Ethics Flashcards

Question

Autonomy

Answer 1

- Individuals have the right to choose what is best for themselves i.e. to make choices in accordance with their own life plan - Informed, competent people - So long as the choice doesn't infringe on the rights of others - Compare paternalism i.e. 'doctor knows best'

Answer 2

Informed competent people – Competent: a three year-old won’t always know what’s best for themselves e.g. I want ice-cream for breakfast Informed: if we don’t have the correct information, we can’t make a good decision. For example, imagine you only tell a patient about one inexpensive, and not particularly effective treatment and neglect to tell them about a cheaper and more effective treatment. Because the individual hasn’t been properly informed they can’t give informed consent. Though they have consented, they haven’t given informed consent, and so autonomy not respected. Infringing on rights of others e.g. killing someone else, demanding a very expensive treatment when there’s a cheaper one available Paternalism – Quite an old-fashioned idea, but how much should health professionals influence a patient’s decision? Doctor knows best i.e. some things (EBM) health professional will know best, but you won’t know best about a person’s life plan. Therefore, decision-making needs to be a collaborative approach between patient/HCP. See P2 of the pharm CoE, which says that pharmacists must enable and involve the patient to make a decision.

Answer 3

Determining competency - Is a very odd choice a red flag for incompetency? (kevin Wright) - Determined on a case-by-case basis Conflict with other concepts - Beneficence - Non-maleficence - Justice

Answer 4

Case by case basis: Beware of using broad categorisations e.g. people with dementia/learning impairment Competency is particular to the individual and can fluctuate Competency depends on the gravity of the decision Mature minors Conflict with beneficence – Kevin Wright case – it’s arguable that it wouldn’t be in Kevin’s best interests to have his foot amputated, which conflicts with autonomy Someone demands antibiotics when they are going to be of no use. It will also decrease antibiotic resistance, so here it’s arguable that demanding antibiotics that are not medically indicated infringes on the rights of others Conflict with non-maleficence – it’s arguable that amputating Kevin’s foot would be harmful/if the antibiotics have side effects (as well as no benefit) then they’re harmful. Conflict with justice - demanding a very expensive treatment when there’s a cheaper (and just as effective) one available,

Answer 5

Beneficence - Doing good - Protecting and promoting wellbeing - To act in the patient's best interest Non-Maleficence - Do no harm - Minimise harm: harms and benefits must be weighed against each other

Answer 6

Minimise harm: many medical interventions involve harming the patient, so harms and benefits must be weighed against each other

Answer 7

What counts as a benefit? Who determines what is beneficial? - Short term v long term harms and benefits - Physical v. psychological harms/benefits - Therapeutic uncertainty Conflict with autonomy Conflict with justice

Answer 8

What counts as a benefit – use Kevin Wright case as an example. Conflict with autonomy – should we refuse to amputate Kevin Wright’s foot because it’s not in his best interests/harmful? Should we refuse antibiotics and risk the person never going back to the doctor/pharmacist again (i.e. feeling belittled) Conflict with justice – giving your patient the very best treatment with the least harms may be very expensive, and could mean other patients lose out e.g. doctors who always mark their referrals as urgent, vit C case

Answer 9

- Treating all people fairly and without discrimination; respecting rights - Distributes justice - caused by scarcity of resources - Problems - Conflict with other principles - What is fair?

Answer 10

Conflict with beneficence – drug A would be best for the patient, but it’s very expensive, so patient gets a cheaper, inferior drug. Conflict with non-maleficence – drug x may give the patient some unpleasant side effects, drug y avoids these side-effects but is very expensive. ‘It’s not fair’ is one of the first ‘arguments’ that many kids learn. What is fairness? V hard to answer.

Answer 11

- Equal shares - Equal outcomes - share according to need - Share according to merit - Share according to free market exchanges

Answer 12

Need – what if some people are very hungry, and slightly different what if some people have already had two pieces of cake but are still hungry Merit - share only with those who have contributed to society in some way $ - “Healthcare is just like any other commodity and should be available to those who can afford to buy it” the right of the wealthy to spend their money as they choose (i.e. on their health) Donation – can I give my piece of cake to someone else Transparency. In so far as possible, we expect for the rules of distribution to be open (public), and subject to discussion. Generally, if we know what the rule is, and know that it is fair, we can accept missing out because of that rule.

Answer 13

L15, pg 17 & 18

Ethics Flashcards

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