Intro to medical law and ethics

Question 1

What are ethics?

Answer 1

The body of moral principles or values governing or distinctive of a particular cultureor group

Question 2

Where do ethical principles come from?

Answer 2

Two traditions:
1) Duties: “Right and Wrong” actions; action by individuals or group, Absolute values

DEONTOLOGY

2) Considering the benefits and harms to the individual as well as society; looking at the consequences as a whole and not just to the individual

UTILITARIANISM (a type of consequentialism)

Question 3

What comprises Ethics?

Answer 3

• Principles
• Values
• Honesty
• Standards, rules of behaviour that guide the decisions, procedures and conduct of individuals that respect the rights of all stakeholders affected by its operations”

Question 4

What is meant by morality?

Answer 4

Our attitudes, behaviours and relations to one another

Question 5

What is meant by consequentialism?

Answer 5

The moral worth of an action is determined by its outcome

Question 6

What is utilitarianism?

Answer 6

Described by Jermey Bentham:

The greatest good for the greatest number (maximising pleasure/ happiness and minimising pain/ unhappiness)

Question 7

Components of ethics and clinical decisions?

Answer 7

1) Duties
2) Four principles:
- Respect for Autonomy
- Non-malfeasance
- Beneficence
- Justice

Question 8

Respect for autonomy?

Answer 8

• Promote the right to self determination

- Confidentiality, informed consent, promote capacity

Question 9

Non-malfeasance?

Answer 9

The avoidance of harm

Question 10

Beneficence?

Answer 10

To do good

Question 11

Justice?

Answer 11

• Fairness/equality = Non discrimination and equal treatment for equal need.
• Individual versus population = Rationing, limits to autonomy

Question 12

How to stay ethical

Answer 12

• Non-judgmental approach
• Not imposing personal views & respecting patients’ views
• Confidentiality
• Not exceeding your competency
• Fitness to practise

Question 13

GC guide to non-judgemental approach?

Answer 13

GMC guide 2006: you must not discriminate on grounds of age, colour, culture, disability, ethnic or national origin, gender, lifestyle, marital or parental status, race, religion or beliefs, sex, sexual orientation, or social or economic status.

Question 14

Not Imposing Your Personal Views and Respecting Patients’ Views

Answer 14

• Fair presentation of facts/options
  not letting your views affect your advice/actions
  (Should you divulge your opinions?)
• Willingness to refer elsewhere
• Not bullying/belittling etc (also applies to colleagues, juniors, other health workers etc)

Question 15

Fitness to practice?

Answer 15

It is not just about competency

You have a specific duty to take appropriate action to protect patients, not just by your own actions but also to protect patients if you or others are unfit to practise.

Question 16

Duty of candour?

Answer 16

This means that you must be open and honest with patients when something goes wrong with a patient’s treatment or care which causes, or has the potential to cause, harm or distress. Even if the patient is unaware or has not complained.

You must apologise to the patient and offer an appropriate remedy or support to put matters right (if possible) and explain fully the short and long term effects of what has happened.

Requires complete honesty to not only the patient but also the relevant organisations (Employer, health authority etc) even if there is only the potential for compromise