Making Ethical Medical Decisions 8-1-14 Flashcards
What are clinical ethics?
Clinical ethics is the art of making decisions that improve the quality of patient care and respect the moral sensibilities of stakeholders.
Who are the primary ‘stakeholders’ in the patient-physician relationship? What provides context and framework?
The primary stakeholders in patient-physician relationship are the patient and the physician, but decisions are framed and evaluated by communities: medical profession; legal authorities; political climate; consumers and providers, and communities of tradition and values.
What is moral reasoning?
Moral reasoning is applying philosophical and judicial principles to resolve ethical questions about patient care within my community.
What is preconventional, conventional, and post-conventional reasoning?
Pre: black and white
Conventional: shades of gray
Post: continuum of dark to light
(Rorschach –> Nite Owl –> Doctor Manhattan)
What is nonmaleficence?
The physician avoids harming the patient
What is beneficence?
Beneficence: The physician seeks what is best for the patient.
What is autonomy?
Autonomy: The physician respects the authority of the patient.
What is justice?
Justice: The physician acts justly toward all patients. All equates to fairness in healthcare.
What 4 factors feature in an ethical decision?
Ethical decisions are informed by:
Medical indications: What are the medical facts?
Patient preferences: What does the patient want (and not want)?
Quality of life: What will the patient’s life be like?
Social context: What is the impact of and on the world of the patient?
What are 6 values that make up ethical decisions?
Utility: The consequence is beneficial: the greatest good for the greatest number.
Duty: The duty itself is good: a categorical imperative admits no exceptions and needs no outcome.
Virtue: One’s character is good: our acts express who we are.
Empathy: The actor has empathy: individuals who care about others do the right thing.
Authority: The actor has the authority or power: might makes right.
Casuistry: There is settled precedent: best practice is best.
Ethical decisions are professional, and you should probably know this list of stuff for the test.
Professional - physician role
Viewpoint: Empathetic/partner Goal: Curative/heal Class: "Part of the Profession" Context: Hospital/clinic/office/field Question: What is best practice?
Be able to answer these questions:
What complicates ethical decision making?
What principles guide ethical decision making?
What values are often applied?
How does a professional approach differ from others?
How do pre-, post-, and conventional thinking effect ethical decision making?
What are the 4 pillars of medical ethics?
- Autonomy
- Nonmaleficence
- Beneficence
- Justice
