Week 5 - Ethics and Healthcare Flashcards
1
Q
what is ethics?
A
- the study of standards of right and wrong in human behaviour
- ethics also refers to code of behaviour or conduct
- ethical standards in healthcare are shaped by morals, values, and a sense of duty
–> in professions, ethics encompass the morality and moral beliefs of the profession, influencing professional behaviour
2
Q
what is morality?
A
- morality extends from beliefs about right and wrong, encompassing values, beliefs, and sense of duty.
- it guides how individuals treat others and behave in society, reflecting personal moral beliefs.
- morality shapes a person’s character and defines their ethical conduct
3
Q
what is the teleological theory?
A
- defines an action as right or wrong depending on the results it produces
- theoretically, the “right” action brings about the most benefit for the most people
4
Q
what is deontological theory
A
- a moral and honest action is taken, regardless of the outcome
- it requires that people follow the rules and do their duty
5
Q
what is virtue ethics?
A
- looks at the ethical character of the person making the decision, rather than at their reasoning
- the theory operates under the belief that a person of moral character will act wisely, fairly, and honestly and will uphold the principles of justice
- unlike teleological and deontological theories, it does not provide guidelines for decision making
6
Q
what is divine commands ethics?
A
- the view that follows philosophies and rules set out by a higher power (god)
7
Q
ethical principles in healthcare
A
- beneficence
- non-maleficence
- respect
- autonomy
- fidelity
- justice
- truthfulness/verocity
8
Q
what is beneficence?
A
- refers to showing kindness to or doing good for others
- guides the process toward a morally right outcome
9
Q
what is non-maleficence?
A
- refers specifically to causing no harm
- do not kill, do not cause pain or suffering, do not incapacitate, do not cause offence, and do not deprive others of the goods of life
10
Q
what is contentious objection?
A
involves healthcare professionals not providing certain treatments to their patients, based on reasons of morality or “conscience.”
11
Q
what is compassionate interference?
A
the act of imposing treatment against a patient’s will (without their consent) when deemed in the best interests of the patient
12
Q
what is respect in healthcare?
A
- all patients have the right to be treated with respect by those who care for them
-health care providers and their colleagues also have the right to be treated with respect by patients as well as by those they work with
–> respecting others involves honouring their right to autonomy, being truthful, not withholding information, and honouring their decisions
13
Q
what is autonomy?
A
- underscores a person’s right to self-determination
- autonomy recognizes the right of a mentally competent individual, given all of the relevant facts, to make independent decisions without coercion
14
Q
what is self-determination?
A
the freedom to make one’s own decisions
- every person has the right to make decisions regarding his or her health autonomously, even if these decisions appear irrational to third parties
15
Q
significance of autonomy
A
- the principle of autonomy serves as the basis for the principles involved in informed consent and self-determination regarding treatment choices
- patients must be mentally capable and fully informed about their situation to be able to make autonomous and knowledgeable decisions about their health care
16
Q
how are paternalism and the principle of autonomy in opposition to each other?
A
- paternalism involves making decisions for others based on the belief that the decision-maker knows what is best for the individual often without their input or consent.
- paternalistic actions are driven by the desire to protect or promote the well-being of the person being acted upon, but they may disregard the individual’s preferences, values, or ability to make decisions for themselves.
- autonomy emphasizes the right of individuals to make their own choices about their healthcare
- it respects individuals as capable of making informed decisions based on their own values, preferences, and goals
- autonomy prioritizes self-determination and personal freedom, even if those choices may not align with what others perceive as best for the individual
17
Q
what is fidelity?
A
- is the principle of faithfulness or loyalty in healthcare
- fidelity involves meeting the reasonable expectations of the health care team, patients, their families, and employers by being loyal, truthful, and faithful
- it also entails showing respect and earning and maintaining trust in professional relationships
18
Q
what is justice?
A
1) distributive justice
- deals with the proper and equitable allocation of health care resources based on priority and need
2) compensatory justice
- relates to the paying of compensation for wrongs done
3) procedural justice
- acting in a fair and impartial manner
19
Q
what is veracity/truthfulness?
