ethics qs Flashcards
what do you understand abt euthanasia / assisted dying? does euthanasia have a place in modern medicine?
euthanasia = actions taken to deliberately end someone’s life, often to relieve suffering
MENTION IT IS A COMPLEX TOPIC THAT HAS ARGUMENTS BOTH WAYS
active = an individual deliberately intervenes to end someone’s life - eg. doc injecting patient w terminal illness w overdose of muscle relaxants
passive = when individual causes death by withholding treatment that is necessary to maintain life eg. withholding antibiotics from someone w bacterial pneumonia
voluntary = euthanasia carried out at request of person who dies
involuntary = patient who dies wants to live but killed anyway (manslaughter/murder)
assisted suicide = physician intentionally gives the patient the means to take lethal medication themselves
assisted dying = only used in context when patient alr dying, terminally ill, and asks for help to die
terminally ill adults bill = mps voted in favour to legalise = bill allows adults, over 18, who have mental capacity to make the choice, and are expected to die within 6 months, who are terminally ill to choose to end their life
- they need to make two seperate declarations, w witnesses and signed, and have 2 independent doctors have the decision they are eligible
- the doctor prepare substance but person take substance themselves (voluntary euthanasia), but still illegal to coerce someone to end their life (possible 14 year sentence)
FOR:
- enables dignity during death + control over their own death = autonomy
- family and friends would be saved from having to see someone they love suffer for long periods of time
AGAINST:
- principles of hippocratic oath = do no harm + non maleficence
- could also put pressure on vulnerable patients who have long term illness by family friends, feel like burden
- may damage trust between patient and doctor
- some people may change their mind but feel like they have to go through with their choice
do you agree w abortion?
MAKE SURE SAY COMPLEX MATTER AND HAVE TO ADDRESS BOTH SIDES
- not black or white issue
- under current uk legislation (abortion act), can be medically carried out if baby in first 24 weeks, and done in licenced clinic/hospital
- 2 doc must agree that doing abortion would cause less damage than continuing w pregnancy
autonomy = patients should have right to abortion if they wish
beneficence = important to have best interests of mother at centre of healthcare (mental + physical)
- abortion may be most loving thing to do for foetus if has severe deformities, as may have issues w baby’s quality of life
non-maleficence = doctor prevent any harm, so need to consider harm to mother and foetus in discussion of abortion
- sanctity of life could disagree w abortion, killing foetus which is life and should not be killed, always bad to kill a baby, intrinsically good.
- but confidentiality and hipaa should always be upheld in case of abortions
patient refuses treatment for life threatening condition, discuss ethical issues involved:
duty of doctor = has to fully inform patient of benefits of treatment, as well as risks of having and not having treatment
autonomy = has to let patient make their own decision once presented w the options and respect their choice, but only considered if patient is competent, otherwise respect choice of patient family etc..
beneficence + non maleficence = beneficial thing to do may be to provide patient w treatment but if against patients wishes, may do more harm than good
- despite decision made, still have to act in patients best wishes and prioritise patient care quality
14 year old patient ask for oral contraceptive pill?
- uk legislation = under 16 cannot consent to sexual activity
- doctor inform patient of benefist of treatment (protected sex) and risks of not having treatment (unprotected sex)
doctor has duty to ensure safety of patients but also ensure child protection and safety, confirm sexual abuse not happening - competence is major part to consider, aware of gillick competence if patient is gillick competent
autonomy = doctors must respect decision made by patient, but patient autonomy is not absolute
beneficence + non maleficence = doc must continue act in patient best interest and personal views not interfere, make sure to consider confidentiality and effect on trust between doctor-patient relationship
A Patient Diagnosed With HIV Reveals To Their GP They Have Not Disclosed This Information To Their Partner
You Are A Student At Medical School…
One Day In The Teaching Hospital, You See One Of Your Fellow Students Putting Medical Equipment From The Stock Room Into Their Bag. When You Ask Them About It, They Say They Only Want To Practise Their Clinical Skills And Ask You Not To Tell Anyone.
What Does ‘Patient Confidentiality’ Mean?
When Would It Be Appropriate To Breach This?
A 13-Year-Old Patient Reveals To You That They Are Sexually Active And That Their Parents Do Not Know…
What Would You Do As A Doctor In This Situation?
A Depressed Patient Who Has Refused Treatment Has Mentioned Having Suicidal Thoughts And You Are Concerned About His Wellbeing…
Discuss The Ethical Issues Involved.
Do You Think The NHS Should Fund Treatment For Smokers?
What Would You Do If You Saw A Colleague Making A Mistake With A Patient’s Medication?
Is It Ever Ethically Acceptable For NHS Doctors To Go On Strike?
You Are A GP And Your Patient Confides In You That They Are Regularly Using Illicit Drugs…
What Should You Do?
Should Vaccination Of Children Become Mandatory?
