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TOK Oral - Medical Ethics
Transcript of TOK Oral - Medical Ethics
Ethics tries to find a beneficial balance between the activities of the individuals and its effects on a collective. (Cardiogram Effect) What are Medical Ethics? Autonomy The patient has the right to refuse or choose their treatment. Beneficence A practitioner should act in the best interest of the patient. Non-maleficence "First, do no harm." Justice Concerns the distribution of scarce health resources, and the decision of who gets what treatment (fairness and equality). Dignity The patient (and the person treating the patient) have the right to be treated with dignity. Truthfulness and Honesty Informed consent and confidentiality. Medical ethics may be personally altered by one's... Culture
E.g. Indian doctors may deny treatment to the "untouchables".
E.g. A Christian may deny treatment to a Muslim or vice-versa.
E.g. Greed. Doctors exaggerate the extent of diseases so that they can recommend more complicated treatment and thus make more money. Declaration of Professional Responsibility: Allows physicians to take an oath, so that they promise to remain truthful within all of their practices. Are oaths taken by physicians substantial enough to block the passage of individual beliefs and values into the subjective process of treating health issues? Would the medical field benefit from getting rid of physicians altogether and replacing them with mechanical equipment that would inform patients of all treatment options so that culture, religion and personal biases no longer stand in the way of the patients' options? To what extent do such humanistic aspects such as personal values, cultures, religions, etc. affect one's own sense of ethics when treating health problems and how do they harm the healing process, altogether? The following two cases address patient autonomy. The first involves the rights of an individual to decide her own fate, even against her physicians' judgments. The second case involves the rights of a parent to care for her child in the manner that she sees fit.
YOU BE THE JUDGE. Case Scenarios A woman enters the emergency room with stomach pain. She undergoes a CT scan and is diagnosed with an abdominal aortic aneurysm, a weakening in the wall of the aorta which causes it to stretch and bulge. The physicians inform her that the only way to fix the problem is surgically, and that the chances of survival are about 50/50. They also inform her that time is of the essence, and that should the aneurysm burst, she would be dead in a few short minutes. The woman is a model; she worries that the surgery will leave a scar that will negatively affect her work; therefore, she refuses any surgical treatment. Even after much pressuring from the physicians, she adamantly refuses surgery. Feeling that the woman is not in her correct state of mind and knowing that time is of the essence, the surgeons decide to perform the procedure without consent. They anesthetize her and surgically repair the aneurysm. She survives, and sues the hospital for millions of dollars. Case 1 You are a general practitioner and a mother comes into your office with her child who is complaining of flu-like symptoms. Upon entering the room, you ask the boy to remove his shirt and you notice a pattern of very distinct bruises on the boy's torso. You ask the mother where the bruises came from, and she tells you that they are from a procedure she performed on him known as "cao gio," which is also known as "coining." The procedure involves rubbing warm oils or gels on a person's skin with a coin or other flat metal object. The mother explains that cao gio is used to raise out bad blood, and improve circulation and healing. When you touch the boy's back with your stethoscope, he winces in pain from the bruises. You debate whether or not you should call Child Protective Services and report the mother. Case 2 Do you believe that the physician's actions can be justified in any way?
Is there anything else that they could have done?
Is it ever right to take away someone's autonomy? (Would a court order make the physicians' decisions ethical?)
What would you do if you were one of the health care workers? Should we completely discount this treatment as useless, or could there be something gained from it?
When should a physician step in to stop a cultural practice?
Should the physician be concerned about alienating the mother and other people of her ethnicity from modern medicine?
Do you think that the physician should report the mother? When can conflicts/ethical dilemmas occur? Autonomy vs. Beneficence/Non-maleficence Euthanasia Communication & Confidentiality Medical Ethics in an online world Conflicts of Interest Vendor relationships
Treatment of family members Is it better to live longer in pain or die earlier with less suffering?
Ex. 1- Reporting gunshot wounds
Ex. 2 - Revealing STD to a spouse
Ex. 3- Revealing teenage pregnancy to patient’s parents
Abortion- When does life begin? Is it ethical to terminate a pregnancy with a birth defect? Does rape justify abortion?
Genetic and prenatal testing: What if testing shows that your unborn baby has a defect?
Birth control: Should it be available to minors?
Your personal health information: Who has access to your records?
When you talk with your doctor, is it ethical for her to withhold information from you or your family?
Organ Transplants Other cases...