Date post: | 10-Feb-2018 |
Category: |
Documents |
Upload: | marc-imhotep-cray-md |
View: | 224 times |
Download: | 0 times |
of 22
7/22/2019 IVMS Shaping Professionalism: Bioethics III
1/22
Marc Imhotep Cray, M.D.
Shaping Professionalism:Bioethics III
Medical EthicsPrepared and presented by
Marc Imhotep Cray, M.D.Basic Medical Sciences and Clinical Knowledge (CK) Teacher
http://www.imhotepvirtualmedsch.com/http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
2/22
Marc Imhotep Cray, M.D.
Medical ethics Medical ethics is grounded in
philosophical ethics, it concerns itself
with the ethical questions and dilemmasin medicine.
Medical ethics is not any special ethics
but an ethics which deals with specialcases from medical practice.
http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
3/22
Marc Imhotep Cray, M.D.
Doctor-patient relationship Medical ethics has three centres:
doctor, patient and society.
Its centre is the doctor-patientrelationship.
http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
4/22
Marc Imhotep Cray, M.D.
The moral duties of the doctor The duty to help, cure
The duty to promote and protect the patients
health The duty to inform
The duty to confidentiality
The duty to protect the patients life
The duty to respect the patients autonomy
The duty to protect privacy
The duty to respect the patients dignity
http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
5/22
Marc Imhotep Cray, M.D.
The moral rights of the patient The right to high quality medical service
The right to autonomous choice
The right to decide
The right to be informed
The right to privacy The right to health education
The right to dignity
http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
6/22
Marc Imhotep Cray, M.D.
Principles of biomedical ethics Nonmaleficence
Beneficence
Respect for autonomy
Justice
http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
7/22Marc Imhotep Cray, M.D.
Hippocratic oath
5-4 centuries B.C.An obligation of nonmaleficence and an
obligation of beneficence are both
expressed in the Hippocratic oath:
I will use treatment to help the sickaccording to my ability and judgement,
but I will never use it to injure or wrongthem.
http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
8/22Marc Imhotep Cray, M.D.
Nonmaleficence and
beneficence The principle of nonmaleficence asserts
an obligation not to inflict harm
intentionally. Principles of beneficencepotentially demand more than theprinciple of nonmaleficence, because
agents must take positive steps to helpothers, not merely refrain from harmfulacts.
http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
9/22Marc Imhotep Cray, M.D.
The differerence of two
principles Nonmaleficence
One ought not to
inflict evil or harm
Beneficence
One ought to
prevent evil or harmOne ought toremove evil or harm
One ought to do orpromote good
http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
10/22Marc Imhotep Cray, M.D.
The concept of autonomy The word autonomy is derived from the
Greek autos (self) and nomos (rule,
governance or law). It was first used to referto the self-rule or self-governance ofindependent Hellenic city-states. Autonomyhas since been extended to individuals and
has acquired meanings as diverse as self-governance, liberty rights, privacy, individualchoice, freedom of the will, causing onesbehaviour, and being ones own person.
http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
11/22Marc Imhotep Cray, M.D.
Autonomous personWe analyze autonomous persons intems of
liberty(independence from controllinginfluences)
agency(capacity for intentional action)
http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
12/22Marc Imhotep Cray, M.D.
Autonomous actionWe analyze autonomous action in termsof persons who act
Intentionally
Withunderstanding
Without controlling influencesthatdetermine their action
http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
13/22Marc Imhotep Cray, M.D.
To respect an autonomous
agentis to acknowledge that persons right to holdviews, to make choices, and to take actionsbased on personal values and beliefs. Suchrespect involves respectful action, not merelya respectful attitude. Respect involvestreating persons to enable them to actautonomously, whereas disrespect forautonomy involves attitudes and actions thatignore, insult, or demean others autonomyand thus deny a minimal equity to persons.
http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
14/22Marc Imhotep Cray, M.D.
Informed consent is
analyzable through the account of autonomous choice. A
person must do more than express
agreement or comply with a proposal. He/shemust authorize through an act of informedand voluntary consent.
in terms of the social rules of consent in
institutions that must obtain legally validconsent from patients or subjects beforeproceeding with therapeutic procedures orresearch.
http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
15/22Marc Imhotep Cray, M.D.
The standards used to
determine the incompetence Inability to express or communicate a
preference or choice.
Inability to understand ones situation and itsconsequences.
Inability to understand relevant information.
Inability to give a (rational) reason.
Inability to give risk/benefit related reasons. Inability to reach a reasonable decision.
http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
16/22Marc Imhotep Cray, M.D.
Paternalism
Defined as the intentional overriding of onepersons known preferences or actions byanother person, where the person who
overrides justifies the action by the goal ofbenefiting or avoiding harm to the personwhose will is overriden.
http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
17/22Marc Imhotep Cray, M.D.
Weak paternalism
In weak paternalism an agentintervenes on ground of beneficence or
nonmaleficence only to preventsubstantially nonvoluntary conduct, i.e.to protect persons against their own
substantially nonautonomous actions.
http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
18/22Marc Imhotep Cray, M.D.
Strong paternalismStrong paternalism involves interventionsintended to benefit a person despite thefact that the persons risky choices and
actions are informed, voluntary andautonomous.
http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
19/22Marc Imhotep Cray, M.D.
A central problem inbiomedical ethics
Whether respect for autonomy ofpatients should have priority over
professional beneficence.
http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
20/22Marc Imhotep Cray, M.D.
