M1.1: Ethics - Beneficence

• Ethics

  A branch of philosophy that studies and draws conclusions of the degree of goodness and badness of human actions and conduct in relation to the purposes of human living.
• WHAT MAKES HUMAN ACT AN ACT?

  • Intention
  • Circumstances
  • Will

  If one or more is missing from the three, it is not considered a human act.
• Bioethics

  Systematic study of human conduct in the areas of life sciences and of health care, in so far as that conduct is examined from the view point of moral values and principles.
• WHY IS THERE A NEED TO STUDY BIOETHICS IN HEALTHCARE?

  ● There is a HCP-patient relationship

  ○ Patient relationship

  ● The HCP is a healer of another’s body

  ● The HCP does not have a total right and/or bligation over the patient

  ● The HCP must be guided by principles

  ○ Autonomy

  ● The HCP must be able to decide on certain actions/procedures without the prejudice to the patient
• Bioethical Principles

  Autonomy, Beneficence, Non-Maleficence, Justice
• Autonomy

  Refers to the right to make one’s decisions. The principle of autonomy means that the medical practitioner respects a client’s right to make decisions even when those choices seem to the medical practitioner not to be in the client’s best interest In order for the patient to clearly make a decision, explain only the necessary information he/she needed in a patient-friendly manner
• Autonomy


  An adult patient who suffers from no mental incapacity has an absolute right to choose whether to consent to medical treatment
• Autonomy


  Presenting all treatment options to patient
• Autonomy


  Explaining risks in terms that a patient understands
• Autonomy


  Ensuring that a patient understands the risks and agrees to all procedures before going to surgery
• Beneficence

  ● One has the obligation to help others further their important and legitimate interests

  ● For the good of others

  ● The term beneficence refers to actions that promote the wellbeing of others

  ● In medical context, this means taking actions that serve the best interests of patients
• Beneficence


  Resuscitating a drowning victim
• Beneficence


  Encouraging a patient to quit smoking and start an exercise program
• Beneficence


  Talking to the community about STD prevention
• Beneficence


  Talking to the community about STD prevention
• IMPLICATIONS OF BENEFICENCE

  1. There is an obligation to confer benefits that is, doing or promoting good, and actively prevent and remove harm or evil
  2. There is an obligation to weigh and balance the possible good against the possible harm
• THE IMPOSSIBILITY OF DOING ALL GOOD - THIS ARISES FROM LIMITATIONS OF:

  1. The Nature of Time and Space
  2. One's own limitations
  3. The state of the art in a given area, as well as the availability of state of the art tools
  4. One’s obligation to avoid evil
• Nature of time and space

  You will not be able to attend to your clients if you are in a different place or you are attending to other people
• One's own limitations

  Your competency as a student is limited. You would need the help of other people who is competent to do the job. Referral is also an obligation
• The state of the art in a given area, as well as the availability of state of the art tools

  Limited by equipment and facilities. If assigned in a barrio, there are limitations on the resources that a healthcare professional may provide
• One's obligation to avoid evil

  Sometimes we cannot avoid evil in the course of providing healthcare. Example: Adverse effects of drugs are inevitable, but drug is necessary and will do more good than harm
• Beneficence

  It is the duty of the healthcare professional to inform the patient or the significant other about the risks (both known and unknown risks)
• Beneficence

  Doing good and avoiding evil is NOT simply a question of principles but of practical wisdom of knowledge, skills, and common sense weighing the

  relevant aspects of the factual and social situation as well as the concrete meaning of human dignity in a particular time and space.
• Beneficence

  You have to weigh certain aspects, such as the patients social situations, how the provision of healthcare affects the relatives, the patient per se and the meaning of his dignity in a particular time and place
• Beneficence

  In doing good, consider the dignity of patient. “Always treat patients as a human being”