Medical Ethics: Non-Maleficence Principle
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Questions and Answers

What is the potential outcome if Mr.D. refuses to undergo surgery?

  • He will have to accept higher health risks
  • He will die without the surgery (correct)
  • He will survive with a minor health issue
  • He will have to tell his wife

Why might Mr.D. be hesitant to undergo surgery?

  • He is afraid of upsetting his wife
  • He has pressing business obligations
  • He is afraid of surgery
  • All of the above (correct)

What is important to do when discussing Mr.D.'s condition with him?

  • Use clear and unambiguous language to avoid misinterpretation (correct)
  • Downplay the risks of not undergoing surgery
  • Avoid discussing the seriousness of his condition
  • Use ambiguous language to avoid upsetting him

What should Dr.C. do after explaining the situation to Mr.D.?

<p>Refrain from any form of coercion and let Mr.D. decide (C)</p> Signup and view all the answers

What might the surgery represent to Mr.D.?

<p>An undesirable loss of control (A)</p> Signup and view all the answers

Why is it important to directly acknowledge and address Mr.D.'s concerns?

<p>To facilitate a decision for the surgery (B)</p> Signup and view all the answers

What kind of language should be used when discussing Mr.D.'s condition?

<p>Clear and unambiguous language to avoid misinterpretation (D)</p> Signup and view all the answers

What is Dr.C.'s obligation in this situation?

<p>To attempt to persuade Mr.D. due to a fiduciary obligation (B)</p> Signup and view all the answers

What is the primary concern of Dr. C. regarding Mr. D.'s request to delay surgery?

<p>The potential harm of delaying surgery (D)</p> Signup and view all the answers

What is the main ethical issue in this scenario?

<p>Ensuring the doctor's duty to prevent harm (C)</p> Signup and view all the answers

What is the doctor's obligation regarding Mr. D.'s request?

<p>To prevent harm to Mr. D. (D)</p> Signup and view all the answers

What should the doctor try to determine first in this scenario?

<p>If Mr. D. is aware of the dangers of not having surgery (B)</p> Signup and view all the answers

What is the doctor's role in this scenario?

<p>To prevent harm to Mr. D. (B)</p> Signup and view all the answers

What is the potential consequence if Mr. D. delays surgery?

<p>Mr. D. may die or suffer serious harm (D)</p> Signup and view all the answers

What is the doctor's ultimate goal in this scenario?

<p>To prevent harm to Mr. D. (D)</p> Signup and view all the answers

What should the doctor try to do in this scenario?

<p>Educate Mr. D. about the risks of delaying surgery (D)</p> Signup and view all the answers

What is a major factor in determining outcomes in medicine?

<p>Biological variability (D)</p> Signup and view all the answers

Why might Dr. C suggest that Mr. D see another doctor?

<p>To provide a second opinion and increase certainty in prognostication (C)</p> Signup and view all the answers

What is Dr. C's greatest concern if Mr. D delays the bypass?

<p>Mr. D's endangering his own life (B)</p> Signup and view all the answers

Who might be an ally in persuading Mr. D to act more safely?

<p>A family member, such as Mrs. D (B)</p> Signup and view all the answers

Under what circumstances might Dr. C breach confidentiality?

<p>If Mr. D's life is in imminent danger (C)</p> Signup and view all the answers

Why is it important for Dr. C to respect Mr. D's autonomy?

<p>To respect Mr. D's right to make decisions about his own health (A)</p> Signup and view all the answers

What is the main challenge in prognostication in medicine?

<p>Lack of certainty due to biological variability (B)</p> Signup and view all the answers

What should Dr. C remain if Mr. D continues to make a bad choice?

<p>Compassionate and respectful (A)</p> Signup and view all the answers

What is the core principle of the Hippocratic Oath that a physician must follow?

<p>To never use treatment to injure or wrong patients (B)</p> Signup and view all the answers

What is the term for the principle of doing no harm in medical practice?

<p>Non-maleficence (A)</p> Signup and view all the answers

What is the primary obligation of a physician, according to the course objectives?

<p>To do no harm to the patient (D)</p> Signup and view all the answers

What is the Latin phrase that translates to 'Above All (or First) Do no Harm'?

