International perspectives and military ethics Flashcards
What is the issue with saying ‘medical ethics in times of armed conflict is identical to ethics in times of peace’?
It is over simplistic and lacks content. Have to decide between being a soldier or a HCP first. Context needs of military override NHS obligations.
What is the meaning of deontology?
The binding DUTY to Pts. Always tret a pt as an end and not as a means.
Use actions that can be applied across whole societies without a -ve impact.
Work to best of ability at all times with duty at the heart of care, regardless of age, race, gender, culture
What is the meaning of utilitarianism?
Producing good consequences for the greatest number of people. Maximum good for maximum people.
Difficulty to quantify pleasure so is subjective.
Why were the principlist ethics created and what are they?
Produced as deontology too strict. Autonomy - right to choose for self. Truth
Non-maleficence - avoid harm
Beneficence - do good
Justice - fairness
What is the four quadrant approach to care?
Used for reasoning to resolve moral issues by applying theoretical rules to new situations. Used case by case for rapid decisions. Little MDT decision making.
It combines deontology, utilitarianism and 4P’s
1) Medical indications (beneficence, non-maleficience)
2) Pt preferences (Autonomy)
3) QoL (benefits and non-maleficience)
4) Context (fairness)
What is the main issue in military medical ethics?
The dual conflict between being a soldier vs HCP. Always soldier first. May involve salvage medicine due to the resources.
What is salvage medicine?
Pts are sorted based on the rate, urgency and complexity of casualties.
Due to limited resources in battle, focus on least injured first as use less resources and to return them to the battlefield quicker and treat more complex patients if the resources are available. - Utilitarianism
How is salvage medicine different to NHS care?
NHS prioritises the more complex patients first.
What is coalation medicine?
A temporary alliance that means soldiers and captured soldiers should receive the same gold standard of care. But at times of resource scarcity, high care may become low care.
What is the legal v professional conflict of a soldier?
Have a duty to care for all Pts and must do best to alleviate all suffering but being a soldier means that some pts are prioritised whilst others are left behind.
