Basic Principles of Health Care & Ethical Discourse PDF

BASIC PRINCIPLES OF HEALTH CARE AND THE NATURE OF RIGHTS IN ETHICAL DISCOURSE  Topic Outline VERACITY OTHER RELEVANT FIDELITY ETHICAL PRINCIPLES a. Principle of Double Effect JUSTICE b. Principle of Legitimate BENEFICENCE...

BASIC PRINCIPLES OF HEALTH CARE AND THE NATURE OF RIGHTS IN ETHICAL DISCOURSE  Topic Outline VERACITY OTHER RELEVANT FIDELITY ETHICAL PRINCIPLES a. Principle of Double Effect JUSTICE b. Principle of Legitimate BENEFICENCE Cooperation c. Principle of Common Good and NON-MALEFICENCE Subsidiarity  Group Reporters BARROSA BESA BOQUIRON DELGADO BEJISON BRAGA CASTILLO ESCANILLA SERGIO CAROCHE CONSORTE GARCIA Block A Block B Block C Block D  VERACITY Also known as the TRUTH-TELLING. In nursing, veracity is an ethical principle of HONESTY and TRUTHFULNESS. For healthcare professionals, this includes being honest about a patient’s diagnosis, prognosis, treatment options, and the risks and benefits of those options. The BINDING PRINCIPLE between patients and nurses.  VERACITY Binds both the health practitioner and the patient in an association of TRUTH. PROTECTS the patients from harm. Patients have the right to expect a HIGHER LEVEL OF TRUTHFULNESS Lying is RARELY justified  VERACITY Lying cannot entered into lightly as it interferes directly with the person’s AUTONOMY. Harm to a patient’s AUTONOMY and the potential loss of the practitioner’s CREDIBILITY make lying to a patient a practice that in almost all cases, should be AVOIDED.  VERACITY Patient MUST TELL THE TRUTH in order that appropriate care can be provided and the practitioner needs to DISCLOSE FACTUAL INFORMATION so that patient can exercise personal autonomy.  ROLE FIDELITY Role fidelity is defined as the “faithful practice of the duties contained in a particular practice.” In healthcare, it means adhering to the ethical standards, obligations, and expectations inherent in one's role, whether as a doctor, nurse, therapist, or any other healthcare provider.  ROLE FIDELITY The role in which the individual practitioner will respond to the BASIC questions of biomedical ethics. Whatever the assigned role, the ethics of health care require that the practitioner practice faithfully within the constraints of the role.  ROLE FIDELITY Most often the areas of acceptable practice are CONTAINED and PRESCRIBED by the SCOPE OF PRACTICE of the STATE LEGISLATION that enables prefession’s practice.  JUSTICE The ethical principle of justice is both simple and complex. Deals with fairness, just deserts, and entitlements. Requires procedural justice in disputes and distributive justice in healthcare.  Types of Justice Procedural Justice Distributive Justice Compensatory Justice society healthcare retributive justice due process in cases Deals with the Compensation for a of disputes between distribution of scarce wrong that has been individuals resources done  Methods for the Distribution In our society we use several methods for the distribution of goods and services, attempting in some measure to provide a system in which individuals receive their due share.  Methods for the Distribution To each an equal share (e.g., elementary and secondary education) To each according to need (e.g., aid to the needy and programs such as food stamps) To each according to effort (e.g., unemployment benefits)  Methods for the Distribution To each according to contribution (e.g., retirement systems) To each according to merit (e.g., jobs and promotions) To each according to ability to pay (e.g., free market exchange) Example: Healthcare disparities in the Philippines are evident, with better care available in urban areas compared to rural regions.  Summary Encompasses multiple dimensions in healthcare. Ensures equitable treatment and access to services. Focuses on the fair allocation of healthcare resources. Important to keep justice central in complex healthcare systems. Promote policies and practices that support fairness for everyone. Commitment to justice for all individuals, regardless of their circumstances.  