Medical Ethics I Flashcards
1
Q
Introduction
A
- Philosophy- Concerned with the nature and validity of each major aspect of human existence
- Morality- Concerned with standards of right or wrong behaviour
- Morals- What is considered right or wrong behaviour based on social custom
- Ethics
- Concerned with the moral dimensions of human life/evaluating human action
- What is right or wrong based reason
- Reflective and critical
2
Q
Moral Relativism and Moral Objectivism
A
- Do morality and ethical rules exist independently of humans or are they human conventions (Are they things we come up with or do they exist)
- Views on the validity of moral beliefs
- Moral relativism- the view that ethical standards, morality and positions of right or wrong are culturally based and therefore subject to a person’s individual choice; we can all decide what is right or wrong for ourselves
- Moral objectivism- the view that moral beliefs are capable of being objectively valid; capable of being true or false/rational or irrational
3
Q
Values
A
- Ideas, beliefs, custom, characteristics considered valuable and worthwhile by an individual, a particular group or society in general
- Influence behaviour, help make choices and decisions
- Personal values- beliefs or attitudes about what is good, right, desirable, worthwhile
- Values may reflect how one should act (for example, to be honest, self-disciplined, caring etc) or to what one wants to accomplish or obtain in life (For example, wealth, security, fame, health)
- Acquired in different ways, in the conscious (Or subconscious) way through:
- Family, friends, teachers, those whom we admire
- Work, environment, colleagues, role-models and promoted through professional codes of ethics etc- professional values
4
Q
Law and Morality (1)
A
- Law- What not to do
- Morals- what you should do
- Natural law theorists
- Argue that the law should reflect morality
- Higher law that sets out the basic moral code
- Utilitarian approach
- Crimes without victims should not really be crimes al all
- Crimes that only do harm to the criminal should be decriminalised
5
Q
Common ethical theories
A
- Teleology- actions are ‘right’ or ‘wrong’ according to the balance of their good or bad consequences
- Utilitarianism is a teleological theory that judges act based on their utility or usefulness (how useful the act is will tell us what to do)
- Deontology- actions are performed out of duty or moral obligation; every person is an end and not solely a means to another person’s end
6
Q
Teleology (Consequentialism)
A
- Teleology comes from the Greek telos, meaning purpose or end
- More commonly known as consequentialism
- For consequentialists, whether an action is morally right or wrong depends on the action’s consequences
- In any situation, the morally right thing to do is whatever will have the best consequence
- Questions arise as to what kind of consequences- i.e. needs to be combined with a theory about what the best consequence is
7
Q
Utilitarianism- A consequentialist theory
A
- Utility is a term used to refer to the degree to which an action produces good/avoids evil
- Actions are right if they maximise happiness/pleasure and minimise unhappiness/pain; or, that actions are right is they have the greatest utility
- Basis of utilitarianism is to ask what has intrinsic values (value in itself) and then assess the consequences of the action in terms of intrinsically valuable things
- Utilitarianism has had a considerable influence upon legislation
8
Q
Duty theories
A
- Morality is based on specific foundational principles of duty that are absolute, obligatory and irrespective of the consequences that might follow our actions
- I.e. the right thing to do
9
Q
Deontology
A
- According to deontologists
- There are acts we have the duty to perform because these acts are good in themselves (I.e. intrinsically good)
- We have a duty to refrain from acts that are intrinsically bad or wrong
- Consequences are irrelevant to determining what is moral or not
10
Q
The fundamental bioethical principles
A
- Autonomy
- Beneficence
- Non-maleficence
- Justice
11
Q
Ethical issues in relation to four principles
A
- Autonomy- Decisional capacity
- Non-maleficence (not doing bad)- Beneficence (Doing good)
- Life-sustaining decisions, QoL, euthanasia and assisted suicide
- Justice
- Rationing and managing healthcare costs
12
Q
Autonomy (1)
A
- Derived from the Greek ‘Autos’- self-rule
- Autonomy or self-determination a dominant principle of medical ethics
- Encompasses the capacity to think and decide and to act on the basis of such thought and decision- closely related to the notion of choice
- Informed consent to medical treatment lies at the heart of autonomy and privacy and confidentiality, and are all derived from the principle of respect for persons
13
Q
Autonomy (2)
A
- Respect for autonomy- requires HCP to help patients come to their own decisions and able to respect and follow those decisions
- Person’s autonomy may be restricted in certain circumstances, for example
- To prevent that person from harming other
- To prevent that person from harming him/herself
- To benefit that person
- To benefit other
14
Q
Non-maleficence
A
- First, do no harm
- Expresses the commitment to the protection of patients from harm
- Affirms the requirement of competence and the standard of duty of care
- Failure to prevent harm to the patient from errors and malpractice represents a failure to act by the principle of non-maleficence
- Withdrawing or withholding of life-sustaining treatment, the treatment of terminally ill patients and the provision of futile treatment all raise issues concerning the principle of non-maleficance
15
Q
Beneficence (1)
A
- Principle of beneficence means that HCP has a duty or obligation to promote the health and welfare of the patient and not merely refrain from causing harm
- Beneficence requires positive action, to always act in the best interests of the patients
- The principle of beneficence is a primary goal of HCP
- May conflict with the principles of respect for patient autonomy
- Without an appropriate balance has led to considerable paternalism in healthcare
