Ethics Midterm Flashcards
what’s ethics
how a person should behave (knowing)
what’s morality
value of human being (doing)
aim of ethics
to be good / act well in your profession
what are the ethical claims
- descriptive / empirical
- normative / prescriptive / evaluate
define descriptive / empirical claim
how the world is
define normative / prescriptive / evaluate claim
how the world should be
describe personal ethics
ethical values for situations in every day life
describe professional ethics
rules / guidelines used for professional life
describe ethical reasoning
the ability to identify, asses, and develop ethical arguments from a variety of ethical positions
describe ethical argument
an argument based on ethical theories
how to develop an ethical argument
Duty & Right (taking correct actions)
Character & Relationship (being good people)
Consequences (predicting best possible outcomes)
how to decide what’s ethical
obedience (compliance)
Imitation (copying)
Feeling / Desire (presentment)
Intuition (instinct)
Habit (practice)
Core values in medicine & medical ethics
Compassion (concern fro patient’s condition and distress)
Competence (scientific, technical, cultural, ethical abilities)
Autonomy / Self-determination (individual and collective devision-making procedures)
Ethical code in medicine
- help resolve disputes
- adhere to professional duty & maintain a clear conscience
- identify and ethical challenge and not make self look uninformed
- maintain patient respect
- maintain respectful relationships with coworkers
- maintain efficiency in decision making and care process
- reduce burnout
what happens in absence of ethics
- ethical violations
- medical errors
- patient feels their dignity isn’t repeated (they aren’t hear)
- lack of trust in doctor-patient relationship and the medical profession
- lack of adherence to treatment
- conflict of interest
- causing physical / emotional / financial / injury to patient through inappropriate behaviour
- doctors withholding / promoting treatments to meet personal or institutional interest
modern issues in bioethics
- designer babies
- dna banks
- genetic modification and agricultural activity
- human genome and associated challenges
3 ethical theories
- consequentialism (includes utilitarianism)
- deontology
- virtue ethics
what’s consequentialism
best end results
cons of consequentialism
- difficulties to predict end result
- difficulty in measuring and comparing the “goodness” of consequences
- choosing different time periods may produce different consequences
- ignores things we regard as ethically relevant
what’s utilitarianism
best end result for most people
decision making method to utilitarianism
- identify different actions
- determine benefits / risks of actions
- choose that w/ most benefits
types of utilitarianism
- act
- rule
act utilitarianism
principles of utility used to guide actions
rule utilitarianism
principle of utility used to make rules which in turn guide actions
Utility & welfare maximisation
providing max amount of wellbeing for the most amount of people
cons of utilitarianism
- difficult to know with certainty whether the consequences of our actions will be good or bad
- requires assigning values to the benefits / harms resulting from our actions
- severe limitations accounting for values such as justice and individual rights
what’s deontology
correct action if it follows the rules
cons of deontology
- 1 set of rules not suitable for all cases
pros of deontology
- simple to apply (=following rules)
- fits well with our natural intuition
- doesn’t require weighing benefits –> avoids subjectivity and uncertainty
types of deontology
- hypothetical imperative
- categorical imperative
what’s hypothetical imperative
do this in order to get that
what’s categorical imperative
do this!
define virtue ethics
taking certain person’s behaviour as an indication of their character
4 cardinal virtues
- Prudence
- Justice
- Fortitude
- Temperance
what’s prudence
right reason applied to action
–> take counsel , judge , command
what’s justice
treat equals equally
what’s fortitude
moral courage to make right decision
what’s temperance
all decision made free from self-interest
distinctive focus of virtue ethics
- considering character
- right acts for right reason
- golden mean (whatever is moderate is right)
parameters of an ethical act
- self (are you ready to accept yourself)
- universalisability (I you can universalise and act and its still right, then its ethical)
- means (people are equal and deserve equal treatment and respect)
Rule based ethical theory in medical practice
- doctor attends to each patient w/ same set of rules
- rules which are set before consultation and aren’t permitted to be broken
- the moral acts of the doctors are to judged in terms of their conformity to rules, duties or obligations
determination of healthcare allocation
- QALYs
- DALYs
QALYs
generic measure of disease burden, including both quality and quantity of life live
DALYs
measure of disease burden, expressed as the cumulative number of years lost due to ill-health / disability
Gnome
to wit/ judge what departure from common rules is called upon (moral intelligence)
What’s dignity
basic values of human beings entitling them to respect
- being treated like somebody
what does dignity include
- respect
- privacy
- autonomy
- self-worth
when is dignity at risk
- sickness
- decline / toward death
- disability
- lack of capacity
- elderly
- childhood
- prison
4 principles of healthcare ethics
- Autonomy
- Beneficience
- Non-maleficience
- Justice
what’s autonomy
self-rule (patient decides treatment)
what does autonomy depend on
- capacity
- necessity
- risk to others
what’s beneficence
doing good for patients
what’s non-maleficence
avoid harm
what’s justice
treat equals equally
what are human rights
respect for the person and their dignity
–> human right and moral rights are complementary
what are physicians’ legal rights
doctor’s duties and obligations towards protecting citizens
what’s a clinical ethics committee comprised of
- admin.
- legal members
- medical ethics academics
- religious rep.
- lay members
structured case analysis model
- summarise case
- state moral dilemmas
- state assumptions being made / to be made
- analyse case w/ reference to
- ethical principles
- consequences
- professional codes
- the law - acknowledge justifiable ethical solutions and those that aren’t justifiable
- state preferred approach w/ explanation
what’s consent
voluntary agreement
–> respects patient’s autonomy (primacy of consent)
what happens if patient is unconscious
- seek rep
–> if rep isn’t present and emergency, presume consent given
main idea of WMA Dec. on patient rights
- right to self- determination (autonomy)
- consent
- patient rights
3 requirements for valid consent
- competence
- voluntariness
- information
information
- procedures
- alternative (other treatment options)
- risks / benefits
- questions
- diagnosis
- prognosis
- uncertainties
- purpose of treatment
- bills
- conflict of interest
consent = continuous
can change mind (must be repeatedly gained)
types of consent
- explicit (actively given)
- implied (reasonably inferred but not directly expressed)
respecting patient’s autonomy
- preconditions
- information
- consent
preconditions
competence / ability to understand and decide
–> voluntariness in deciding
information
- disclosure of info.
- rec. of a plan
- understanding of info. and plan
consent
- decision (in favour of plan)
- authorisation (of chosen plan)
exceptions to requirements of informed consent
- patient voluntarily passes authority to physician
- disclosure of info. causing harm to patient
what’s capacity
ability to give permission to have treatment or to withhold permission and refuse treatment
what does capacity comprise of
- understand (info. relevan to decision)
- retain (info.)
- use (decision making process)
- communicate (decision)
what happens if patient isn’t capacitous
- proxy-decision maker
- advance decisions (living wills)
mental capacity act
- adults have rights to own decision
- everyone’s encouraged to own decisions
- right to make unwise decisions
- proxy = best decision for patient
- proxy doesn’t affect patient’s freedom