A
- truthfulness is a principle that patients should expect of a health care provider
- contributes to the building of a bond of trust vital to the patient-health provider relationship
- truthfulness is necessary to build and maintain trust among colleagues and others with whom one works
20
Q
what is the double effect?
A
requires a person to choose the option that achieves the most favourable outcome or that causes the least harm.
–> acting in a manner that brings about the most good or the least harm
21
Q
what is a fiduciary relationship?
A
- the relationship between a patient and a healthcare provider
- refers to the special legal and ethical obligation that healthcare providers have towards their patient
- this relationship is characterized by trust, confidence, and reliance, with the healthcare provider (the fiduciary) obligated to act in the best interests of the patient (the beneficiary)
22
Q
what is an ethics committee?
A
- consists of a group of people who provide health care professionals with guidance in making controversial medical decisions
23
Q
what is duty of care?
A
- the obligation to act in a competent manner according to the standards of practice
- to keep patients safe
24
Q
what is a code of ethics?
A
- a formal statement of an organizations or professions values regarding professional behaviour
- provides guidance for ethical decision making, self evaluation and best practices policies
25
ethical behaviour in the workplace
- all workers must adhere to ethical principles like beneficence, non-maleficence, autonomy, and justice
- personal relationships between patients and healthcare providers are prohibited
- colleagues must remain impartial and not choose favourites among the staff
- health care providers have an obligation to report a fellow health care provider’s misconduct or incompetence (i.e job performance or a violation of confidentiality)
26
what is meant by the “balance of power” between a health care provider and a patient?
27
moral controversies in healthcare
- the right to die
- the right to self-determination
- the rights of a fetus
- the rights of women to abortion
- the right to be treated with respect and fairness regardless of one’s race, religion, culture, socioeconomic status, or sexual orientation
- the rights of an individual to health care
28
what are rights in healthcare?
entitlements or things that can and should be expected of health care providers and the health care system
--> can be tangible = the right to see a specialist covered under provincial plan
--> can be intangible = treating a patient with respect
29
what are a patients rights in healthcare?
- the right to access to one’s own health information
- the right to confidentiality
- the right to informed consent
- the right to timely health care deemed medically necessary
- the right to have health care needs addressed in a timely manner
30
what is the difference between active and passive euthanasia?
active = killing
passive = letting die
- active euthanasia is killing a patient by active means by injecting a patient with a lethal dose of a drug.
- passive euthanasia is intentionally letting a patient die by withholding life support such as a ventilator
31
ethical considerations of end-of-life care
- ethical concerns range from DNR orders, a patient choosing to withdrawal life-saving measures, requesting palliative care and medical assistance in dying (MAiD)
32
what is DNR order?
- do not resuscitate order
- usually requested by individuals who are gravely ill and feel that extending their lives would leave with poor quality of life, regardless of their age
- sometimes it is referred to as "allow natural death" (AND)
- this includes withdrawing or not initially implement life-saving or life-prolonging measure
33
what is an advance directive?
- also called a living will or treatment directive
- specificies the nature and level of treatment a person would want to receive in the event they become unable to make those decisions at a later time
- advance directives are prepared to ensure their wishes are known and honoured by family members, and carried out by medical caregivers
34
what are the levels of care?
level 1:
- resident wishes to stay in their home
- recieve comfort and support measures for pain control
level 2:
- resident wants to stay in the facility and receive all treatments, medications, interventions that are possible at that facility
level 3:
- would be transferred to an acute care facility from LTC facility
- would recieve recommended diagnostic imaging and tests, and IV if required, antibiotics and other medication
- doesn't include CPR, or transfer to an CCU or ICU unit
level 4:
- person is transferred to an acute car facility for all active measures required to sustain life
35
What is meant by the “allocation of health resources,” and why does it present an ethical problem?
- allocation of resources refers to who gets what resources when and for what reason
- rising healthcare costs, expensive technologies and limited access to many services have made allocation of resources an increasing concern the health care industry
- priorities should be based on need, but how does a person, organization, or government assess need?
36
ethical concerns regarding MAiD
- raises numerous concerns including
--> fears of misuse of the process for disabled and vulnerable people
--> concerns that a person may choose MAiD for socioeconomic reasons (i.e poverty) and feel there is no way forward
- the concept of being eligible for MAiD based on the grounds of a mental health diagnosis
