concise - health ethics

Question 1

health definition

Answer 1

a state of complete physical, mental and social well being and not merely the absence of disease or infirmity

Question 2

ethics

Answer 2

system of moral principles and branch of philosophy which defines what is good for individuals and society

Question 3

consequentialism

Answer 3

concerned with the outcomes or consequences of behaviour; form the basis for any valid moral judgement

Question 4

4 theories in medical ethics

Answer 4

utilitarian
deontology
virtue ethics
morality

Question 5

utilitarian

Answer 5

act is evaluated solely in terms of its consequences, produce the greatest possible balance over disvalue, maximising well-being and minimise suffering

Question 6

deontology

Answer 6

duty to follow natural laws and rights, rightness or wrongness from the character of the act itself rather than the outcomes

e.g. doctors ought to respect every human being, both oneself and every other person, even if this leads to unfortunate consequences

Question 7

virtue ethics

Answer 7

person rather than action based

focuses on the character of the agent, integrates reason and emotion, deemphasises rules, consequences and particular acts

Question 8

morality

Answer 8

concern about the distinction between good and evil or right and wrong

Question 9

5 focal virtues

Answer 9

1. Compassion: active regard for another’s welfare combined with an imaginative awareness and emotional response of deep sympathy, tenderness and discomfort at another’s misfortune
2. Discernment: an understanding of why as well as how
3. Trustworthiness: patient advocates, ombudsman, legally binding directives
4. Integrity
5. Conscientiousness

Question 10

limitations of virtue ethics

Answer 10

Assessment of virtue is culture – nonspecific
Notion of virtue is too broad to allow for practical application
An emphasis on the moral character of individuals ignores social and communal dimensions
Conflicting virtues: Honesty vs. Kindness

Question 11

Four principles

Answer 11

transcend national, religious and cultural barriers

Autonomy
beneficence
non-maleficience
justice

Question 12

Autonomy

Answer 12

self rule or self governance; obligation to respect the decision making capacities of autonomous person, subsumes informed consent before treatment, confidentiality, honesty (lack of deceit) and good communication
Emmanuel Kant -> treat others as ends in themselves and not merely as an means to an end

Question 13

Beneficence

Answer 13

doing the right thing for patients; provide benefit to others, better off than before, also incorporates empowerment; helping the patient to make appropriate decisions for themselves

Question 14

non-maleficience

Answer 14

do no harm intentionally or inadvertently where ever possible, means evidence based practice and keeping up to date

Question 15

Justice

Answer 15

moral obligation to act on the basis of fair adjudication between competing claims, utility, need vs benefit

distributive justice - fair distribution of scarce resources
right based justice - respect for people’s rights
legal justice - respect for the law

Question 16

An autonomous action

Answer 16

1. Intentional
2. Done with understanding
3. Done without controlling influences that determine an individual’s actions.

Question 17

conflict between principles

Answer 17

1. It is morally prohibited to risk death for a patient whose life threatening condition can be medically managed by suitable medical techniques.
2. It is morally prohibited to disrespect a first party refusal of treatment.

Question 18

doctrine of dual effect

Answer 18

1. nature of the act is itself good
2. agent intends the good effect and not the bad either as a means to the good or as an end itself
3. good effect outweighs the bad to justify causing the bad effect and the agent exercises due diligence to minimize the harm

Question 19

conflict with the law

Answer 19

1. . Euthanasia Homicide
2. Gross Negligence Manslaughter
3. Suicide (pact, assisted)
4. Abortion (follow Act 1978 to the letter)
5. Assault
   - Principle of Necessity: If a patient is unable to give consent, you can only give the treatment necessary to preserve life and limb in an emergency
6. Theft