1.01. Bioethical Principles

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Bioethical Principles


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Bioethics vs. Medical Ethics

Biomedical Ethics or Bioethics =human life issues.

Medical Ethics = Patient Care


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Why study bioethics?

physician - patient relationship that isconsensual and fiduciary in nature

physician is a healer of anothers body

physician doesnt have a total rightand/or obligation over the patient

physician must be guided by principles

physician must be able to decide oncertain actions or procedures withoutprejudice to the patient


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PRINCIPLE OF

NON-MALEFICENCE

Do no harm

Hippocratic oath: First of all, do noharm.

requires of us that we not intentionallyor directly create a needless harm orinjury to the patient, either through actsofcommission or omission;

affirms the need for medical competence Non maleficence is not necessarily violated

if a proper balance of benefits exists


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PRINCIPLE OF BENEFICENCE

Do good positive expression of non maleficence the duty of health care providers to be of

a benefit to the patient, as well as to takepositive steps to prevent and to removeharm from the patient

highlights that we have a positiveobligation to advance the healthcare

interests and welfare of our patients(including our society) and to assist themin their choices to live life to the fullest


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PRINCIPLE OF LEAST HARM

similar to beneficence, but deals withsituations in which neither choice isbeneficial

In this case, a person should chooseto do the least harm possible andto do harm to the fewest people


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Assignment:

JUSTICE

AUTONOMY

Quizz will serve as a pre and posttest


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PRINCIPLE OF AUTONOMY

"auto" and "nomos" = self-government, self-determination

affirms that we ought to be the

authors of our own fate, the captainof our own ship

moral right of an individual to

determine what is good for himselfmandates a strong sense of

responsibility for ones own life

central element on patients right


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Implicationsa person has a right to determine what

will be done to him

Human beings should be allowed tomake decisions for themselveshuman beings should be accepted as

responsible for their own actions anddestinies.

doesnt mean absolute freedom, manstill has to follow the guidelines of morallaw

a duty not to constrain anothers

autonomous choices and actions.


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Positive Assets

enhances a persons worth and self

imageprotects a person from being usedor abused

it develops a mature therapeuticalliance between patient andphysician


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PRINCIPLE OF JUSTICE

rendering what is due or merited

equal distribution of harm andbenefits, of burdens and comforts,of goods and services among thosewho need them

allocation of healthcare resourcesaccording to a just standard


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PRINCIPLE OF JUSTICE

2 basic types

Comparative

what an individual or group receives is

determined by balancing the competingclaims of individuals or groups.

distribution determined by the gravity ofthe condition or need.

Distributive / Non Comparative distribution determined by a certain

principle, rule or standard.


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Hippocratic Oath

Awareness/Idea of a Supreme Being

Honor, integrity, professionalism

Passing on the torch

Beneficence/Non-Maleficence Justice

Value of human life from the womb

Proper referralVeracity

Confidentiality


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The Principle of Justice andSocial Responsibility

Actions are consistent, accountableand transparent

Does not to discriminate on age, sex,religion, race, position or rank

For the greater good of Society

Respect for the LawEquity and Distribution of Burdens &

Benefits


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The Principle of Paternalism

the act of being fatherly to someone

Personal - a person decides on thebasis of ones best knowledge onwhat is good for another

State - refers to the control exertedby legislature, an agency or othergovernmental body over particularpractices and procedures in medicine


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PersonalThe person is sick and seeks medical

expertise and assistance, part ofpatients autonomy is transferred tothe physician upon consultation

The recipient has some incapacitywhich prevents decision making

There is possibility of harm unless a

paternal decision is made, benefit ofintervention outweighs that of non-interference, best interest of thepatient


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State Paternalism

To improve the quality of medicaleducation

To upgrade the standard of medicalcare

To control health related conditionssuch as drug addiction, spread ofAIDS, and other communicablediseases


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The Principle of Veracity

Truth telling

Obligation to full and honestdisclosure

If you override this principle:

You endanger doctor-patient

relationship which is based on trustYou offend against the principle of

autonomy


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Fosters trust and shows respect

Helps patients to become informed

participants in health care decisionsAffirms the human and moral quality

of the patient

The facts belong to the patient,entrusted to the physician

Withholding information in life and

death situations deprives the patientof time for preparation


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It may be justified to withholdinformation when:

There is compelling reason to thinkthat disclosure would create a realand predictable harmful effect on the

patientThe patient states an informed

consent not to be told the truth

What if the patients family asks youto withhold a terminal/seriousdiagnosis and prognosis?


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2 Types of approach

Person Oriented

- The physician has a moral obligationto inform the patient about hiscondition

Problem-oriented

- Considers the nature of the patientsproblem, illness or condition


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The Principle of Confidentiality Based on loyalty and trust

Maintain the confidentiality of all personal,medical and treatment information

Information to be revealed only with

consent and for the benefit of the patient Except when ethically and legally required

Disclosure should not be beyond what is

required


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Patient gives a written and validconsent

To other participating professionals

Statutory requirements

Ordered by Court

Public interestApproved Research


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Sanctity/Inviolability of Life

Life is inviolable because it came

from God

Only God has complete control anddominion over life

Mans life is holy and has an eternaldestiny

Each individual, regardless of the

state of health, is not to be used asmeans, and is to be treated withdignity because he is valuable


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Dignity of the Human Person

Created in the likeness and image ofGod

Endowed with intelligence to knowand a free will to decide or choose

Called into existence in relation toGod

Each person is unique andirreplaceable


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Christian Ethical Principles

Stewardship/Accountability

Totality

Double EffectCooperation

Subsidiarity

SolidarityPersonalized Sexuality

1.01. Bioethical Principles

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