<p>Primum non nocere (C)</p> Signup and view all the answers

What is the term for the opposite of non-maleficence?

<p>Maleficence (C)</p> Signup and view all the answers

What is an example of a violation of the principle of non-maleficence?

<p>A doctor killing patients through lethal injection (A)</p> Signup and view all the answers

What is the relationship between the physician's responsibility and the principle of non-maleficence?

<p>The physician's responsibility is to do no harm to the patient (A)</p> Signup and view all the answers

What should a physician do when a patient does not approve of their treatment decision?

<p>Respect the patient's autonomy and decision (D)</p> Signup and view all the answers

What might Dr. C do if Mr. D refuses to undergo bypass surgery?

<p>Seek consultation with wise friends, spiritual counselors, or an ethics committee (A)</p> Signup and view all the answers

What is the purpose of obtaining informed consent?

<p>To ensure the patient understands the risks and consequences of a procedure (C)</p> Signup and view all the answers

Why might Dr. C have Mr. D sign an 'against medical advice' document?

<p>To ensure Mr. D understands the risks of not undergoing the procedure (D)</p> Signup and view all the answers

What is inherent in the practice of the medical profession?

<p>Harm (C)</p> Signup and view all the answers

What might be the consequence of administering a toxic chemotherapy to a patient with a brain tumor?

<p>Harm to the patient (A)</p> Signup and view all the answers

Why are principles of medical ethics not absolute?

<p>Because each case has unique circumstances and considerations (B)</p> Signup and view all the answers

What is the purpose of an ethics consult?

<p>To assist the doctor in resolving an ethical dilemma (D)</p> Signup and view all the answers

What does 'informed refusal' refer to?

<p>A patient's decision to refuse a procedure with full understanding of the risks and consequences (C)</p> Signup and view all the answers

Study Notes

Non-Maleficence

  • Non-maleficence is the principle of not causing harm to patients.
  • It is a moral obligation for doctors to prevent harm and avoid actions that could cause harm to patients.

Primum Non Nocere

  • "Primum non nocere" is a Latin phrase that means "above all, do no harm" or "at least, do no harm."
  • This phrase is part of the Hippocratic Oath, which physicians take to promise to do no harm to their patients.

Physician's Obligation

  • A physician's obligation is a course of action that is required to take, whether legal or moral.
  • The prohibition of disablement and killing is a fundamental aspect of a physician's obligation.
  • Examples of violating this obligation include treatment blinding, killing patients, and giving harmful medicines.

Case Study: Mr. D.

  • Mr. D. is a patient who refuses to undergo surgery for his heart condition, despite the doctor's warnings.
  • The doctor, Dr. C, tries to persuade Mr. D. to undergo surgery, but Mr. D. is hesitant due to his business obligations.
  • The doctor's dilemma is to balance respect for Mr. D.'s autonomy with the need to prevent harm to Mr. D.

Ethical Considerations

  • Respect for the patient's personal wishes and values is essential, but so is preventing harm to the patient.
  • The doctor must consider issues of decision-making, competency, autonomy, coercion, persuasion, and confidentiality.
  • In cases where the patient is behaving dangerously, the doctor should try to determine if the patient is aware of the dangers and has decisional capacity.

Communication and Persuasion

  • The doctor should use clear and unambiguous language to explain the risks and consequences of not undergoing surgery.
  • The doctor may need to persuade the patient to undergo surgery, but the line between persuasion and coercion may not be clear.
  • The doctor should try to find an ally, such as a family member, to help persuade the patient to act more safely.

Confidentiality and Breach of Confidentiality

  • Confidentiality is essential in the patient-physician relationship, but there may be situations where breaching confidentiality is necessary to save a life.
  • The doctor may need to warn the patient's family or loved ones of the dangers of the patient's decision.
  • Informed consent is essential before undertaking potentially harmful procedures or medical therapies.
  • The doctor should also ensure that the patient is fully informed about the risks of not having a procedure done.
  • Informed refusal is also important, and the doctor should make sure that the patient is fully informed about the risks and consequences of their decision.

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Explore the doctor's obligation to avoid harm to patients, ethical rules, and case variations in medical practice.

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