Ben Sturgess
400 BC - Hippocratic Oath
1948 - Declaration of Geneva
2006 - Good Medical Practice
1.
I solemnly pledge to consecrate my life to the service of humanity;
2.
I will give to my teachers the respect and gratitude that is their due;
3.
I will practice my profession with conscience and dignity;
4.
The health of my patient will be my first consideration;
5.
I will respect the secrets that are confided in me, even after the patient has died;
6.
I will maintain by all the means in my power, the honour and the noble traditions of the medical profession;
7.
My colleagues will be my sisters and brothers;
8.
I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political
affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;
9.
I will maintain the utmost respect for human life;
10.
I will not use my medical knowledge to violate human rights and civil liberties, even under threat;
11.
I make these promises solemnly, freely and upon my honour
C
lassifying actions as right or wrong
V
irtue Ethics
C
onsequentialism Utilitarianism vs Egoism
D
eontology Duty based Ethics
P
lato, Aristotle, Thomas Aquinus
V
irtues - the behaviours that allow a good life. Arête
P
ractical wisdom – the reasoning when two virtues
are in conflict. Phronesis E.g. Compassion vs Honesty
F
lourishing – The outcome of practicing the wise
and virtuous life. Eudiamonia
C
ardinal Western Virtues Temperance
To act in moderation
Prudence
To judge between actions
Fortitude
To confront fear and pain
Justice
Moderation between self and others
Christian
Faith, Hope and Charity (Love) Corinthians 13:13
Romans
Authority, Humour, Mercy, Dignity, Tenacity, Frugalness, Gravity, Respectability, Humanity, Industriousness, Dutifulness, Prudence, Wholesomeness, Sternness, Truthfullness
Buddist
Right Viewpoint, Values, Speech, Action, Livelihood, Effort, Mindfulness, Meditation
Samurai
Not to be outdone in Bushido, Be use to one’s master, Filial to ones parents, Manifest great compassion
Jeremy
Bentham 1861
An action is determined solely by its contribution to overall utility – The Greatest Happiness
Act – Look at potential actions and chose that which
promotes greatest happinessR
ule – Look at the rule that leads to action and chose the
rule that if continually followed leads to the greatest utility – The rule of not killing people
Karl Popper 1945
Negative Utilitarianism Do the Least Harm The relief of suffering
Immanuel Kant
– 1724-1804V
alue of acts are not based on goodness or badness of outcomes.P
rerogatives – Agents do not always seek the best outcomeC
onstraints – Limitations on the actions that an agent can take
Contingent duties (circumstantial)
The Duties of a Doctor GMC 2006
Categorical imperative
(absolute) Based on priori (independent of experience) reasoning about
the nature of things. “the duty to promote human freedom and rationality”
B
enificence - Salus aegroti suprema lex
Make the care of your patient your first concern
N
on-malificence - primum non nocere
First do no harm
Protect and promote the health of patients and the public
Double Effect – You can act if your intention is in the
patients best interest but leads to his demise
Autonomy - Voluntas aegroti suprema lex
The patient has the right to choose or refuse treatment
Respect patients' right to reach decisions with you about their treatment and care
The right of self determination Article 19 - Universal declaration of Human Rights
Justice
The distribution of scarce resources Egalitarianism – The equal distribution of resources Utilitarian Bioethics - QuALYs
D
ignity Treat patients politely and considerately
Respect patients' right to confidentiality
H
onesty Be honest and open and act with integrity
Informed Consent
Do you have any ?
Codes of Ethics – Duties of a Doctor
Ethical Theories
Virtue Utilitarianism - Bentham Deontological – Kant
Values of Medical Ethics - Framework
Beneficence Non-maleficence Autonomy Justice Dignity Honesty
http://
en.wikipedia.org/wiki/Ethics
Being Good
– Simon Blackburn Oxford Paperbacks ISBN-10: 0192853775
Medical Ethics & Law: An introduction – Victoria Tippett
Radcliffe Publishing ISBN-10: 1857758943