Ethics & Law

Question 1

Deontological Ethics

Answer 1

• Immanuel Kant
• “an action in and of itself determines moral worth, not the outcome… emphasis is on principles, rules, maxims, and duties”
• just follow the rules and you did the right thing, despite the outcome

Question 2

Utilitarianism Ethics

Answer 2

• John Stuart Mill
• emphasis is to maximize positive outcomes for all involved
• the greatest good for the greatest number
• action is right if more people benefit from it than are harmed

Question 3

values

Answer 3

of importance to the individual

Question 4

morals

Answer 4

doing the right things based on personal and collective values

• collective values of a community or society
• just bc u don’t like cats doesn’t mean that u kick it out of the way

Question 5

ethics

Answer 5

principles adopted by a group that guide behaviour

Question 6

autonomy

Answer 6

individual freedom, choice, self-legislation

Question 7

examples of autonomy in TM

Answer 7

• right to refuse transfusion/products

- patient centered care

Question 8

veracity

Answer 8

truth-telling, open relationship

Question 9

examples of veracity in TM

Answer 9

• risks of receiving transfusion (trxns)

- risks of NOT receiving transfusion

Question 10

beneficence

Answer 10

doing good,, obligation to care for those in need

Question 11

examples of beneficence in TM

Answer 11

clincally appropriate use of products

Question 12

non-maleficence

Answer 12

doing no harm, protect those in care

Question 13

examples of non-maleficence in TM

Answer 13

• screening donors (Hb/age/weight, TD testing)

- compatibility testing

Question 14

justice

Answer 14

fairness, respect for all

Question 15

examples of justice in TM

Answer 15

• access to products, availability

- wise use of scarce resources

Question 16

what is consent?

Answer 16

permission to perform procedure or event to happen

• legal requirements = voluntary, age, capacity, informed, documented
• implied consent = verbal/non-verbal behaviour
• expressed consent = written

Question 17

examples of consent in TM

Answer 17

• consent form/included in consent for other procedures (eg. major surgery)
• consent can be revoked - patient condition changes, different procedures

Question 18

we as MLTs are bound by confidentiality

Answer 18

• organization policy (APL)
• professional code of ethics (CSMLS, CMLTA)
• provincial legislation (Health Infomation Act, Health Professions Act, FOIPP)

ex:

• discussing cases in public areas
• rare product use
• patient phones blood bank for blood group result

Question 19

assault

Answer 19

intent to harm

Question 20

battery

Answer 20

causing harm/injury

Question 21

examples of assault and battery in TM

Answer 21

• transfusing without consent

- phlebotomy without consent

Question 22

negligence

Answer 22

• doing something you are not supposed to and causing harm (or not doing something you are supposed to)
  > duty of care
  > breach of standard of care
  > harm or loss/damages
  > causation - direct link b/w person owing a duty causing harm to substandard care

Question 23

principles that guide decision making in TM

Answer 23

• autonomy
• veracity
• beneficence
• non-malifecence
• justice

Question 24

treating people equally in TM

Answer 24

lottery:
- equal opportunity, fair, difficult to corrupt
- ignores other relevant information (age, health status, etc.)

first come, first served:

• easy to administer
• favours those with wealth, power, resources

Question 25

prioritarianism (favouring the worst off)

Answer 25

sickest first:

• helps those suffering now, makes sense of good use of temporary resources; ‘rule of rescue’
• requires diagnosis, ignores those who will become sick, ignores other principles

youngest first:

• benefits those who’ve had the least life, values lives
• prioritizes infants over adolescents and young adults

Question 26

maximizing total benefits: utilitarianism

Answer 26

number of lives saved:

• saves more lives - benefits the greatest number; no need to judge quality over quantity
• ignores other principles

prognosis

• maximizes life- years
• ignores other principles

Question 27

promoting and rewarding social usefulness

Answer 27

instrumental value

• directs resources to those who can help (healthcare workers, public servants); futures oriented
• vulnerable to abuse, direct resources away from health needs

reciprocity

• rewards those who have contributed; past-oriented
• vulnerable to abuse, direct resources away from health needs, requires significant investigative resources

Question 28

guidelines in TM

Answer 28

• reasonable: based on scientific evidence, agreed upon by credible stakeholders
• open and transparent: published, accessible, open to scrutiny
• inclusive: involve all stakeholders to participate in decision making
• responsive: opportunity to revisit, revise, allow for change with new emerging information
• accountable: mechanisms in place for decision-makers to be accountable for actions and inactions