ethics y1 Flashcards
Deontological theory
what one MUST do, based on duties and obligations
Teleological theory
purpose or consequences of moral acts.
Consequentialist Theory
moral value of an act, rule or policy is to be found in its consequences, not in intentions or motives
sub class of teleological moral theory.
Utilitarianism
morally right thing to do i=greatest happiness for the greatest number of people.
-ve consequential
cant predict 100% conseq = uncertain
so concertned w wnes that may overloook moral imp of means
Virtue ethics
purpose, of a human life is to live according to reason. This leads to ‘happiness’ in the sense of human flourishing. This flourishing is achieved by the habitual practice of moral and intellectual excellences, or ‘virtues.
Casuistry
case-based reasoning
focus on practical decision-making in particular cases based on precedent.
4 pricnipelse
Respect for autonomy: respecting the decision-making capacities of autonomous persons; enabling individuals to make reasoned informed choices.
Beneficence: balancing benefits of treatment against the risks and costs; the healthcare professional should act in a way that benefits the patient.
Non maleficence: avoiding causing harm; the healthcare professional should not harm the patient. Most treatment involves some harm, even if minimal, but the harm should not be disproportionate to the benefits of the treatment.
Justice: respect for justice
respect for justice
Distribution of a fair share of benefits,
• Legal justice - doing what the law says,
• Rights based justice, which deals in the language, and perhaps the rhetoric, of claimed human rights, and hence goes beyond, though it includes, legal rights.
Framework for discussing ethics in case studies.
Summary of case
• What are the clinical and other significant relevant facts?
• What are the possible options?
• What are the morally significant features of each option?
Consider:
• Patient options • Patient capacity • Best interests • Non-maleficence (or any of the other principles) Consequences for patient and others:
- Justice/Equality
- What are the duties of the health professional?
- What does the law/guidance say about each option?
- Are there other contextual features (religious and cultural factors, practicality of options etc)
- Choose your preferred option
- Summarise the arguments for and against this option?
- Conclusion
checkilist
Medical factors/indications
Diagnosis
Treatment
Prognosis
Preferences
Patient
Family
Team
Quality of life
Before
During
After
Context
Support system
Cost, availability
Special circumstances
Legal issue
Medical factors:
How do we make the diagnosis and what is the diagnosis? Are there social factors? What are the treatment alternatives? What is the survival rate and prognosis? Likely outcome to treatment and the treatment effectiveness may also be relevant.
Preferences
Do patients really want detailed explanations of the extent of their disease and how much has been disclosed? What is their understanding of condition and treatment? Has the patient indicated any preferences? What role do family members see themselves as having?
qol
quality of residual life, the psychological harm if any, from treatment or medical intervention. Patient’s opportunity to settle emotional as well as financial accounts or to realize deferred personal goals. Has patient indicated what they would like to happen?
Contextual features:
What are the unique psychological or social factors particular to the patient that might help and assist any ethical analysis? Cultural beliefs may be important. Are there legal issues to consider, patient is a minor or elderly where capacity is uncertain?
