Overview of Ethics PDF

# Overview ## Ethics - The attempt to arrive at an understanding of the nature of human values. - How we ought to live and what constitutes right conduct. ## Ethical Arguments - **Top down deductive:** where one specific ethical theory is consistently applied to each problem. - **Bottom up induc...

# Overview ## Ethics - The attempt to arrive at an understanding of the nature of human values. - How we ought to live and what constitutes right conduct. ## Ethical Arguments - **Top down deductive:** where one specific ethical theory is consistently applied to each problem. - **Bottom up inductive:** using past medical problems to create guides to practice. - An approach where theories are considered which best fit one's own beliefs before applying. ## Morality - Concern with distinction between good and evil, right and wrong (universal). ## Ethics - A system of moral principles and a branch of philosophy. - Defines what is good for individuals and society (differs in different cultures). ## Doctrine of Dual Effect - Harmful effect is inseparable from the good effect. - The nature of the act is good and the intention is good. - The good effect **outweighs** the bad effect. - Normally, if you carry out an action knowing that X is a likely consequence of that then the law regards you as intending to cause X. ## Meta-ethics - The nature of ethics and moral reasoning. - Exploring fundamental questions. - Right/wrong/defining the good life. ## Normative Ethics - Determining the content of our moral behaviour. - Focus is on the act itself, the person performing it, and its consequences. ## Applied Ethics - Attempting to deal with specific realms of human action, crafting criteria for discussing issues. - Emergence of ethical investigation in specific areas. - Environmental, medical, public health ## Ethical Theories - Philosophical attempts to create ethical theories. ## Facts vs. Values - Ethical decisions cannot be made without knowing the facts. - Some ethical theories require calculations based on fact. - Ethics can inform our knowledge of facts. ## Law and Ethics - Laws are necessary in an increasing litigious society. - Laws are easily made - concerning how easily opinions change. - Rapid developments - leaves law trying to catch up. - Ethics often informs law as jurisprudence (philosophy of law). - Laws cannot cover every eventuality. # 14.16 Ethics ## Ethical Fallacies - **Reasoning a false arguments** - **Ad hominem:** responding to arguments by attacking a person's character rather than their argument. - **Authority claims:** saying its correct because someone said so. - **Begging the question:** petition principii - assuming the initial point to the argument. - **Dissenters:** identifying those who disagree does not prove the claim is not valid. - **Motherhoods:** inserting a soft statement to disguise the disputable one. - **Confusing necessary and sufficient**. - **Traditional Ethics = 3As (alcohol, adultery, advertising)** - **Introduction of ethics teaching following Pond Report in 1986** ## Confidentiality ### Disclosure allowed if: - **Required by law:** - Notifiable diseases - Regulatory bodies - Ordered by judge or police - **Patient consent** - **Public interest:** - Serious communicable disease - Serious crime - Research - Education ### Criteria for disclosure: - **Anonymous:** if practical - **Patient consent** - **Kept to a necessary minimum** - **Meet current law - data protection** - After death confidentiality continues. - **Notifiable diseases to be reported to WHO:** - Cholera - Yellow Fever - Plague (Yersiniiiaaaaaa) ## GMC "Duties of a Doctor" - Protect and promote the health of patients and the public. - Provide a good standard of practice and care. - Recognise and work within the limits of your competence. - Work with colleagues in the ways that best serve patients' interests. - Treat patients as individuals and respect their dignity. - GMC (2009) - Tomorrow's Doctors; graduates will be able to behave according to ethical and legal principles. - **Only deontological?** # The Four Principles - **Autonomy:** - Allowing a patient to make a rational and informed decision if they have capacity, with obligation to respect their decisions. - The autonomous individual freely acts in concordance with a self chosen plan. - Decision made intentionally, with understanding, and without controlling influences that determine an individuals actions. - **Beneficence:** - Doing the right thing to benefit the other. - Balancing risks against benefits - **Non-maleficence:** - Preventing harm, reducing harm, and doing no harm. - **Justice:** - Being fair in the distribution of risks and benefits. - Need vs. Benefit. # Ethical Theories - **Utilitarianism/consequentialism (teleological)** - **Act/Rule/Hedonistic/Preference** - "greatest happiness principle" of John Stuart Mill. - Maximising good and minimising harm for all involved. - **Act-judging actions in terms of the goodness of their consequences without reference to their rules of action to maximise good. E.g. killing one to save many.** - **Rule-actions are moral when they conform to the rules that lead to the greatest good.** - **Hedonistic - maximise the net pleasure, minimise pain.** - **Preference - utility **increases** as preference/desire is satisfied.** - **Deontology** - Inherent morality determines worthiness of actions, without concern for potential consequences. - "Do unto others as you would be done by" - **Virtue Ethics** - Focus on the character of the person and their internal morality rather than individual acts (benevolence / charity). - An action is virtuous if innate and not after assessing or evaluating situation - genuinely intending to do the right thing. - 5 focal virtues are: - Compassion - Discernment - Trustworthiness - Integrity - Conscientiousness - **Kantianism** - Judges the morality of an action based on the actions adherence to rules. - Obligatory duty. - Following natural laws and rights. - Categorical imperatives - set of universal moral premises from which duties are derived (do not lie, do not kill...). - Deon = duty (in Greek)