Truth Telling - PUBLIC HEALTH Flashcards
Name five key principles of truth-telling
- Do not Harm
- Do not kill
- Do not bear FALSE witness
- Keep patient’s secret
- Don’t have inappropriate relationships with patients
What is the problem with the principles of ‘do not harm’
Could be used to justify lying
Define medical ethics
Inquiry into norms and values: what is good, bad, right or wrong in the context of medical practice
Define clinical truth
Contextual, circumstantial and personal that CANNOt ignore objective truth
Three basis of medical ethics
Deontology
Consequentialism
Virtue
Define deontology
Based on the belief that we owe a duty of care to each other
What is the formula of universal law as dictated by immanual kant
Before acting, consider: could I live in a world where everyone acted in this way
What is the formula of humanity as dictated by Immanuel Kant
People are always to be treated as ends in themselves, never as means to an end
How does deontology relate to truth-telling
Compel the need to tell the whole truth in a way that is not necessarily the most helpful (ignores the consequences)
Define consequentialism
Consequences are what matters, means are important
Relation of consequentialism with truth-telling
- Hard to know what consequences will be
2. Actions can be wrong even if consequences are good
What is virtue ethics
Characteristics that promote human flourishing
Name four virtues
- Compassion
- Patience
- Kidness
- Fidelity
Pros of virtue ethics (2)
- Centres ethics on the person and what it means to be human
- Includes the whole of a person’s life
Cons of virtue ethics (3)
- Doesn’t provide clear guidance on what to do in moral dilemmas
- No general agreement on what makes a virtue
- Any list of virtues ay be relative to the culture it was drawn up in
Four principles of medical ethics
- Autonomy
- Beneficence
- Non-maleficence
- Justice
When is autonomy limited
Children or lack of mental capacity
Con of autonomy for doctors
Reduces them to information-provider
Exceptions to non-maleficence
Side-effects of medication, surgical wounds and infection risks
5 Cs in ethical practice
- Candour
- Consent
- Capacity
- Confidentiality
- Communication
What is candour
Openness, honesty and transparency without compulsion
When is candour used in a clinical environment
Disclosure or error or uncertainty
Decisions influenced by resources
Put matter right, apologies and explain what has happened and its consequences
How does cultural thoughts apply to truth-telling
Some cultures may limit the amount of truth you can tell
Navajo believe discussing bad news will make it happen
What is Aleatory Uncertainty
I can’t know any more
What is Epistemic Uncertainty
I don’t know any more
What is Ethical Uncertainty
I don’t know what I should do
What is Choice uncertainty
I don’t know what I want to do
What is whistle-blowng
Raising concerns about a person, practice or organisation (e.g. going to the press)
Why is being a whistle-blower good
Must make the care of patient the first concern
Will you get in trouble for being a whilst-blower
Yes but it’s the cost of doing the right thing
How do we raise concern
- Internally raise it
- Report to hospital leads
- Give deadline for response and action
