Ethics

• Particular moral principles

  • Cultural norms/family norms
  • Religious codes
  • Organizations (ex. hospitals)
  • Professional Codes
• Four topics method

  1. Gather the facts
  2. Define the central ethical dilemma using the four principle approach
  3. Explore the specifics for the clinical case
  4. Discuss and come to resolution
• Four principle clusters:

  1. Respect for autonomy (informed consent, privacy & confidentiality)
  2. Beneficence (compassion, fidelity and veracity)
  3. Nonmaleficence (futile or pointless treatments, rule of double effect)
  4. Justice (fairness and equitable distribution of benefits & burdens)
• Respect for autonomy:

  • Freedom to act in a self-determined manner
  • Refers to the right to make one's own decisions regarding treatment options
  • May be suspended if a client is incapable of self-rule such as infants and suicidal clients
• Derivative principles of autonomy:

  • privacy and confidentiality
  • advocacy
  • informed consent
• Beneficence

  • Means doing good
  • Performing deeds of mercy, kindness and charity
  • Preventing or removing harm, promoting good
  • Usually overridden by respect for autonomy
• Derivative principles of beneficence

  • Compassion= caring
  • Fidelity= obligation to be *faithful* to agreements and promises, loyal to patients
  • Veracity= honesty or truthfulness
  • Altruism= deeds of mercy, kindness, charity
• Paternalism

  • Healthcare professionals exercise of unilateral authority over a patient to make decisions usually out of a perceived obligation of beneficence
  • Derivative principle of both beneficence and autonomy
• Nonmaleficence

  • Do no harm
  • obligation to not cause intentional harm
• Derivative principles of nonmaleficence:

  • Due diligence
  • Rule of double effect (causing harm for greater good)
  • Futile or pointless treatments
  • Slippery slope arguments
• Justice

  • Often referred to as an obligation to treat all people fairly
  • Derivative principles: respect for others (all persons are of equal value & importance), equality/impartiality, and veil of ignorance (make justice-based decisions without bias)
• Ethics Committees

  • Write guidelines and policies for organization
  • Provide education, counseling, and support on ethical issues
  • Provide guidance to a competent client, an incompetent client's family, or healthcare providers when ethical issues arise
  • Ensure that relevant facts of a case are brought out
  • Provide support to caregivers
  • Reduce legal risks
  • Forum for diverse views