Lecture 11 - ELSI

Question 1

What is utilitarian ethics?

Answer 1

Doing what is best for the majority

Question 2

What is deontological ethics?

Answer 2

Basing your actions on the rules and not what you think the consequences might be. Described as ‘obligation’ or ‘doing your duty’

Question 3

Who decides what treatments are available on the NHS?

Answer 3

An independent committee within NICE
Consists of 
- a chair
- 2 lay members
- health & social care professionals
- care providers
- technical experts

Question 4

What kind of evidence is used by the committee to decide whether a treatment should be available or not?

Answer 4

Reviews of primary research
Unpublished data
Economic modelling
Patient and clinician testimony
ICERs

Question 5

What is meant by opportunity cost?

Answer 5

The value of the best alternative use of resources i.e. what is the value of the treatment that you are losing out on to pick this one instead

Question 6

What is the ICER cut-off? (How much is the government willing to spend per QALY gained)

Answer 6

£20,000

Question 7

What 3 things are required for informed consent?

Answer 7

1. Disclosure of all information
2. Voluntariness - freedom from coercion
3. Competence/capacity to make decisions

Question 8

What is an orphan drug?

Answer 8

A drug intended to treat a condition so rare that it would normally not have treatments developed by pharmaceutical companies due to economic reasons

Question 9

Give and example of when a drug was shown to benefit one population but not another

Answer 9

BiDil = nitric oxide enhancer, used to treat end stage CVD
Initial trials called off due to lack of efficacy although subgroup of African Americans appeared to show benefit (because African Americans have decreased nitric oxide)
Later trials proved this huge benefit and it was FDA approved