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Question 1

What is deontology?

Answer 1

Moral theory- there is clear cut rights and wrongs and there is never any exception.
It is not fair to make exceptions, moral rules apply to everyone.
Eg, lying in every circumstance is bad

Question 2

What is Consequentialism/ utilitarianism?

Answer 2

A moral theory- ‘we should act always so as to produce the greatest good for the greatest number’
Important to think of benefits vs harm.
Should make decisions as an unbiased spectator

Question 3

What is virtue theory?

Answer 3

Virtue theory does not tell you what to do, instead focuses on doing what a ‘good’ person would do.
Finding the golden mean of excess and deficiency, eg be in the middle of cowardice and recklessness

Question 4

What traits are associated with each of the 3 moral theories?

Answer 4

Question 5

What are the 4 pillars of ethics?

Answer 5

Autonomy- respecting the patients wishes/ letting patients be in charge on their care

Beneficence- do good

Non-maleficence- do no harm

Justice- everyone offered same oppurtunities and treated legally

Question 6

What is the GMC guidance on cosent?

Answer 6

• Involve and support patients in decision making
• Have a meaningful dialogue exchange with relevent information specific to the individual patient
• Listen to patient

–Find out what matters and share relevent information about benefits and harms

Question 7

What is battery and negligence?

Answer 7

Battery= non-consenual touching, exception in emergency medicine

Negligence= breach of duty that cause harm. Can be brought up if doctor has not given patient enough info

Question 8

What age in Scotland are patients deemed to have capacity?

Answer 8

16

Question 9

What is written in the adults with incapacity act, Scotland (2000)?

Answer 9

Act allows treatment to be given to promote mental and physical wellbeing

If a wellfare attorney or guardian has been appointed, the doctor must seek consent from them. When there is no proxy a doctor is authorised to provide medical treatment

Where there is disagreement a second opinion must be sought. Cases can also be referred to the court of session

Question 10

How are patients deemed to have capacity?

Answer 10

They must be able to fully understand and believe the info given about the treatment.

Question 11

In what circumstances can doctors break confidentuality?

Answer 11

In child abuse cases

Best interests of the public

Required by law

Demanded to by the presiding officer of a court

Question 12

What is the GMC guidance on non-invasive treatment?

Answer 12

For some quick or non-invasive interventions it is okay to rely on a patients non-verbal consent.

a explain what you’re going to do and why

b make clear the patient can say no, and stop immediately if they do

c be alert for any sign that they may be confused or unhappy about what you are doing.

Question 13

What do you do if there is a disagreement in the health team about what to do to benefit the patient?

Answer 13

a involve an independent advocate or local mediation service
b consult a more experienced colleague and/or an independent expert
c hold a case conference or seek advice from a clinical ethics committee.

Question 14

If a person who lacks capacity refuses to let you break confidentuality to help them, what should be done?

Answer 14

Try to convince them

If still no consent but you believe sharing info will help the overall benefit of the patient, share it

Question 15

Do competent patients have the right to demand treatment?

Answer 15

A competent patient has the right to refuse any examination, investigation or treatment, but does not have the right to demand treatment.

Question 16

In what cases is chossing the sex of a baby in IVF allowed?

Answer 16

For medical reasons, eg you have a gene that has a high change of influencing females

Question 17

What criteria is there for couples undertaking IVF?

Answer 17

Non-smoking for 3 months

-BMI between 18.5 and 30

One partner cannot have a biological child

Couples must have been co-habiting for two years

Question 18

What are the rules for embryos for IVF?

Answer 18

Can be stored for upto 5 years

Both partners have to consent to them being used, and either partner can veto

Question 19

What are the abortion rules in the UK?

Answer 19

Has to be beforr 24 weeks unless there is severe handicap

must be approved by 2 doctors

Only can occur on approved premises

Need a reason- if prenancy would physically or mentally injur mother, the child or other children/family of the mother

Question 20

What are the different ethical approaches to reproductive medicine?

Question 21

What are the different moral views on the status of an embryo?

Answer 21

a) they are a human organisation and it is murder
b) they have the potential to be a child
c) they are not yet a person

Question 22

In what case of abortion is a second opinion not needed?

Answer 22

If the termination is needed to save the women’s life

Question 23

What are the different types of euthanasia?

Answer 23

Question 24

What are the arguments against euthanasia?

Answer 24

• sanctity of life
• slippery slope
• risk to vulnerable patients
• diagonistic/ prognostic error

Question 25

What is advance care planning?

Answer 25

Helps patients to discuss with doctors their future wishes that will take effect if they ever lose capacity.

It is a voluntary process and may result in a written record of the patients wishes

the statements are not legally binding but help doctors decide on best route of treatment

Question 26

What is the age of legal capacity (Scotland) act 1991?

Answer 26

A person under the age of 16 can have legal capacity to consent to treatment if a medical practitioner believes they are capable of understanding risks and nature of treatment

Question 27

What is being ‘Gillick compent’?

Answer 27

A child having sufficient understanding and intelligence to be capable of making their mind up on a decision

Question 28

What does the GMC state about treating minors?

Answer 28

a involve children and young people in discussions about their care

b be honest and open with them and their parents, while respecting
confidentiality

c listen to and respect their views about their health, and respond to
their concerns and preferences

d explain things using language or other forms of communication
they can understand

e consider how you and they use non-verbal communication, and
the surroundings in which you meet them

f give them opportunities to ask questions, and answer these honestly
and to the best of your ability

g do all you can to make open and truthful discussion possible, taking
into account that this can be helped or hindered by the involvement
of parents or other people

h give them the same time and respect that you would give to adult
patients.

Question 29

Can parents override the consent of a competent young person?

Answer 29

Parents cannot override the competent consent of a young person
to treatment that you consider is in their best interests. But you can rely on parental consent when a child lacks the capacity to consent.
In Scotland parents cannot authorise treatment a competent young person has refused.

Question 30

What age is a child presumed to have formed a view?

Answer 30

12; this view should be taken into account

Question 31

What does case law suggest about 16-18 year olds right to refuse life saving treatment?

Answer 31

Case law indicates that a young person aged 16 or 17 in England and Wales cannot refuse a life-saving treatment or one necessary to prevent serious harm. (In Scotland, more weight is given to respecting the minor’s autonomy. There is uncertainty as to the extent to which Scottish law allows those under 18 years the absolute right to refuse medical treatment.)