The concept of justice
The terms fairness, desert (what isdeserved), and entitlement (that to whichone is entitled) have been used by variousphilosophers in attempts to explicate
justice. These accounts all interpret justiceas fair, equitable, and appropriate
treatment in light of what is due or owedto person.
http://www.imhotepvirtualmedsch.com/http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
21/22Marc Imhotep Cray, M.D.
Principles of distributive justice
To each person an equal share (formalequity)
To each person according to need
To each person according to effort To each person according to contribution
To each person according to merit
To each person according to free-marketexchanges
R f R d
http://www.imhotepvirtualmedsch.com/http://www.imhotepvirtualmedsch.com/7/22/2019 IVMS Shaping Professionalism: Bioethics III
22/22
Reference Resources andFurther Study
Bioethics Online Study Recourses
NIH - Bioethics ResourcesUniversity of Toronto - Joint Center for BioethicsWorld Medical Association - Medical Ethics Manual
Virtual Mentor
Video Education (drimhoteptv)
IVMS-MEDICAL ETHICS & PROFESSIONALISM12 videos, 3 hrs. and 16 min.http://www.youtube.com/playlist?list=PL08E700EA3F8313EB
E-Textbook
Medical Ethics Today: The BMAs handbook of ethicsand law Books; 3 edition (January 30, 2012)Updateshttp://bma.org.uk/practical-support-at-work/ethics/medical-ethics-today
Best Price $148.33or Buy New $181.49
http://bioethics.od.nih.gov/http://www.jointcentreforbioethics.ca/http://www.wma.net/en/30publications/30ethicsmanual/index.htmlhttp://virtualmentor.ama-assn.org/http://www.youtube.com/playlist?list=PL08E700EA3F8313EBhttp://www.youtube.com/user/drimhoteptvhttp://www.youtube.com/playlist?list=PL08E700EA3F8313EBhttp://www.youtube.com/playlist?list=PL08E700EA3F8313EBhttp://www.youtube.com/playlist?list=PL08E700EA3F8313EBhttp://www.youtube.com/playlist?list=PL08E700EA3F8313EBhttps://drive.google.com/file/d/0B01zkigSrsyFeDY0WFJ0WW12T2c/edit?usp=sharinghttp://bma.org.uk/practical-support-at-work/ethics/medical-ethics-todayhttps://www.amazon.com/gp/offer-listing/1444337084/ref=as_li_tf_til?tag=rbwo1na-20&camp=0&creative=0&linkCode=am1&creativeASIN=1444337084&adid=1AV7D5T4Y167QXTCF3CG&https://www.amazon.com/dp/1444337084/ref=as_li_tf_til?tag=rbwo1na-20&camp=0&creative=0&linkCode=as1&creativeASIN=1444337084&adid=1AV7D5T4Y167QXTCF3CG&https://www.amazon.com/gp/offer-listing/1444337084/ref=as_li_tf_til?tag=rbwo1na-20&camp=0&creative=0&linkCode=am1&creativeASIN=1444337084&adid=1AV7D5T4Y167QXTCF3CG&https://www.amazon.com/gp/offer-listing/1444337084/ref=as_li_tf_til?tag=rbwo1na-20&camp=0&creative=0&linkCode=am1&creativeASIN=1444337084&adid=1AV7D5T4Y167QXTCF3CG&http://bma.org.uk/practical-support-at-work/ethics/medical-ethics-todayhttp://bma.org.uk/practical-support-at-work/ethics/medical-ethics-todayhttp://bma.org.uk/practical-support-at-work/ethics/medical-ethics-todayhttp://bma.org.uk/practical-support-at-work/ethics/medical-ethics-todayhttp://bma.org.uk/practical-support-at-work/ethics/medical-ethics-todayhttp://bma.org.uk/practical-support-at-work/ethics/medical-ethics-todayhttp://bma.org.uk/practical-support-at-work/ethics/medical-ethics-todayhttp://bma.org.uk/practical-support-at-work/ethics/medical-ethics-todayhttp://bma.org.uk/practical-support-at-work/ethics/medical-ethics-todayhttp://bma.org.uk/practical-support-at-work/ethics/medical-ethics-todayhttp://bma.org.uk/practical-support-at-work/ethics/medical-ethics-todayhttps://drive.google.com/file/d/0B01zkigSrsyFeDY0WFJ0WW12T2c/edit?usp=sharinghttps://drive.google.com/file/d/0B01zkigSrsyFeDY0WFJ0WW12T2c/edit?usp=sharinghttp://www.youtube.com/playlist?list=PL08E700EA3F8313EBhttp://www.youtube.com/playlist?list=PL08E700EA3F8313EBhttp://www.youtube.com/playlist?list=PL08E700EA3F8313EBhttp://www.youtube.com/playlist?list=PL08E700EA3F8313EBhttp://www.youtube.com/watch?v=EpKG0VbZTGo&list=PL08E700EA3F8313EBhttp://www.youtube.com/user/drimhoteptvhttp://www.youtube.com/playlist?list=PL08E700EA3F8313EBhttp://virtualmentor.ama-assn.org/http://www.wma.net/en/30publications/30ethicsmanual/index.htmlhttp://www.wma.net/en/30publications/30ethicsmanual/index.htmlhttp://www.wma.net/en/30publications/30ethicsmanual/index.htmlhttp://www.wma.net/en/30publications/30ethicsmanual/index.htmlhttp://www.jointcentreforbioethics.ca/http://www.jointcentreforbioethics.ca/http://www.jointcentreforbioethics.ca/http://www.jointcentreforbioethics.ca/http://bioethics.od.nih.gov/http://bioethics.od.nih.gov/http://bioethics.od.nih.gov/http://bioethics.od.nih.gov/http://www.imhotepvirtualmedsch.com/