Truth Telling - PUBLIC HEALTH

Question 1

Name five key principles of truth-telling

Answer 1

1. Do not Harm
2. Do not kill
3. Do not bear FALSE witness
4. Keep patient’s secret
5. Don’t have inappropriate relationships with patients

Question 2

What is the problem with the principles of ‘do not harm’

Answer 2

Could be used to justify lying

Question 3

Define medical ethics

Answer 3

Inquiry into norms and values: what is good, bad, right or wrong in the context of medical practice

Question 4

Define clinical truth

Answer 4

Contextual, circumstantial and personal that CANNOt ignore objective truth

Question 5

Three basis of medical ethics

Answer 5

Deontology
Consequentialism
Virtue

Question 6

Define deontology

Answer 6

Based on the belief that we owe a duty of care to each other

Question 7

What is the formula of universal law as dictated by immanual kant

Answer 7

Before acting, consider: could I live in a world where everyone acted in this way

Question 8

What is the formula of humanity as dictated by Immanuel Kant

Answer 8

People are always to be treated as ends in themselves, never as means to an end

Question 9

How does deontology relate to truth-telling

Answer 9

Compel the need to tell the whole truth in a way that is not necessarily the most helpful (ignores the consequences)

Question 10

Define consequentialism

Answer 10

Consequences are what matters, means are important

Question 11

Relation of consequentialism with truth-telling

Answer 11

1. Hard to know what consequences will be

2. Actions can be wrong even if consequences are good

Question 12

What is virtue ethics

Answer 12

Characteristics that promote human flourishing

Question 13

Name four virtues

Answer 13

1. Compassion
2. Patience
3. Kidness
4. Fidelity

Question 14

Pros of virtue ethics (2)

Answer 14

1. Centres ethics on the person and what it means to be human
2. Includes the whole of a person’s life

Question 15

Cons of virtue ethics (3)

Answer 15

1. Doesn’t provide clear guidance on what to do in moral dilemmas
2. No general agreement on what makes a virtue
3. Any list of virtues ay be relative to the culture it was drawn up in

Question 16

Four principles of medical ethics

Answer 16

1. Autonomy
2. Beneficence
3. Non-maleficence
4. Justice

Question 17

When is autonomy limited

Answer 17

Children or lack of mental capacity

Question 18

Con of autonomy for doctors

Answer 18

Reduces them to information-provider

Question 19

Exceptions to non-maleficence

Answer 19

Side-effects of medication, surgical wounds and infection risks

Question 20

5 Cs in ethical practice

Answer 20

1. Candour
2. Consent
3. Capacity
4. Confidentiality
5. Communication

Question 21

What is candour

Answer 21

Openness, honesty and transparency without compulsion

Question 22

When is candour used in a clinical environment

Answer 22

Disclosure or error or uncertainty

Decisions influenced by resources

Put matter right, apologies and explain what has happened and its consequences

Question 23

How does cultural thoughts apply to truth-telling

Answer 23

Some cultures may limit the amount of truth you can tell

Navajo believe discussing bad news will make it happen

Question 24

What is Aleatory Uncertainty

Answer 24

I can’t know any more

Question 25

What is Epistemic Uncertainty

Answer 25

I don’t know any more

Question 26

What is Ethical Uncertainty

Answer 26

I don’t know what I should do

Question 27

What is Choice uncertainty

Answer 27

I don’t know what I want to do

Question 28

What is whistle-blowng

Answer 28

Raising concerns about a person, practice or organisation (e.g. going to the press)

Question 29

Why is being a whistle-blower good

Answer 29

Must make the care of patient the first concern

Question 30

Will you get in trouble for being a whilst-blower

Answer 30

Yes but it’s the cost of doing the right thing

Question 31

How do we raise concern

Answer 31

1. Internally raise it
2. Report to hospital leads
3. Give deadline for response and action