Introduction To Medical Ethics PDF

Diploma in Healthcare Please do not reproduce, redistribute or share without the prior express permission of the author. INTRODUCTION TO MEDICAL ETHICS AME 1212 Please do not reproduce, redistribute or share without the prior express permission of the author. ...

Diploma in Healthcare Please do not reproduce, redistribute or share without the prior express permission of the author. INTRODUCTION TO MEDICAL ETHICS AME 1212 Please do not reproduce, redistribute or share without the prior express permission of the author.  Introduction to Medical Law & Ethics Objectives: To define the glossary terms To describe the similarities & differences between law & ethics To discuss the differences The application of law & ethics Please do not reproduce, redistribute or share without the prior express permission of the author.  The difference between Ethics and Moral The word “Morals” and “Ethics” originally meant much same thing: Both words refer to the general area of right and wrongs in the theory and practice of human behaviour Morals refer to standards of behaviour actually held or followed by individuals and groups Ethics refer to the science or study of morals and its activity in the academic context Please do not reproduce, redistribute or share without the prior express permission of the author.  What makes an action moral or not? The act itself “What” The motive “Why” The circumstances: when, where, how, to whom and how often Please do not reproduce, redistribute or share without the prior express permission of the author.  Why study Law & Ethics Health care team with medical professionals often decide on critical issues relating to patient’s needs. Understanding of law helps to protect you & your employer from being sued. Study of law, ethics can assist the medical professionals in making good decision based on reason & logic rather on emotion or feeling. Please do not reproduce, redistribute or share without the prior express permission of the author. Medical Law Addresses legal rights & obligations that affect patients & protect individual rights, including those of health care employees. The law provides a type of yard stick to measure our actions & punishes persons who break the law. Please do not reproduce, redistribute or share without the prior express permission of the author.  What is Bioethics? It is derived from Greek bio- life and ethicos moral The science/art that aims at identification, analysis, and resolution of the ethical issues in almost any field that is related to human life and health. -Deciding what we should do (what decisions are morally right or acceptable) -Explaining why we should do it (how do we justify our decision in moral terms) -Describing how we should do it (the method or manner of our response when we act on our decision) Please do not reproduce, redistribute or share without the prior express permission of the author. Ethics- is a branch of philosophy related to morals & judgments (right, wrong, good, bad, when making judgments) Medical ethics based on principles regulating the behaviour of health care professionals including practitioners. It is the branch of bioethics that is related to the identification, analysis and resolution of moral problems that arise in the healthcare of individual patients Please do not reproduce, redistribute or share without the prior express permission of the author. Ethics involve formal consideration of the interest of others in deciding how to act or behave. Medical ethics mandate the welfare and confidentiality of the individual and patients Please do not reproduce, redistribute or share without the prior express permission of the author. Please do not reproduce, redistribute or share without the prior express permission of the author.  Reasons to discuss ethics We face ethical dilemmas everyday There are often no black or white, but grey It has been recognized as an area important in medical education If dealt with poorly can lead us into sticky situations Please do not reproduce, redistribute or share without the prior express permission of the author.  Why is Ethics an increasing issue for healthcare? An increasingly technological society with complicated issues that never had to be considered before The changing fabric of society, particularly in terms of family structure Healthcare has become a consumer-driven system based on clients becoming more knowledgeable Please do not reproduce, redistribute or share without the prior express permission of the author. Ethics are based on several categories such as: I) Utilitarianism ii) Natural rights or rights based on ethics iii) Duty-based ethics iv) Virtue-based ethics Please do not reproduce, redistribute or share without the prior express permission of the author. Utilitarianism – the principle of the greatest good for the greatest number. Also called as cost/benefit analysis. Consequence base theory or a means to end. When faced with a decision, a utilitarian asks, “How does the action relate to everyone who is affected by it? If it is beneficial to the majority, then it is right. If it is detrimental to the majority, then it is wrong.” Utilitarians tend to reason as follows: “I strongly believe that x is the best decision because the consequences benefit the greatest number of people.” Advantages – encourages efficiency and productivity for looking beyond the individual to access the impact of decision on all who will be effected. It is consisted with profit maximization getting the most value for the least cost. Disadvantages – virtually impossible to quantify all important variables. It can result in a based allocation of resources especially when some people lack of representation of voice e.g. the poor, the elderly, handicap. The rights of some people may be ignored in order to achieve a utilitarian outcome. Please do not