Week 2 Ethics

Question 1

Define the ethical principles.

Answer 1

• non-maleficence,
• beneficence
• promoting best interests.

Question 2

Define the various models of clinical decision-making and its effect on the doctor-patient relationship:

Answer 2

• paternalism
• autonomy
• shared decision-making

Question 3

Steps in approach to Ethical Dilemmas

Answer 3

What is the problem or dilemma?
What are the medical facts?
What are the concerns, values, and preferences of the clinicians?
What are the concerns, values and preferences of the patient?
What are the ethical issues?
What ethical guidelines are at stake?
What practical considerations need to be addressed?

Question 4

Non-maleficence,

Answer 4

“Above all, Do No Harm” Primum non nocere

1. Physicians should not provide interventions that are known to be ineffective.
2. Physicians should not act with malice or with bias.
3. Doctors should act with due care and diligence.
4. Physicians must not do anything that would purposely harm patients.
5. When benefits and burdens are evenly balanced, physicians should err on the side of not intervening.

Question 5

Beneficence

Answer 5

1. Physicians possess skills and knowledge that enable them to assist others.
2. They are expected to refrain from causing harm, but they also have an obligation to help their patients.
3. Beneficence requires physicians to promote patients’ “important and legitimate interests.”

Question 6

Promoting best interests.

Answer 6

Understand the patient's perspective.
Address misunderstanding and concerns.
Try to persuade the patient.
Negotiate a mutually acceptable plan of care
Ultimately let the patient decide.

Question 7

Paternalism

Answer 7

The obedience of a patient to the prescriptions of his physician should be prompt and implicit.

Question 8

Autonomy

Answer 8

Autonomy is the dominant value in medical decision making.
People value highly the ability to make decisions about their bodies and healthcare in accordance with their values and goals.

Question 9

Shared decision making

Answer 9

Physician discloses information

Helps patient deliberate