Medical Ethics

Question 1

What are the 4 pillars of medicine?

Answer 1

-Beneficence (doing good)
-Non-maleficence (doing no harm)
-Autonomy (giving the patient freedom to choose freely, where they are able)
-Justice (ensuring fairness)

Question 1

What is beneficence?

Answer 1

All medical practitioners have a moral duty to promote the course of action that they believe is in the best interests of the patients. This should be both doing medically “good” and humanely “good”.

Question 2

Why is beneficence important?

Answer 2

Beneficence is important because it ensures that healthcare professionals consider individual circumstances and remember that what is good for one patient may not necessarily be great for another.

Question 3

What is non-maleficence?

Answer 3

A medical practitioner has a duty to “do no harm” or allow harm to be caused to a patient by neglect.

Question 4

How does non-maleficence differ to beneficence

Answer 4

–N-M acts as a treshold for treatment: If a treatment causes more harm than good, then it shouldn’t be considered. Contrast to beneficence where all options are considered.
–Beneficence is in response to specific situation, N-M is a constant in clinical practice.

Question 5

What is autonomy?

Answer 5

When a patient has the ultimate decision-making responsibility for their treatment.

Question 6

Why is patient autonomy important?

Answer 6

Autonomy is important because we need to make sure that the patient is actively involved in their diagnosis and treatment – and not just deferring to their Doctor

Question 7

What is Justice (In a medical ethics context)?

Answer 7

Justice is the idea that no one is unfairly disadvantaged when it comes to access to heathcare.
It is also the principle that when making an ethical decision, one must think whether it’s compatible with the law, the patient’s rights and that it’s fair.

Question 8

What is consequentialism?

Answer 8

This is the idealogy that the morality of an action is dependent solely on it’s consequences- “the ends justify the means”.

Question 9

What is utilitarianism?

Answer 9

-The best course of action is the one that brings the most benefit.
-Often takes into consideration wider society and not just patient in question.
-Form of consequentialism

Question 10

What is deontology?

Answer 10

-The correct course of action is dependent on what your duties and obligations are.
-“duty based ethics”
-Following the rules.

Question 11

What is capacity in medicine?

Answer 11

Capacity is the ability to give consent.
It relies on the patient’s ability to interpret information and make an informed decision.

Question 12

How is capacity assessed?

Answer 12

In order to have capacity, a person must be able to:
1. Understand the information
2. Remember the information
3. Use the information to make a decision (weigh up pros and cons)
4. Communicate their decision

Question 13

Mental Capacity Act 2005

Answer 13

1. Assume someone has capacity until proven otherwise.
2. All decisions made on behalf of someone who lacks capacity should be made in their best interest.
3. Least restrictive option should be found.
4. Introduces advanced direcives (living wills)
5. In some scenarios: restrictions may amount to “deprivation of liberty”

Question 14

How can you define consent in healthcare?

Answer 14

1. It is voluntary
2. It is informed
3. The patient must have capacity

Question 15

How is consent given?

Answer 15

TWO MAIN WAYS: verbal and written
However, also non-verbal as long as they understand what is about to take place.

Question 16

Children and consent

Answer 16

• The children act 2004 states adulthood is reached age 18.
• 16 and 17 year olds are presumed to able to make independent decisions.
• Typically U16 who have their competency assessed: Gillick competence.
• If a child cannot demonstrate this competence- consent can be given on their behalf (e.g. by parent/guardian)

Question 17

Gillick competence

Answer 17

Outlines whether a U16 can consent to their own medical treatment without their parents having to know or give permission.

Question 18

What are the 6 NHS core values?

Answer 18

1. Respect and dignity
2. Commitment to quality of care
3. Compassion
4. Improving lives
5. Working together for patients
6. Everyone counts

Question 19

NHS core value- respect and dignity

Answer 19

Every person, whether patient, family or staff, is treated as an individual. Their commitments and aspirations in life are respected as well as their abilities and limits being respected.

Question 20

NHS core value- Commitment to quality of care.

Answer 20

Insisting on quality and striving to get the basics of quality of care.
Do this by wlecoming and encouraging feedback from patients.

Question 21

NHS core value- Compassion

Answer 21

Ensuring that compassion is central to the care the NHS provides: no matter how small the act of compassion is.

Question 22

NHS core value- Improving lives

Answer 22

Strive to improve lives and wellbeing. Cherish excellence and professionalism wherever it is found.

Question 23

NHS core value- Everyone counts

Answer 23

• Maximise resources in order to provide care for the benefit of the whole community- making sure that no one is excluded.
• Some people need more help, and difficult decisions will need be made.

Question 24

NHS core value- Working together for patients.

Answer 24

Patients come first in everything that we do.
Fully involve patients and professionals inside and outside the NHS.
Put the needs of patients and the community before organisational boundaries.

Question 25

What is assisted suicide?

Answer 25

Facilitating/making it possible for a patient to commit suicide (e.g. by giving medication with which they can take to end their life)

Question 26

What is active euthanasia?

Answer 26

When medical professional or another person actively does something which ends their life (e.g. lethal injection)

Question 27

What is passive euthanasia?

Answer 27

When a medical professional stops life-saving treatment or medication for a patient.