BENEFICENCE Acts of mercy and charity Any action that benefits another Physicians commit to "apply measures for the benefit of the sick" Duty to promote patient health and welfare above all else  BENEFICENCE Obligation to honor patients' personal choices Balance between care and respect for autonomy Nurses' primary commitment to patient health, well- being, and safety Importance of provider-patient trust for patient morale  BENEFICENCE Historical Context Simplicity of beneficence before modern medicine Focus on psychological support in earlier healthcare practices  BENEFICENCE Modern Challenges Advanced life-support techniques can prolong life Distinction between biological life and meaningful existence Life without awareness or relationships may not constitute true beneficence  NON-MALEFICENCE One ought not to inflict evil or harm Rooted from the Hippocratic Oath: "I will never use treatment to injure or wrong the sick." Focus on the duty to refrain from causing harm. Beneficence and Non-maleficence are interrelated yet distinct. OTHER RELEVANT ETHICAL PRINCIPLES PRINCIPLE OF DOUBLE EFFECT PRINCIPLE OF LEGITIMATE COOPERATION PRINCIPLE OF COMMON GOOD AND SUBSIDIARITY PRINCIPLE OF DOUBLE EFFECT When a course of action has both good and harmful effects. Ethical considerations when harmful side effects are foreseen but unintended. This principle is finally found not to be useful formulation for practice, but it helps to ask the right question to certain situations.  PRINCIPLE OF DOUBLE EFFECT GUIDING ELEMENTS The course chosen must be good or at least morally neutral. The good must not follow as a consequence of the secondary harmful effects. The harm must never be intended but merely tolerated as causally connected with the good intended. The good must outweigh the harm. PRINCIPLE OF LEGITIMATE COOPERATION This is an application of the Principle of Double Effect to situations involving cooperation with someone else's actions In healthcare, this principle helps professionals navigate situations where they may be indirectly involved in practices or decisions that conflict with their ethical beliefs.  PRINCIPLE OF LEGITIMATE COOPERATION To achieve a well-formed conscience, one should always judge it unethical to cooperate formally with an immoral act (that is, directly to intend the evil act itself), but one may sometimes judge it to be an ethical duty to cooperate materially with an immoral act (that is, only indirectly intend its harmful consequences) when only in this way can greater harm be prevented, provided: a. that the cooperation is not immediate and b. that the degree of cooperation and the danger of scandal is taken into account. TYPES OF COOPERATION 1. Formal Cooperation(absolute evil) Identification with the purpose Directly intend the evil action Object of the actor motive of the agent is evil in nature Always illicit E.g.Bank robbery, abortion How should we know if a person is formally cooperating?  1. Does the act  2. Agrees 3. Advice 4. Counsel 5.Condone (justify/forgive) 2. Material cooperation  You cooperated in the act but not in the purpose  Indirectly intend the evil action. -Immediate(can be licit, can also be illicit)- if one cooperates in an evil act by performing something that is essential for the performance of the evil action.  -Mediate(licit) - if one cooperates in an accidental or non-essential manner in the evil action.  CRITERIA FOR JUDGING THE MORALITY OF COOPERATION Proximity to the Immoral Act: - The closer one's actions are to the immoral act (both physically and causally), the harder it is to justify cooperation. Gravity of the Act: - The more serious the wrongful act, the stricter the criteria for justifying cooperation. Degree of Necessity: - Cooperation may be permissible if it is necessary to achieve a proportionate good or prevent a greater evil. Intent of the Cooperating Agent: - Cooperation may be morally permissible if the agent does not intend the immoral outcome, and it is necessary for a greater good.  PRINCIPLE OF COMMON GOOD AND SUBSIDIARITY Vatican II Definition: "sum total of social conditions which allows people, either as groups or as individuals, to reach their fulfillment more fully and more easily." It is about the progress of persons.  PRINCIPLE OF COMMON GOOD AND SUBSIDIARITY The common good refers to achieving the best possible outcome for the largest number of people, which is underpinned by decision-making that is ethically and morally sound and varies by the context in which the decisions are made PRINCIPLE OF COMMON GOOD AND SUBSIDIARITY Subsidiarity Explained: A corollary of the common good, ensuring individuals can participate in decisions that affect them. Tasks should be assigned to the smallest possible group that can effectively handle them. Higher-level groups intervene only when necessary.  PRINCIPLE OF COMMON GOOD AND SUBSIDIARITY Example: State intervention in family issues only if the family is overburdened, promoting self-help as a dignity component. Thank You