Truth Telling - PUBLIC HEALTH Flashcards

1
Q

Name five key principles of truth-telling

A
  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
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2
Q

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

A

Could be used to justify lying

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3
Q

Define medical ethics

A

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

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4
Q

Define clinical truth

A

Contextual, circumstantial and personal that CANNOt ignore objective truth

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5
Q

Three basis of medical ethics

A

Deontology
Consequentialism
Virtue

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6
Q

Define deontology

A

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

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7
Q

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

A

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

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8
Q

What is the formula of humanity as dictated by Immanuel Kant

A

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

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9
Q

How does deontology relate to truth-telling

A

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

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10
Q

Define consequentialism

A

Consequences are what matters, means are important

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11
Q

Relation of consequentialism with truth-telling

A
  1. Hard to know what consequences will be

2. Actions can be wrong even if consequences are good

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12
Q

What is virtue ethics

A

Characteristics that promote human flourishing

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13
Q

Name four virtues

A
  1. Compassion
  2. Patience
  3. Kidness
  4. Fidelity
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14
Q

Pros of virtue ethics (2)

A
  1. Centres ethics on the person and what it means to be human
  2. Includes the whole of a person’s life
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15
Q

Cons of virtue ethics (3)

A
  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
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16
Q

Four principles of medical ethics

A
  1. Autonomy
  2. Beneficence
  3. Non-maleficence
  4. Justice
17
Q

When is autonomy limited

A

Children or lack of mental capacity

18
Q

Con of autonomy for doctors

A

Reduces them to information-provider

19
Q

Exceptions to non-maleficence

A

Side-effects of medication, surgical wounds and infection risks

20
Q

5 Cs in ethical practice

A
  1. Candour
  2. Consent
  3. Capacity
  4. Confidentiality
  5. Communication
21
Q

What is candour

A

Openness, honesty and transparency without compulsion

22
Q

When is candour used in a clinical environment

A

Disclosure or error or uncertainty

Decisions influenced by resources

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

23
Q

How does cultural thoughts apply to truth-telling

A

Some cultures may limit the amount of truth you can tell

Navajo believe discussing bad news will make it happen

24
Q

What is Aleatory Uncertainty

A

I can’t know any more

25
What is Epistemic Uncertainty
I don't know any more
26
What is Ethical Uncertainty
I don't know what I should do
27
What is Choice uncertainty
I don't know what I want to do
28
What is whistle-blowng
Raising concerns about a person, practice or organisation (e.g. going to the press)
29
Why is being a whistle-blower good
Must make the care of patient the first concern
30
Will you get in trouble for being a whilst-blower
Yes but it's the cost of doing the right thing
31
How do we raise concern
1. Internally raise it 2. Report to hospital leads 3. Give deadline for response and action