7-Ethics-W2011 - Ethics ValuesDefined the more carefully...

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Ethics
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Values Defined “… the more carefully you scan your own frailties, the more tender you are for those of your fellow creatures” Reference: Cushing, H. (1925). The life of Sir William Osler. Oxford: Clarendon Press. Conflict in Values: Some situations may create an ethical dilemma if we have to choose between 2 or more conflicting choices. Ex. Doing the right thing vs. doing what’s best for the patient
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Biomedical Ethics Application of ethical principles and theories to the problems that occur in the fields of health care and medicine The “appropriate” thing to do in a given situation (good, bad, right, wrong, etc) Hippocratic Tradition and Beneficence Oath to “help sick” and “do no harm” Help others achieve their interests and protect them from harm Decisions made “with” or “for” patients? Is there potential conflict?
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Paternalism Making choices for others without their consent ex. physician doing a procedure without asking the patient Professional is in the dominant position in our health care system
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Autonomy Increase in self-care (ex self-help books) Individual is in control of their health from a decision-making perspective Self-determination and moral independence 1) does one know what one really wants, 2) contradicting preferences, 3) changing preferences, 4) different types of consent
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Justice People living longer, technology making medicine more costly An issue of fairness (services, availability) ex. health care systems Can vs. US ex. keeping coma patient vs. no basic health care coverage Ethical dilemmas not clear cut in reality; ethical principles may conflict with one another
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Informed Consent Intended to give the patient more authority over their health state Designed to ensure that the patient is being helped and not harmed Written consent can not be attained at every step It helps promote feelings of relatedness Involves disclosing to the patient: 1) what is going to be done to him or her 2) the potential risks and desired outcomes 3) obtaining the patient’s consent (or refusal)
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Informed Consent Type of information that must be shared with the patient: 1. Proposed treatment(s) should be explained Diagnosis, prognosis, types of intervention, and desired outcomes 1. Patients should be given alternatives to the proposed treatment and the risks inherent to all treatments May include doing nothing at all 1. Patient can request that treatment be discontinued at any time without fear of reprimand
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Giving or Refusing Consent Dilemma: what a feels is the “best” decision of him or her is not congruent with the professionals decision Some patients seek no treatment, others will seek excessive treatments
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7-Ethics-W2011 - Ethics ValuesDefined the more carefully...

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