reproduce, redistribute or share without the prior express permission of the author. Rights-based ethics – based on premise that there are moral entitlements by virtue of being human. E.g. right to health care, the right to free speech. Advantages – protect the individual from the injury, consistent with rights to freedom and privacy. It is consistent with an accepted standard of social behaviour, independent of outcomes. Disadvantages - can imply individual selfish behaviour that if misinterpreted may result in anarchy. Can foster personal liberties that may create obstacles to productivity and efficiency. Please do not reproduce, redistribute or share without the prior express permission of the author. Duty based ethics – based on absolute moral rules. It advocates that some acts are right or wrong because of the sorts of things they are, and people have a duty to act accordingly, regardless of the good or bad consequences that may be produced. Advantages – It creates a foundation for human conduct and moral absolutes. Disadvantages – difficult to identify who should determine what the rule and principle of moral behaviour should be. Please do not reproduce, redistribute or share without the prior express permission of the author. Virtue-base ethics – based on the premise that there is an acquired human quality which tends to enable us to achieve the goods or rewards which are result of virtuous practices. Advantages – virtues behaviour includes such attributes as perseverance, courage, integrity, compassion, fidelity, humility and justice. Disadvantages – while there are few disadvantages there is a concern that the persons can be taken advantage of if they become too complacent and trusting. Please do not reproduce, redistribute or share without the prior express permission of the author.  Principles or values that drive Ethical behavior Established throughout lifetime. Own set of principles or values that drive ethical behavior Today's some respected virtues are: 1.Beneficence - the obligation to act for the benefit of the patient and supports a number of moral rules to protect and defend the right of others prevent harm, remove conditions that will cause harm, help persons with disabilities and rescue persons in danger. 2.Fidelity - loyalty & faithfulness to others, e.g. performing duty to treat others. Please do not reproduce, redistribute or share without the prior express permission of the author. 3. Gentleness - mild & tender-hearted approach to others. A gentle approach to patient's care is the most welcoming virtues. 4. Humility - acquiring an unpretentious and humble manner. To be truly humble we must be entirely honest with ourselves. 5. Justice - implies fairness in all our actions with people. Balance our behaviour to be fair to all. - NO favouritism. Please do not reproduce, redistribute or share without the prior express permission of the author. 6. Perseverance - to persist with a task or idea even against obstacles, e.g.. It takes perseverance to complete one’s education. 7. Responsibility - a sense of accountability for one’s action. (stress can weaken responsibility). Medical professional must be responsible for their actions. 8. Sanctity of life - sacredness of human life. One should advocate for people who cannot speak out for themselves like small children and elderly people. Please do not reproduce, redistribute or share without the prior express permission of the author. 9. Tolerance - respect those with opinions, practice, race, religion, and nationality differ from ours. Tolerance requires a fair and objective attitude towards opinion and practice that differ from ours. 10. Work - effort applied towards some end of goals. Work is a part of our everyday existence that includes activities such as studying, child rearing, home maintained, gardening, hobbies and religion activities. Please do not reproduce, redistribute or share without the prior express permission of the author.  Interpersonal ethics The expectations of employees in the workplace is that they will be treated with respect, integrity, honest, fairness, empathy, sympathy, compassion, and loyalty. 1. Integrity - stick to one’s principles e.g.. healthcare professional will wash their hands between each patients contact. 2. Honest - quality and truthfulness. 3. Fairness - treating everyone equally. 4. Empathy - ability to understand the feeling of others. Please do not reproduce, redistribute or share without the prior express permission of the author. 5. Sympathy - feeling sorry or pity someone. 6. Compassion - ability to have gentle caring attitudes towards patients and fellow employees. 7. Loyalty - faithfulness to a person, e.g. Employers expect loyalty from employees and vice versa. Please do not reproduce, redistribute or share without the prior express permission of the author. 8. Privacy or Confidentiality - save guard another person’s confidentiality or information. 9. One process - entitlement of all employees to have certain procedures followed when they believe their rights are in jeopardy. 10. Sexual harassment - any type of gender harassment is seen as one person exerting power over another. Please do not reproduce, redistribute or share without the prior express permission of the author.  READING/ LEARNING REFERENCES TEXTBOOKS George D Pozgar (2004) Publisher: Jones and Barlett: Legal aspect of Healthcare Administration. (9th Edition) MAIN REFERENCES Jonsen Albert R (2006) Publisher: McGraw Hill Medical Publishing. Clinical Ethics: A Practical Approach to Ethical Decision in Clinical Medicine. Please do not reproduce, redistribute or share without the prior express permission of the author.  Thank you Address Telephone Website Lot 33-40, Blok C, Plaza Juta, +6088 431 025/35 kk.cyberjaya.edu.my KM 7.2 Off Jalan Tuaran, 88400 Likas, Kota Kinabalu, Email Sabah, Malaysia [email protected]