<aside> 💡 Ethical Issues in Healthcare

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1. Define what ethics is and how it applies to health care
   • Ethics
     • Standards of right/wrong
     • Prescribe what humans ought to do
     • For good of individual/society
     • Any medical decision takes ethics into consideration
   • Ethics in health care:
     • Clinical:
       • Issues at patient/physician interface
         • Informed consent
         • Truthfulness
     • Institutional
       • Issues within the institution in which medicine is practiced
         • Distribution of resources
   • Influences on ethics:
     • Religion
     • Conscience/intuition
     • Law
     • Risk/benefit analysis
     • Societal norms
2. Describe 4 ethical principles and their application in medical practice
   • Autonomy
     • Greek – autos (self) nomos (law)
     • Our actions result of our own choice
     • Harm principle:
       • Preventing harm to others is only reason to take away autonomy
       • Their own good, either physical or moral not good reasons
     • One is best to decide what is best for themselves
     • Must be weighed up against potential harm to other individual/society:
       • Isolation for COVID-19
     • Examples:
       • Truth telling
       • Gaining informed consent
   • Nonmaleficence
     • Above all do no harm
     • Ought not to inflict evil or harm
     • Intentionally refraining from actions that cause harm:
       • Physical
       • Emotional
       • Cultural
       • Social harm
     • Respecting confidentiality, cultural differences, patient preferences
       • Confidentiality:
         • Respecting patients’ privacy by not disclosing their information to unauthorized/unnecessary parties
         • Circumstances to breach confidentiality
           • Harm to patient (Abuse)
           • Criminal activity
           • Harm to others (threats, infectious disease (notifiable disease), fitness to drive)
   • Beneficence
     • Ought to do or promote good, and prevent/remove evil or harm
     • Beneficence and nonmaleficence:
       • Sometimes need to do harm in order to do good; good outweighs bad
         • Taking blood
         • Surgery
         • Physiotherapy
     • Examples:
       • Patient perspective
       • Patient advocacy
   • Justice:
     • Social
       • Treating patients with a similar diagnosis in a similar way
       • Equitable access to healthcare
     • Distributive
       • Equitable distribution of resources
   • God committee
     • Seattle artificial kidney center
     • Chose who would get dialysis
     • Physicians, lawmaker, community members
     • Age, number of dependents, social value and healthcare access, drug abuse, existing medical consideration, previous transplant failure
     • Utility = best outcome
     • Equity = access
   • TSANZ
     • Ethically irrelevant
       • Race, cultural & religious beliefs, gender, relationship status, sexual orientation
       • Disability
       • Social status
       • Capacity to pay
       • Location of residence
       • Age except where it may affect outcome
     • Ethically relevant
       • Relative urgency of need
       • Medical factors which affect likelihood of success
       • Relative severity
       • Relative time on waiting list
       • Likelihood the recipient will comply with necessary ongoing treatment after transplantation
3. Compare terms rights, obligation and duty
   • Rights
   • Obligations
   • Duty
4. Differentiate between legal and moral rights
5. Differentiate between legal and ethical issues in medical decision making
6. Discuss patient autonomy and informed consent