Introduction to values in medicine

Question 1

What is values based practice?

Answer 1

A skills-based approach to balanced descision making where complex and conflicting values are involved

Question 2

Four key elements of values-based practice

Answer 2

Awareness

Reasoning

Knowledge

Communication

Question 3

What are patient values?

Answer 3

Unique preferences, concerns and expectations that each patient brings to a clinical encounter.

Must be integrated into clinical decisions if they are to serve the patient.

Question 4

Sources of medical law

Answer 4

Common law: laws made by judges

Statute law: laws made by parliament

European law: laws made by european parliament

Question 5

Advantages and Disadvantages of common law

Answer 5

Adv:;

Slow changes
Fits with other law
Sensitive issues considered outside political arena

Disadv:
Conservative
Retrospective
No community consultation

Question 6

Advantages and disadvantages of statute law

Answer 6

Adv:
Overides common law
Clear and conclusive
Prospective
Carefully planned - systematic
Reflects community attitudes

Disadv:
Inflexible
Difficult to change
Hard for rapidly changing areas (e.g. biotech)

Question 7

Advantages and disadvantages of European law

Answer 7

Adv:
Embeds ethical principles
Avoids conflict between domestic and international law
Enforces individual human rights
Better policy outcomes

Disadv:
Too much power to judges
Only imposed against government and public authorities
Subject to parliamentary sovereignty

Question 8

Three approaches to ethical reasoning

Answer 8

Principles:
professional codes - e.g. ;hippocratic oath, declaration of geneva/helsinki, duties of a doctor (GMC)
moral theories - e.g. deontology, utilitarianism, virtue ethics

Particulars: attention to case - context, case comparison, consistency of judgement

Perspectives: patient, hcp, family, society

Question 9

Approaches to statutory interpretation:

Answer 9

Literal approach: Judge gives the text its plain, ordinary meaning

Purposive approach: judge looks into the purpose for which the statue was enacted.

Question 10

Human rights Act in medical practice

Answer 10

1. Right to life
2. Prohibition of torture, inhumane or degrading treatment
3. Right to libery and security
4. Respect for privacy and family life
5. Freedom of thought, conscience and religion
6. Prohibition of discrimination