Medical Ethics in 2017 Flashcards
What is the hippocratic oath?
To treat the ill to the best of ones ability, to preserve a patients privacy, to teach the secrets of medicine to the next generation and so on…
What are the four ethical principles that underpin medical practice?
Autonomy
Non-maleficence
Beneficence
Justice
What do each of these 4 ethical principles mean?
Autonomy - promote the right to self determination - confidentiality, informed consent, promote capacity (e.g. patient’s right not to take advised treatment even if fully informed of benefits)
Non-maleficence - the avoidance of harm/do no harm (e.g. culture of sputum and discussion with microbiology to minimise risk antibiotic resistance)
Beneficence - to do good (e.g. care has been maximised for example by treatment of infection, discussion with colleagues in microbiology, involvement of practice team, referral for specialist opinion)
Justice - fairness (non discrimination and equal treatment for equal need), individual vs. population (rationing and limits to population)
What are the duties of doctor registered with the GMC?
Make the care of your patient your first concern
Listen to patients and respect their views
Be honest and trustworthy
What is meant by ethics?
The body of moral principles or values governing or distinctive of a particular cultureor group
What is the Hippocratic tradition?
To help and not to harm
Never give poison to anyone to cause death - not even if asked
What comprises ethics?
Principles
Values
Honesty
Standards
What is meant by morality?
Our attitudes, behaviours and relations to one another
Where do ethics come from?
Duties and considering the benefits and harms to individual and society; looking at the consequences not just to the individual
What are some particular relevant factors ethically?
Non-judgmental approach - it doesn’t matter her the patient got his/her condition/complaint (you must not discriminate on grounds of age, colour, culture, disability, ethnic or national origin, gender, lifestyle, marital or parental status, race, religion or beliefs, sex, sexual orientation, or social or economic status)
Not imposing personal views & respecting patients’ views (fair presentation fo facts/opinions, not letting your views affect your advice/actions, willingness to refer somewhere else, not belittling/bullying - also applies to colleagues)
Confidentiality (rare occasions where confidentiality should be breached)
Not exceeding your competency (applicable at all stages of the undergraduate medical course and your subsequent career)
Consent (what is informed consent? how much information should we give the patient? when does the patient have a right to refuse?)
Fitness to practise
What is the Duty of Candour?
This means that you must be open and honest with patients when something goes wrong with a patient’s treatment or care which causes, or has the potential to cause, harm or distress.
If you are unsure of the consequences immediately seek the advice of an appropriate senior colleague to peer review your view and subsequently tell the patient (or the patient’s advocate, carer or family) when something has gone wrong even if the patient is not aware or has not complained.
You must apologise to the patient and offer an appropriate remedy or support to put matters right (if possible) and explain fully the short and long term effects of what has happened.
This duty requires you to be open and honest with all parties as well as any relevant organisations such as your employer, practice principal or the Health Authority or Board; you must take part in reviews and investigations when requested.
You must raise concerns where appropriate if you believe a patient’s best interests potentially have been or actually have been compromised.
As a doctor or a student you should encourage other peers and colleagues to be open and honest; you must not stop someone who has concerns from raising concern.
