M1: Fundamentals of Bioethics & Morality Flashcards
Understanding of the nature of conflicts arising from moral imperatives. Best way we may deal with them. Deals with conflicts in potential outcome (consequences of actions) or with duties. Considers how we should act best in light of our duties and obligations as moral agents.
Ethics
Central to modern medical ethics is a respect for patient _________ and the fundamental principle of _________.
Autonomy. Informed consent.
Ethics deal with _______.
Choices
Physicians should know and exemplify the core values of medicine
Compassion, Autonomy & Competence “CAC”
Serve as the foundation of medical ethics
Respect for fundamental human rights & CAC
Capacity to make practical judgement in matters involving ethical issues. Judges a concrete act as good or evil.
Conscience
Making personal moral decisions is guided by the objective standards of
Moral conduct
The failure either to inform the conscience or follow the conscience after informing it
Sin
The act itself. Primary & essential element. It is what the act itself pursues. May be good, bad or indifferent.
Object
Principal goal or objective. Without it, the act will never be performed.
End or Intention
Accidental aspects of the objects or the intention. May affect the goodness of malice of an act.
Circumstances
Primary and essential element of the morality of an act.
Object
When the object is __________, morality of an act is determined by intention and/or by circumstance.
Morally indifferent
Can make an act whose object is indifferent good or evil
Principal end or intention
Cannot convert a good act into something bad, or vice versa, can decrease or increase the goodness or malice.
Circumstances
What does this patient want?
Autonomy
What can be done for them?
Beneficence
Is the request fair?
Justice
Major principles in medical ethics, four originally developed by
Thomas Beauchamp & James Childress
Four traditional pillars of Medical Ethics
Beneficence, Autonomy, Non maleficence & Justice “BANJ”
Are involved in making informed and voluntary decisions
Rational agents
Basis for the practice of free and informed consent. Uphold a competent, adult patient’s decision, even if it appears medically wrong.
Autonomy
Fundamental concept on which patient’s rights are based
Informed consent
Promoting what is best for the patient. Implies consideration of the patient’s status. Can sometime imply not intervening, if the benefit pf therapy would be minimal.
Beneficence
Focused by the lens of being in a professional caring relationship
Doing good to others
The practice of beneficence is challenged by the respect for
Autonomy
Is a personal decision, and the good that a patient may determine can often differ from that of his/her physician or caregiver.
Determining good
In most cases of treating sick patients this add little to the beneficence principle. Reminds us to ponder the possibility of doing the harm, especially when you cannot cure.
Non maleficence
Latin term for non maleficence
Primum non nocere
Is a constant duty one ought never to harm another individual.
Nonmaleficence
Is a limited duty
Beneficence
A form of fairness. Implies the fair distribution of goods in society and requires that we look at the role of entitlement.
Justice
In Justice, resources are limited & you cannot cure everybody and so priorities must be set, ________.
Triage
Reflect a general concensus about the way physicians should act and they should be followed unless there are good reasons for acting otherwise.
Medical code of Ethics & Policy statements
Can agree on some fundamental ethical principles, fundamental human rights.
Human beings
Non rational
Obedience, Habits, Imitation, Feeling or desire & Intuition “OHIFI”
Rational
Deontology, Consequentialism, Virtue ethics & Principles “DCVP”
Does not mean irrational but simply that is to be distinguished from the systematic, reflective use of reason in decision-making.
Non rational
A common way of deciding especially by children and those who work within authoritarian structures. Following the rules or instructions of those in authority whether you agree with them or not.
Obedience
Subordinates one’s judgement about right and wrong to that of another person, in this case, a role model. Following the example of the role model.
Imitation
What is right is what feels right or satisfies one’s desire. What is wrong is what feels wrong or frustrates one’s desire.
Feeling or Desire
Measure of morality is to be found within each
Individual
Immediate perception of the right way to act in a situation; similar to desire (entirely subjective) differs because of its location in the mind rather than the will. Neither systematic nor reflexive but directs moral decisions through a simple flash of insight.
Intuition
Very efficient method of moral decision-making since there is no need to repeat a systematic decision-making process each time a moral issue arises to one that has been dealt previously.
Habit
Following an authority. Just follow!
Obedience
Role model. Observation & assimilation of values.
Imitation
Following what you felt is right. Personal taste, own value and will.
Feeling/Desire
Immediate perception of the right way to act in a situation. Directs moral decision through a simple flash of insights.
Intuition
Previous cases. Bad or Good.
Habit
Duty, obligation or rule based ethics because rules bind to you to your duty. Normative position that judges the morality of an action based on the action’s adherence to a rule. Well founded rules as the basis for making moral decision, duties & obligations and how best they mey be met.
Deontology
Ethical decision making on an analysis of the likely consequences or outcomes of different choices and actions. Right action is the one that produces the best outcomes.
Consequentialism
One of the best known forms of consequentialism, uses utility as its measure and defines this as the greatest good for the greatest number.
Utilititarianism
Uses ethical principles as the basis for making moral decisions. Applies principles to particular cases or situations in order to determine what is the right thing to do, taking into account both rules & consequences.
Principilism
Identified as the most important for ethical decision-making in medical practice
Respect for BANJ
Focuses less on decision making and more on the character of decision makers as reflected in their behavior.
Virtue ethics
A virtue is a type of
Moral excellence
One virtue that is especially important for physicians
Compassion
Other virtues
Prudence, Honesty & Dedication “PHD”
The most fundamental claim of virtue ethics is that reference to _______ & _______ are essential in the justification of right action.
Character & Virtue
An action is right if and only if it is what an agent with a _______ would do in the circumstance.
Virtuous character
The best outcome
Consequentialism
BANJ
Principilism
What the saints would have done
Virtue ethics
