Ethics

Question 1

consequentialism

Answer 1

end justifies the means (the morally right action is one that gives rise to the best consequences or outcomes)

 John Stuart Mill

Question 2

give 3 types of consequentialism

Answer 2

utilitarianism
egoism
alturism

Question 3

utilitarianism

Answer 3

the best course is the one that promotes most happiness/ pleasure and absence of pain for all (lesser of two evils)

Question 4

egoism

Answer 4

the best course is whats best for you (may be positive, negative, neutral for others)

Question 5

altruism

Answer 5

the best course is whats best for others well-being

Question 6

deontology

Answer 6

duty based theories.
duty of care to each other
there are fundamental rules and duties to follow, and as such certain acts are seen as wrong no matter the consequences

Question 7

moral absolutism

Answer 7

certain acts are good or bad, irrespective of intent or consequences

Question 8

kantian

Answer 8

one must act from duty, and it is the motives of the decision maker, rather than the consequences of the action that make something right or wrong

Question 9

contemporary approach (deontology)

Answer 9

centre on ‘permissible harm’
(can divert a train to save 5 but kill 1*, but cant kill 1 to harvest organs for 5)
*some harm inevitable anyway

Question 10

four principles

Answer 10

autonomy
beneficence
non-maleficence
justice

Question 11

autonomy

Answer 11

freedom for patient to choose and advocate for their own health

(Problem: mental health, pregnant, children )

Question 12

beneficence

Answer 12

what is considered in the patients best interests

Question 13

non-maleficence

Answer 13

balance actions benefits against harm

Question 14

justice

Answer 14

equity and avoiding discrimination at both an individual and societal level

Question 15

dynamism

Answer 15

situations are almost always dynamic, a decision taken at one time may not be appropriate at a later stage

Question 16

clinical truth

Answer 16

contextual, circumstantial, and personal

Question 17

objective truth

Answer 17

reality

Question 18

Formula of universal law (Kant)

Answer 18

could you live in a world where everyone acted this way

Question 19

Formula of humanity (kant)

Answer 19

don’t treat people as a means to an end (don’t use people)

Question 20

virtue ethics

Answer 20

Compassion, patience, kindness, fidelity - characteristics

Assume person of good character will always act in right way …?

Question 21

+vs and -ves of virtue ethics

Answer 21

 +ve
• Whole person taken into account
• Centres ethics on the person and what it means to be a human
 -ve
• No help in moral dilemma
• Virtues not clear
• Virtues dependent on culture they are devised in

Question 22

ethics in practice

Answer 22

Candour
	open and honest
	disclose errors
	Ethical, regulatory (GMC 2013), contractory (NHS), statutory 
Consent
Capacity
Confidentiality 
Communication

Question 23

what are 2 types of uncertainty

Answer 23

objective

subjective

Question 24

2 types of objective uncertainty

Answer 24

aleatory - cant know anymore

epistemic - don’t know anymore

Question 25

2 types of subjective uncertainty

Answer 25

ethical - i don't know what i should know | choice - i dont now what i want to know

Question 26

what does the GMC state about whistle blowing

Answer 26

‘ you must make the care of your patients your first concern’

Question 27

Seedhouse grid – 4 layers:

Answer 27

1. Autonomy (innermost layer – consider first) 2. Beneficence , truth (+ non-maleficence) 3. Balance pt. and society 4. External considerations and law (outmost layer)

Question 28

Complexity theory

Answer 28

consider connectedness of living world  Connectivity and interdependence – how the behaviour of one individual affects others  Co-evolution – adaption/ changes of one aspect on another – doctor and pt. co-evolve  Far from equilibrium – essential for pt. surviving and flourishing  History – pt. and doc influence by prev  Feedback – increase returns  Self-organisation, emergence, creation of new order – Gestalt principle

Question 29

Four quadrant approach

Answer 29

Medical indications - Beneficence and non-maleficence - Review tx/ diagnosis Patient preferences - Autonomy Quality of life - Beneficence and non-maleficence Contextual features - Loyalty and fairness - Encounter Inc. family, law, insurance

Question 30

Conscientious objection

Answer 30

can opt out of providing procedure because of personal beliefs AS LONG AS no direct/ indirect discrimination, harassment of individual pt./group Abortion act 1967:

Question 31

consent (x3)

Answer 31

voluntary informed capacity

Question 32

negligence (x3)

Answer 32

duty of care breached resulting in harm

Question 33

test for whether duty of care was breached

Answer 33

Bolam test - did dr act as majority of peers would have acted

Question 34

what does consent guard against

Answer 34

* Exploitation | * Medical paternalism

Question 35

what are 3 forms of consent

Answer 35

implied (hold out arm for vaccine) written oral

Question 36

capacity

Answer 36

understand retain decide communicate decision

Question 37

which bears most weight, living will or LPA?

Answer 37

Hierarchy: - Living will - Lasting power of attorney - Court of protection - Deputy court of protection - Doctors - (relatives/ patients do not make decisions)

Question 38

when can you break confidentiality

Answer 38

``` o Judge o Police and criminal evidence act o Pt. consent o Other involved in pt. care o Coroner o Police – RTA and terrorism ```

Question 39

what act does confidentiality come under

Answer 39

Data protection act 1998

Question 40

when may someone lack capacity

Answer 40

o Unconscious o Lack understanding o Severe learning difficulties (mental capacity act 2005)

Question 41

what treatment can you give under mental health ac 1983?

Answer 41

- Only enforce treatment for mental health problems e.g. depression, not for medical procedures

Question 42

what does the Mental capacity act 2005 state (3 things)

Answer 42

- A person must be presumed to have capacity unless it is established that he lacks capacity. - An act done, or a decision made, under this Act for or on behalf of a person who lacks capacity must be done, or made in his best interests. - Capacity must be honoured even if unreasonable

Question 43

what law does negligence come under

Answer 43

law of tort