SEAM Flashcards
What is deontology?
Moral theory- there is clear cut rights and wrongs and there is never any exception.
It is not fair to make exceptions, moral rules apply to everyone.
Eg, lying in every circumstance is bad
What is Consequentialism/ utilitarianism?
A moral theory- ‘we should act always so as to produce the greatest good for the greatest number’
Important to think of benefits vs harm.
Should make decisions as an unbiased spectator
What is virtue theory?
Virtue theory does not tell you what to do, instead focuses on doing what a ‘good’ person would do.
Finding the golden mean of excess and deficiency, eg be in the middle of cowardice and recklessness
What traits are associated with each of the 3 moral theories?
What are the 4 pillars of ethics?
Autonomy- respecting the patients wishes/ letting patients be in charge on their care
Beneficence- do good
Non-maleficence- do no harm
Justice- everyone offered same oppurtunities and treated legally
What is the GMC guidance on cosent?
- Involve and support patients in decision making
- Have a meaningful dialogue exchange with relevent information specific to the individual patient
- Listen to patient
–Find out what matters and share relevent information about benefits and harms
What is battery and negligence?
Battery= non-consenual touching, exception in emergency medicine
Negligence= breach of duty that cause harm. Can be brought up if doctor has not given patient enough info
What age in Scotland are patients deemed to have capacity?
16
What is written in the adults with incapacity act, Scotland (2000)?
Act allows treatment to be given to promote mental and physical wellbeing
If a wellfare attorney or guardian has been appointed, the doctor must seek consent from them. When there is no proxy a doctor is authorised to provide medical treatment
Where there is disagreement a second opinion must be sought. Cases can also be referred to the court of session
How are patients deemed to have capacity?
They must be able to fully understand and believe the info given about the treatment.
In what circumstances can doctors break confidentuality?
In child abuse cases
Best interests of the public
Required by law
Demanded to by the presiding officer of a court
What is the GMC guidance on non-invasive treatment?
For some quick or non-invasive interventions it is okay to rely on a patients non-verbal consent.
a explain what you’re going to do and why
b make clear the patient can say no, and stop immediately if they do
c be alert for any sign that they may be confused or unhappy about what you are doing.
What do you do if there is a disagreement in the health team about what to do to benefit the patient?
a involve an independent advocate or local mediation service
b consult a more experienced colleague and/or an independent expert
c hold a case conference or seek advice from a clinical ethics committee.
If a person who lacks capacity refuses to let you break confidentuality to help them, what should be done?
Try to convince them
If still no consent but you believe sharing info will help the overall benefit of the patient, share it
Do competent patients have the right to demand treatment?
A competent patient has the right to refuse any examination, investigation or treatment, but does not have the right to demand treatment.
In what cases is chossing the sex of a baby in IVF allowed?
For medical reasons, eg you have a gene that has a high change of influencing females
What criteria is there for couples undertaking IVF?
Non-smoking for 3 months
-BMI between 18.5 and 30
One partner cannot have a biological child
Couples must have been co-habiting for two years
What are the rules for embryos for IVF?
Can be stored for upto 5 years
Both partners have to consent to them being used, and either partner can veto
What are the abortion rules in the UK?
Has to be beforr 24 weeks unless there is severe handicap
must be approved by 2 doctors
Only can occur on approved premises
Need a reason- if prenancy would physically or mentally injur mother, the child or other children/family of the mother
What are the different ethical approaches to reproductive medicine?
What are the different moral views on the status of an embryo?
a) they are a human organisation and it is murder
b) they have the potential to be a child
c) they are not yet a person
In what case of abortion is a second opinion not needed?
If the termination is needed to save the women’s life
What are the different types of euthanasia?
What are the arguments against euthanasia?
- sanctity of life
- slippery slope
- risk to vulnerable patients
- diagonistic/ prognostic error
What is advance care planning?
Helps patients to discuss with doctors their future wishes that will take effect if they ever lose capacity.
It is a voluntary process and may result in a written record of the patients wishes
the statements are not legally binding but help doctors decide on best route of treatment
What is the age of legal capacity (Scotland) act 1991?
A person under the age of 16 can have legal capacity to consent to treatment if a medical practitioner believes they are capable of understanding risks and nature of treatment
What is being ‘Gillick compent’?
A child having sufficient understanding and intelligence to be capable of making their mind up on a decision
What does the GMC state about treating minors?
a involve children and young people in discussions about their care
b be honest and open with them and their parents, while respecting
confidentiality
c listen to and respect their views about their health, and respond to
their concerns and preferences
d explain things using language or other forms of communication
they can understand
e consider how you and they use non-verbal communication, and
the surroundings in which you meet them
f give them opportunities to ask questions, and answer these honestly
and to the best of your ability
g do all you can to make open and truthful discussion possible, taking
into account that this can be helped or hindered by the involvement
of parents or other people
h give them the same time and respect that you would give to adult
patients.
Can parents override the consent of a competent young person?
Parents cannot override the competent consent of a young person
to treatment that you consider is in their best interests. But you can rely on parental consent when a child lacks the capacity to consent.
In Scotland parents cannot authorise treatment a competent young person has refused.
What age is a child presumed to have formed a view?
12; this view should be taken into account
What does case law suggest about 16-18 year olds right to refuse life saving treatment?
Case law indicates that a young person aged 16 or 17 in England and Wales cannot refuse a life-saving treatment or one necessary to prevent serious harm. (In Scotland, more weight is given to respecting the minor’s autonomy. There is uncertainty as to the extent to which Scottish law allows those under 18 years the absolute right to refuse medical treatment.)
