Why Tell The Truth? Flashcards

1
Q

Utilitarianism

A

Maximise happiness and minimise suffering
Depends on outcome more than whether action is right and wrong
Tell truth if will lead to good outcome
Lie if Leads to better outcome than the truth

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2
Q

What is act vs rule

A

Act: each act evaluated separately
Rule: extrapolate rules such that you could be happy that if people generally
behaved in this way, it would lead to the best outcomes

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3
Q

Advantages of utilitarianism

A

Intuitive
Form of distributive justice - good of societies not just individuals
Flexible - not rigid rules

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4
Q

What is rule utilitarianism

A

Albeit rules which are designed to achieve optimal welfare
Could have overall bad outcome

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5
Q

Disadvantages of utilitarianism

A

Consequence can be difficult to predict
Consequences can be impossible to reach
People have no intrinsic value in this system
One person may be considered more feasible than another - depending on ability to lead to more happiness

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6
Q

What are deontological ethics

A

We are Rational beings capable of reason
Decide what moral duties - right and wrong actions
Actions are inherently wrong and right
Don’t care about outcome
Generate list of rules which apply universally which allows us to always be in the right

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7
Q

Advantages of deontology

A

Accords human beings moral worth - people are not expendable
Reflects how some people perceive morality
Places value on intention - right even if leads to bad outcome
Offers certainty - don’t have to worry about probability of outcomes

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8
Q

Disadvantages of deontology

A

Too rigid - situations that don’t fit so huge lists of exceptions needed
Allows acts that cause immense suffering
Duties often cause conflict

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9
Q

Four principles by Beauchamp and Childress

A

Beneficence - doing good
Non maleficence - avoiding harm
Justice - rights, the law, fairness, distribution of resources
Autonomy - self determination

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10
Q

How is autonomy similar to deontological view

A

Both rational

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11
Q

What is the myth of objectivity

A

None of us are really objective
We all arrive at decisions with pre expiating set of values
One of most important factors influencing decision making
Makes you arrogant

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12
Q

What is virtue ethics

A

Aristotle model of ethics
Cultivates a moral character
Cultivating right values and phronesis (practical wisdom)

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13
Q

Advantages of virtue ethics

A

Phronesis (practical wisdom) describes peoples experience of decision making - acknowledges complexity of decision and influence of our previous experience
Most people have role models that they emulate with
Developmental model - doesn’t expect us to be perfect but allows improvement

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14
Q

Problems with virtues model

A

Nebulous - doesn’t help with decision making
May pick role model whos values u already share
Virtuous character takes ages to develop
Self centred - HCP is central. Virtues exercised in interest of patient. Patient is a denied agency.
Encourages perfectionism - “perfect doctor”
Role model based - can perpetuate problem norms and values

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15
Q

Why tell the truth (due to different theories)

A

Utilitarianism: increase happiness and decreases suffering
Deontology: because duty
Principlism: enables autonomy. Informs patient of all info.
Virtue: what a good person would do
Communitarianism: allows us to trust each other

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16
Q

What is supporting trust

A

Without trust we can’t function as a society
Honesty is required for that trust
Being dishonest leads to a net decrease in trustworthiness of the system - unethical

17
Q

Problems with trust model

A

Like utilitarianism decision making can be complex
Is smth increases trust, but would be detrimental to meeting social needs

18
Q

What is probity

A

Means being honest and trustworthy and acting with integrity
Heart of medical professionalism

19
Q

Can dishonesty be advantageous

A

Ethicist have pointed out social norms - ways of behaving in public and professional
Settings are potentially dishonest - conceal the trust
Politeness involves dishonesty
Professional behaviour may involve presentations inaccurate image of ourselves

20
Q

Why is complete honesty is bad

A

Total honesty would pose social disadvantage
Concealing feelings is a skill

21
Q

Kinds of deception

A

Lies of comission
Lies of omission
Lies of embellishment

22
Q

What are lies of comission

A

Direct statement of an untruth - something we know is false
E.g. inaccurate result

23
Q

What are lies of omission

A

Omitting to tell someone something that is true that would materially affect their understanding of situation
E.g. not mentioning Side effect of treatment

24
Q

What is nocebo effect

A

If tell someone about side effect it will cause them to experience side effect

25
Lies of embellishment
An exaggeration or misrepresentation to generate a misleading interpretation of a situation E.g. plastic surgeon overstating how bad feature looks, overemphasising the risks of diabetic complications to a teenager who has poor glycaemic control
26
What is the last resort theory
Truth has inherent value that a lie does not To outweigh truth need sufficient reasons Deception acceptable as last resort
27
Definition of integrity
As a moral agent, you are undivided Follow same principles in all situations Do not deviate
28
Medical integrity
Making care of patient first concern Even when not advantageous to you Self interest must come second to patients interests This can mean challenging authority or system itself
29
Go over mid staff scandal on pp
30
Why mid staff scandal was caused
Staff were cut to meet financial targets to become foundation trust Complaints were ignored Culture of fear, bullying and intimidation
31
Mismanagement during mid staff scandal
Chronically understaffed wards Receptionists with no medical training triaging in A and E Inadequate training of staff Junior docs left to manage alone overnight Complete failure” of management to address serious problems, or monitor performance
32
Why was mid staff crisis an ethical failure
HCP were competent But Failure to provide adequate care and learn from mistakes Basic personal care failure - washing, feeding, hydration Went unchallenged by HCP
33
Consequence for patients during mid staff crisis
Physical needs unmet: dehydration, depletion of resources, poor healing, poor immune function Emotional/ social needs unmet: stress response, alter neuroendocrine function, poor IMS, bad wound healing Mortality rates increased
34
How midstaff crisis came to an end
Increased mortality flagged up with NHS system Cure the nhs campaign launch Became national scandal led to sig changes
35
Transparency and honesty in healthcare
Be honest with patients about mistakes or errors that have happened in their care
36
What does the duty of candour mean for organisations
Duty to: Inform people about incident Provide reasonable support Provide truthful info Provide apology
37
GMC review of how HCP should approach a mistake
Tell patient when something gone wrong Apologise Offer an appropriate remedy/ support Explain fully to patient long and short term effects of what has happened