Autonomy
(allowing pt to have a choice)
the autonomous individual freely acts in accordance with a self-chosen plan
Beneficence
(best interest)
Prima Facie moral obligation of all doctors
* not limited to best interests but also encompansses medical, emotional and all other welfare issues
Non-maleficence
(do not cause harm)
Bolam test
Doctor is not guilty of negligence if he has acted in accordance with a practice accepted as proper by a reasonable body of medical men skilled in the particular act
Justice
(respecting fairness)
Treat all patients fairly (with equity)
Bolam principle
principle that establishes whether an act or omission by a HCP breached the duty of care and thus they were negligent
Non negligent
if there is an established body of professionals that supports the act, even if the practice was not standard care (e.g. guideline)
Negligence
- a breach of legal duty of care which results in damage
- often passive or an omission
- criminal if: 1) non-concensual treatment 2) not acting in pts best interest
Bolitho test
- adaptation of the bolam principle
- states courts cant just accept what professionals say, must consider if it is logical first
Stigma
mark of disgrace associated with a particular circumstance, quality or person
Process of producing stigma
(5 processes)
- labelling: distinguishing differences btw people
- stereotyping: making asssumptions based on those differences
- othering: separates person e.g. diabetes - diabetics
- stigmatisation
- discrimination: people act on the stigma
Types of stigma
(5 types)
- discrediting stigma: stigma that cant be hidden e.g. in a wheelchair
- discreditable stigma: stigma that can be hidden and kept to close family and friends e.g. HIV/AIDS diagnosis
- felt: shame you feel as a result of stigma, maybe due to your condition (3 further types)
- enacted: discrimination by others
- courtesy: felt by someone who is with someone who is being stigmatised
Felt stigma
3 further types
a) passing not acknowledging symptoms. passing onself as normal e.g. hiding discreditable part of character
b) withdrawing can worsen health conditions
c) covering - avoid situations where stigma may show
e.g. deaf people avoiding loud environments and passing off deafness as day dreaming can exacerbate sense of stigma and worsen health conditions - may also prevent friends and family from noticing
Equality act 2010
legally protects people from discrimination in workplace and in wider society
Health promotion
enabling people to increase control over and to improve their health
(individual -> social and environmental interventions)
Health education
give people knowledge and skill to change potentially health damaging behaviours
examples: adivce from health professionals, mass media campaigns
Health protection
legislation to protect public health e.g. not smoking inside, pollution, seat belts
Disease prevention
- primary: prevent onset of disease. hard for some diseases as hard to know when onset of disease is (could be before symptoms come on)
- secondary: cure/identify disease earlier e.g. screening
- tertiary: manage disease and minimise effects/progression of an irreversible disease
Types of primary disease prevention
- universal - whole population
- selective - risk group
- individual (identify high risk individuals) e.g. genetic mutations
5 aspects of health promotion - according to WHO
- Healthy public policy e.g. sugar tax
- Supportive environments e.g. not smoking in public
- Community action – people follow others
- Personal skills– decision making, dealing w/ emotions etc.
- Reorienting health services
Baettie’s typhology
Beattie’s model of health promotion is a complex analytical model that acknowledges that health promotion is ‘embedded in wider social and cultural practices’ – enables analysis of new, current and previous strategies
types of baettie’s typology
- Health persuasion: Mass media campaign
- Legislation: Smoking ban in public places
- Personal counselling: Opportunistic intervention in counselling sessions
- Community based: Local initiatives
