134 Flashcards
(16 cards)
What are Deontological Ethics
Concerned with what people do not on outcomes
Some acts are right or wrong because of the sorts of things they are and people have a duty to act accordingly
Kant: “rational human beings should be treated as an end in themselves”
Treat others as you wish to be treated
What is consequentialism/utilitarianism
Whether an act is right or wrong depends only on the results of that act
More good consequences an act produces the better or more right the act
Beauchamp & Childress: “the ethically right choice in a situation is the one that produces the most happiness and the least unhappiness for the largest number of people
What is virtue ethics
Looks at the virtue or moral character of the person carrying out the action, rather than at the ethical duties and rules or the consequences of particular actions
Focuses on the moral character or virtues of the physician or scientist
1932-1972 Tuskegee Experiment
Study of the natural progression of syphilis in back populations
When the experiment started there was no treatment
Once there was treatment available it wasn’t given as wanted to continue following ‘natural progression’
Many died and developed horrible consequences
Deceived with amount of health info
The origins of American gynaecology
Techniques refined through experimentation with enslaved black women
Women were operated without anaesthesia over 30 times in 4 years
Racist thinking that black people can withstand more pain than whites
What three bioethics declarations were made post WW2
Nuremberg Code 1947 - consent
Declaration of Helsinki 1964 - code of research
Four ethical principles 1960s - agreed principles in medical practice and research ethics
4 principles of biomedical ethics - human research
Non-maleficence (do no harm) (Hippocratic Oath)
Beneficence (do good)
Autonomy (right to make own choices)
Justice (fair distribution of benefits risks and costs)
Animal rights and ethics opinions by deontology and utilitarianism
Deontology (Kant)
Animals are not self-conscious and are there as a means to an end - the end is man
Utilitarianism (Bentham)
The question is not can an animal reason, but can they suffer
What is vivisection
Surgery on animals which has been expanded to any type of research on animals
For and Against animal experimentation
For
Justified if suffering of animals is minimised
Human benefits are gained which could not be obtained by other methods
Against
It causes suffering to animals
The benefits to human beings are not proven
Any benefits to humans that animal testing does provide could be provided in other ways
The three Rs principle (and who was it by)
Russel and Burch 1959
Replacement - eliminate harm by replacing animals with entities that cannot be harmed (computer models, tissue cultures) or species that would be harmed less
Reduction - only using the minimum number of animals necessary and do not repeat unless needed
Refinement - modifying their methods to inflict less harm on each targeted animal (less invasive, better living conditions)
Explain the 4 phases on clinical trials
Phase I - conducted on small samples, a dosage is established with little risk to volunteers. Takes up to 2 years
Phase II - Larger sample of patients with the disease looking at dosage, response rates and side effects. Takes about 2 years
Phase III - Randomised controlled trial of new drug versus current treatment (if possible), also option of placebo. May be thousands involved and data is collected on response, side effects and death with first real evidence of safety and efficacy
Phase IV - Monitor safety and efficacy with a use of the yellow card system in the UK. Patent runs out after 5 years. Big push to get drugs into practise in first few months
Informed CONSENT
C - Competent enough to make your own decision
O - Open to making the decision
N - Necessary background information to make decision
S - Steps to be followed to agree or disagree given
E - Explanation of steps understood
T - Tick boxes and sign the form
What are the two models of care
Biomedical model
-About accurate diagnosis
-Pathology focused on biology
-Doctor knows best
Biopsychosocial model
-Patient-centred
-Equal power between doctor and patient
What is an expert patient
The understanding that the doctor doesn’t always know the problem
Looking from the patients perspective
Leads to better outcomes and a collaborative approach
What is the PPI paradox
Patients want to be involved in treatment decisions but the trend diminishes when the conditions are more serious
