Bioethics Unit: Clinical Terms and Concepts

Terms and Concepts in the Clinical Relationship

• The Individual and Integrated Care Plan (PIIC) is a reconciliation of multiple plans designed to meet multiple needs, directly addressing specific needs at the appropriate time, and is flexible, with regular reassessment of efficacy and effectiveness, and adjusts to changes in the patient's state.

Advanced Care Plan

• Engagement involves knowing the clinical context deeply, understanding patient/family communication profiles, and obtaining authorization to communicate.
• It is essential to present oneself, explain one's role in case management, and fix moments of discussion.
• Clinical evaluation involves assessing symptoms, impacts, limitations, meanings, and expectations.

Directives Antecipadas de Vontade (Early Directives of Will)

• These are unilateral documents that can be freely revoked at any time, in which a person of age and capacity manifests their conscious will regarding healthcare they wish to receive or not receive.

Total Care

• Total care is a challenge that requires a culture of empathy, compassion, and multidisciplinarity, integrating care among different specialties and professions to achieve the best available care.

Vulnerability

• Vulnerability is a characteristic that must be considered in the clinical relationship, and it is essential to ensure the protection of the vulnerable by complying with the three basic ethical principles: respect for persons, beneficence, and justice.

Belmont Report

• The Belmont Report (1978) establishes the protection of the vulnerable must be ensured by complying with the three basic ethical principles: respect for persons, beneficence, and justice.

Ethics

• Ethics involves understanding why good is good and why evil is evil, and it is different from law, which establishes what is legal and what is illegal, and morality, which determines what is good and what is evil.

Barcelona Declaration

• The Barcelona Declaration (1998) establishes basic ethical principles in European bioethics and biolaw, including autonomy, dignity, integrity, and vulnerability.

Autonomy

• Autonomy is understood as the capacity to idealize and define life goals, have moral awareness, self-control, and privacy, and to reflect and act without coercion.### Ethics in Medical Education

• Ethics is an essential aspect of every interaction between doctors and patients, according to Komesaroff.

• Ethical scrutiny applies only to human actions, not natural phenomena.

The Clinical Relationship

• The clinical relationship involves the power to change life, making it a subject of ethical consideration.
• Bioethics guarantees coherence and normative dimensions, ensuring its capacity to intervene in practical situations.

The Imperative of Responsibility

• The development of science and technology has changed the nature of human action, requiring a new approach to ethics.
• According to Hans Jonas, the human good is no longer immediately determinable, and certain actions have opened a new dimension of ethical significance.

Duty of Knowledge

• Ignorance is no longer an acceptable excuse, and knowledge has become a duty, especially in the context of medical action.
• Hans Jonas emphasizes that knowledge is proportional to the causal scale of our action.

Duty of Prudence

• The responsibility for the use and consequences of technology extends to the place of ethical principle, encompassing duties to man, humanity, nature, and the biosphere.
• Hans Jonas highlights the importance of considering the long-term effects of our actions.

The Duty of a New Humility

• The new nature of human action requires a new ethics of long-term responsibility, co-extended to the scope of our power.
• Hans Jonas advocates for a new kind of humility, acknowledging the excessive magnitude of our power and the limitations of our predictive abilities.

Vulnerability

• Vulnerability comes from the Latin "vulnus" meaning "wound" and "vulnare" meaning "to hurt".
• Vulnerability is understood as exposure to situations of dependence, fragility, insecurity, and uncertainty, as well as the risk of exposure to situations where health or life is at risk.
• Mª do Céu Patrão Neves defines vulnerability as susceptibility to being injured.