Introduction To Healthcare Ethics

13.10.05

Ethics = how you SHOULD behave.

In medical practice, ethical and professional issues arise on a regular basis.

Aims of ethics:
• To reflect on what it is to be an ethical/professional health care practitioner.
• To reflect on the types of ethical and professional principles, values and consideration that help guide our behaviour.
• To be able to identify relevant ethical and professional issues raised by particular health care scenarios.
• To be aware of relevant sources of ethical, professional and legal guidance etc.

Principles and values - four principles (Beauchamp and Childress):
• Respect for autonomy - we should respect the patient's right to make informed and voluntary choices about how we act on them. This clearly ties in with issues of valid consent - ensure you're familiar with what valid consent involves.
• Non-maleficence - we should not act in ways that are likely to harm the patient. Negative obligation - tells us to refrain from behaving in ways like to harm others. Think: what constitutes a harm? Who should decide what constitutes a harm?
• Beneficence - we should act in ways likely to benefit a patient. Positive obligation - tells us to positively act (and not simply refrain from acting) in a way that will benefit others. Think: what constitutes a benefit? Who is in the best position to decide whether the treatment is beneficial to the patient?
• Justice - we should treat all our patients fairly and equitably. Think: what might be suggested to constitute a fair and equitable way of distributing resources?

Beauchamp and Childress argue that the above pose prima facie, not absolute obligations. DISTINGUISH!

Other values or moral considerations:
• Obligations of confidentiality/privacy: What do these entail? How do privacy and confidentiality differ? Why is it important to respect these? Are there circumstances where privacy and confidentiality shouldn't be respected? What are the professional guidelines on the above?
• Obligations of truth-telling: What is involved? Why should we normally tell the truth? How should we go about telling patients the truth? Are there circumstances in which it is better not to tell patients truthful information? What are professional truth-telling/disclosure guidelines.
• Rights (and Human Rights Act): What are rights? Are there any 'absolute' rights? Why are rights important? Which articles of the Human Rights Act are particularly relevant/important for health care professionals?
• Appropriate/non-judgemental attitudes: What are attitudes? What are examples of good and bad attitudes? Why do you think attitudes are often thought to be morally significant?
• Good inter-professional and intra-professional relations: Why do you think good relations between different professionals is important for providing health care?