4 Principals of Ethics
1) Beneficence
- Do good (balance risks and benefits)
2) Maleficence
- Do no harm
3) Autonomy
- Respect patient’s decision
- Patients know what is best for themselves, patients feel more fulfilled
- Decision must be made by a competent patient
Golden Triad of Moral Philosophy
1) Virtue ethics – an action is right if it is what a virtuous agent would do (e.g. not lying)
2) Consequentialism – action is right if it leads to the best consequences
3) Deontology – action is right if it is in accordance to law and rules
4 Quadrants Approach
1) Medical indications
2) Quality of life
3) Patient preference
4) Contextual features
Ethics and Professionalism
- Based on the Medical Act 1983, the GMC has 4 functions:
1) Keep up-to-date registers on qualified doctors
2) Foster good medical practice
3) Deliver high standards of medical education and training
4) Dealing firmly and fairly with doctors whose fitness to practice is in doubt
Statue Law
-Law decided by a legislature or government body
Common Law
-Decision made by the judge based on the precedent or case
Quasi Law
-Rules set out by a regulatory body (e.g. GMC)
Confidentiality
-Principle of privacy and respecting the patient’s wishes
When confidentiality can be broken:
1) Acting in the best interest of the patient (e.g. patient poses a risk to self)
2) Withholding Information poses a risk to others (e.g. contagious diseases)
3) Legal requirement
Consent
-Consent is the voluntary, uncoerced decision made by a sufficiently competent individual based on adequate information and deliberation, to accept rather than to reject a proposed course of action
Types:
1) Imputed – assumes consent
2) Implied – Patient’s actions suggest consent
3) Expressed – oral/written
Valid consent requires:
1) Voluntary
2) Competent
3) Sufficient information
Competence
A competent patient requires the ability to:
1) Understand information presented
2) Weigh up information
3) Retain information long enough to make a decision
4) Communicate back the decision to clinician
