Medical Ethics

Question 1

Define ethics

Answer 1

The body of modern principles or values governing or distinctive of a particular culture or group.

Question 2

Define morality

Answer 2

Attitudes, behaviours and relations between one another

Question 3

Define and describe deontology

Answer 3

Duties, right and wrong actions, absolute values.
Based around Emmanuel Kant.
Act only in such a way that you would be happy to become universal law.
Treat people as ends in themselves, never just means. Basis of Hippocratic Oath.

Question 4

Describe the advantages and disadvantages of deontology

Answer 4

Advantages:
Certainty
Guidelines
Defines actions and behaviour.

Disadvantages:
Not everyone will agree about rules - absolutism to relativism
Life is uncertain with grey areas, different actions may be carried out in different situations.
Non-sensible outcomes

Question 5

Define consequentialism

Answer 5

The moral worth of an action is determined by its outcome.

Question 6

Define and describe utilitarianism

Answer 6

Based on Bentham. The greatest good for the greatest number (maximising pleasure or happiness and minimising pain or unhappiness).

Question 7

Describe the advantages and disadvantages of utilitarianism

Answer 7

Adv:
With all the information, you can work out the outcomes of different actions and choose the best ones
Gives ability to respond to subtly different circumstances.
Not dependent on belief system or ultimate set of rules

Disadv:
Need to know what outcomes are which doesn’t work when things are unpredictable.
End up justifying what most people would think is morally irreprehensible.

Question 8

List the GMC Duties of a Doctor

Answer 8

Make care of patient 1st concern
Provide a good standard of practice and care by keeping knowledge and skills up to date and recognising and working in competence levels.
Take prompt action if patient dignity, safety or comfort compromised.
Promote the health of patients and the public.
Treat patients with dignity and respect by treating patients politely and with respect and respecting confidentiality.
Work in partnership with patients by listening and responding to their questions and concerns, giving them information needed in a way they understand to reach decisions, respecting their right to make decisions about their care and helping them to care for themselves and improve health,
Maintaining trust by acting openly and honestly with integrity, never discriminating unfairly against patients or colleagues and never abusing patient and public trust in the medical profession.

Question 9

Describe the four principles of medical ethics

Answer 9

Respect for autonomy: promoting right to self determination via confidentiality, informed consent and capacity
Non-maleficence: to do no harm
Beneficence: to do good
Justice: fairness or equity (non-discriminatory and equal treatment for equal need). At population level this means rationing and and individually limits autonomy.

Question 10

Apply medical ethics to giving IV fluids to an elderly cancer patient too drowsy to drink

Answer 10

Autonomy: living will, treat delerium
Non-malificence: what are the harms of giving or not giving fluids?
Benificence: what are the benefits of above?
Justice: what are the opportunities for cost. Are we being ageist or sexist?

Question 11

Describe the non-judgemental approach

Answer 11

You must not discriminate on the grounds of age, colour, culture, disability, ethnic or national origin, marital or parental status, race, religion or any beliefs, sex, sexual orientation or social or economic status (GMC, 2006)
Patients are not deserving or undeserving
It doesn’t matter how patients get diseases/illnesses.

Question 12

Explain not imposing your personal views and respecting patients’ views

Answer 12

Fair presentation of facts and opinions
Not letting views affect advice or actions (questionable whether you should divulge your opinions)
Willingness to refer elsewehere
Not bullying or belittling patients or colleagues.

Question 13

Explain confidentiality

Answer 13

Confidentiality is the basis of trust. Patient details should be disclosed to others on a need to know basis only and only on rare occasions, e.g. child protection may confidentiality be breached.

Question 14

Explain not exceeding your competency

Answer 14

Need to have competency to explain informed consent. Not doing anything you haven’t had the appropriate training or supervision of.

Question 15

Describe fitness to practice

Answer 15

The duty to take action if you or a colleague is unfit to practice.