patient phones blood bank for blood group result
assault
intent to harm
battery
causing harm/injury
examples of assault and battery in TM
- transfusing without consent
- phlebotomy without consent
negligence
- doing something you are not supposed to and causing harm (or not doing something you are supposed to)
> duty of care
> breach of standard of care
> harm or loss/damages
> causation - direct link b/w person owing a duty causing harm to substandard care
principles that guide decision making in TM
- autonomy
- veracity
- beneficence
- non-malifecence
- justice
treating people equally in TM
lottery:
- equal opportunity, fair, difficult to corrupt
- ignores other relevant information (age, health status, etc.)
first come, first served:
- easy to administer
- favours those with wealth, power, resources
prioritarianism (favouring the worst off)
sickest first:
- helps those suffering now, makes sense of good use of temporary resources; ‘rule of rescue’
- requires diagnosis, ignores those who will become sick, ignores other principles
youngest first:
- benefits those who’ve had the least life, values lives
- prioritizes infants over adolescents and young adults
maximizing total benefits: utilitarianism
number of lives saved:
- saves more lives - benefits the greatest number; no need to judge quality over quantity
- ignores other principles
prognosis
- maximizes life- years
- ignores other principles
promoting and rewarding social usefulness
instrumental value
- directs resources to those who can help (healthcare workers, public servants); futures oriented
- vulnerable to abuse, direct resources away from health needs
reciprocity
- rewards those who have contributed; past-oriented
- vulnerable to abuse, direct resources away from health needs, requires significant investigative resources
guidelines in TM
- reasonable: based on scientific evidence, agreed upon by credible stakeholders
- open and transparent: published, accessible, open to scrutiny
- inclusive: involve all stakeholders to participate in decision making
- responsive: opportunity to revisit, revise, allow for change with new emerging information
- accountable: mechanisms in place for decision-makers to be accountable for actions and inactions
