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Ethics

Introduction to Ethics

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Zohaib Maqbool
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14 views24 pages

Ethics

Introduction to Ethics

Uploaded by

Zohaib Maqbool
Copyright
© © All Rights Reserved
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
Download as pptx, pdf, or txt
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Introduction to ethics

• Integration of Ethics with Clinical Practice Ethics play as great a role in


clinical practice as the other skills required of a doctor:
• Moral Component + Technical Component = Patient Care
Values
• Values are basic and fundamental beliefs that guide or motivate
attitudes or actions.
• They help us to determine what is important to us. Values describe the
personal qualities we choose to embody to guide our actions; the sort of
person we want to be; the manner in which we treat ourselves and
others, and our interaction with the world around us.
• They provide the general guidelines for conduct.
• Generally, people are predisposed to adopt the values that they are
raised with. People also tend to believe that those values are “right”
because they are the values of their particular culture.
Moral Values
• Morals are formed from the inborn values. Moral is a system of
beliefs that is taught for deciding good or bad whereas values are
personal beliefs or something that comes from within. These are
emotionally related for deciding right or wrong.
• Some examples of moral values include faithfulness in marriage,
loyalty to a company, love and respect for family members, and
commitment to a skill that carries meaning. Morals build on values
to form specific, context-driven rules that govern a person's behavior
• courage is one such value. Those who value courage are willing to
stand up for what they believe, even in the face of strong
condemnation.
• Courage is a moral value when it deals with right and wrong conduct.
Ethical Issue
• The routine day to day ethical issues to which a “right” answer is
usually available by referring to Code of ethics.
• Identifying the issue is important to solve it.
• Mostly goes unnoticed
Ethical Dilemma
Ethical dilemma exists when two or more ethical principles are
conflicting with each other
• Making a difficult choice --- a Dilemma
• Structured approach is required identifying, analyzing and resolving
ethical
• Principles of Biomedical Ethics aimed to identify healthcare’s
“common morality”. These are its four principles:
• Respect for autonomy
• Beneficence
• Non-maleficence
• Justice
• These principles are often in tension with one another, but all
healthcare workers and researchers need to factor each into their
reflections on what to do in a situation.
• Respecting autonomy isn’t just about waiting for
someone to give you the OK. It’s about
empowering their decision making so you’re
confident they’re as free as possible under the
circumstances.
Principalism
• Thomas L Beauchamp (1939—present) and James F Childress (1940—
present) are American philosophers, best known for their work in
medical ethics. Their book Principles of Biomedical Ethics was first
published in 1985, where it quickly became a must read for medical
students, researchers, and academics.
Respect for autonomy

• Beauchamp and Childress were writing at a time when the expertise of doctors
meant they often took extreme measures in doing what they had decided was in the
best interests of their patient. They adopted a paternalistic approach, treating their
patients like uninformed children rather than autonomous, capable adults. This went
as far as performing involuntary sterilisations. In one widely discussed court case in
bioethics, Madrigal v Quillian, ten Latina women in the US successfully sued after
doctors performed hysterectomies on them without their informed consent.
• Legally speaking, the women in Madrigal v Quillian had provided consent. However,
Beauchamp and Childress explain clearly why the kind of consent they provided isn’t
adequate. The women – who spoke Spanish as a first language – were all being given
emergency caesareans. They were asked to sign consent forms written in English
which empowered doctors to do what they deemed medically necessary.
Nonmaleficence: ‘first do no
harm’
• Medicine routinely involves doing things most people would consider
harmful. Surgeons cut people open, doctors write prescriptions for
medicines with a range of side effects, researchers give sick people
experimental drugs – the list goes on
• This is clearly too broad a definition of harm to be useful. Instead,
Beauchamp and Childress provide some helpful nuance, suggesting in
practice, ‘first do no harm’ means avoiding anything which
is unnecessarily or unjustifiably harmful. All medicine has some risk.
The relevant question is whether the level of harm is proportionate to
the good it might achieve and whether there are other procedures
that might achieve the same result without causing as much harm.
Beneficence: do as much good
as you can
• Some people have suggested Beauchamp and Childress’s four
principles are three principles. They suggest beneficence and non-
maleficence are two sides of the same coin.
• Beneficence refers to acts of kindness, charity and altruism. A
beneficent person does more than the bare minimum. In a medical
context, this means not only ensuring you don’t treat a patient badly
but ensuring you treat them well.
• The principle of beneficence can often clash with the principle of
autonomy. If a patient hasn’t consented to a procedure which could
be in their best interests, what should a doctor do?
Justice: distribute health
resources fairly
• Healthcare often operates with limited resources. As much as we
would like to treat everyone, sometimes there aren’t enough beds,
doctors, nurses or medications to go around. Justice is the principle
that helps us determine who gets priority in these cases.
Conclusion
• • When attempting to resolve an ethical challenge in practice, you
should determine if it is an issue or a dilemma.
• • Distinguish between personal and professional dimensions; and
identify the ethical, moral, legal, and values considerations in the
situation.
• • After conducting this preliminary analysis, an ethical decision-
making model can then be appropriately applied

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