Fritz Jahr as Methodological Paradigm in Bioethical Education
1.01. Bioethical Principles
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Transcript of 1.01. Bioethical Principles
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7/31/2019 1.01. Bioethical Principles
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Bioethical Principles
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Bioethics vs. Medical Ethics
Biomedical Ethics or Bioethics =human life issues.
Medical Ethics = Patient Care
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Why study bioethics?
physician - patient relationship that isconsensual and fiduciary in nature
physician is a healer of anothers body
physician doesnt have a total rightand/or obligation over the patient
physician must be guided by principles
physician must be able to decide oncertain actions or procedures withoutprejudice to the patient
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PRINCIPLE OF
NON-MALEFICENCE
Do no harm
Hippocratic oath: First of all, do noharm.
requires of us that we not intentionallyor directly create a needless harm orinjury to the patient, either through actsofcommission or omission;
affirms the need for medical competence Non maleficence is not necessarily violated
if a proper balance of benefits exists
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PRINCIPLE OF BENEFICENCE
Do good positive expression of non maleficence the duty of health care providers to be of
a benefit to the patient, as well as to takepositive steps to prevent and to removeharm from the patient
highlights that we have a positiveobligation to advance the healthcare
interests and welfare of our patients(including our society) and to assist themin their choices to live life to the fullest
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PRINCIPLE OF LEAST HARM
similar to beneficence, but deals withsituations in which neither choice isbeneficial
In this case, a person should chooseto do the least harm possible andto do harm to the fewest people
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Assignment:
JUSTICE
AUTONOMY
Quizz will serve as a pre and posttest
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PRINCIPLE OF AUTONOMY
"auto" and "nomos" = self-government, self-determination
affirms that we ought to be the
authors of our own fate, the captainof our own ship
moral right of an individual to
determine what is good for himselfmandates a strong sense of
responsibility for ones own life
central element on patients right
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PRINCIPLE OF AUTONOMY
Implicationsa person has a right to determine what
will be done to him
Human beings should be allowed tomake decisions for themselveshuman beings should be accepted as
responsible for their own actions anddestinies.
doesnt mean absolute freedom, manstill has to follow the guidelines of morallaw
a duty not to constrain anothers
autonomous choices and actions.
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PRINCIPLE OF AUTONOMY
Positive Assets
enhances a persons worth and self
imageprotects a person from being usedor abused
it develops a mature therapeuticalliance between patient andphysician
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PRINCIPLE OF JUSTICE
rendering what is due or merited
equal distribution of harm andbenefits, of burdens and comforts,of goods and services among thosewho need them
allocation of healthcare resourcesaccording to a just standard
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PRINCIPLE OF JUSTICE
2 basic types
Comparative
what an individual or group receives is
determined by balancing the competingclaims of individuals or groups.
distribution determined by the gravity ofthe condition or need.
Distributive / Non Comparative distribution determined by a certain
principle, rule or standard.
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Hippocratic Oath
Awareness/Idea of a Supreme Being
Honor, integrity, professionalism
Passing on the torch
Beneficence/Non-Maleficence Justice
Value of human life from the womb
Proper referralVeracity
Confidentiality
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The Principle of Justice andSocial Responsibility
Actions are consistent, accountableand transparent
Does not to discriminate on age, sex,religion, race, position or rank
For the greater good of Society
Respect for the LawEquity and Distribution of Burdens &
Benefits
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The Principle of Paternalism
the act of being fatherly to someone
Personal - a person decides on thebasis of ones best knowledge onwhat is good for another
State - refers to the control exertedby legislature, an agency or othergovernmental body over particularpractices and procedures in medicine
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PersonalThe person is sick and seeks medical
expertise and assistance, part ofpatients autonomy is transferred tothe physician upon consultation
The recipient has some incapacitywhich prevents decision making
There is possibility of harm unless a
paternal decision is made, benefit ofintervention outweighs that of non-interference, best interest of thepatient
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State Paternalism
To improve the quality of medicaleducation
To upgrade the standard of medicalcare
To control health related conditionssuch as drug addiction, spread ofAIDS, and other communicablediseases
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The Principle of Veracity
Truth telling
Obligation to full and honestdisclosure
If you override this principle:
You endanger doctor-patient
relationship which is based on trustYou offend against the principle of
autonomy
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Fosters trust and shows respect
Helps patients to become informed
participants in health care decisionsAffirms the human and moral quality
of the patient
The facts belong to the patient,entrusted to the physician
Withholding information in life and
death situations deprives the patientof time for preparation
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It may be justified to withholdinformation when:
There is compelling reason to thinkthat disclosure would create a realand predictable harmful effect on the
patientThe patient states an informed
consent not to be told the truth
What if the patients family asks youto withhold a terminal/seriousdiagnosis and prognosis?
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2 Types of approach
Person Oriented
- The physician has a moral obligationto inform the patient about hiscondition
Problem-oriented
- Considers the nature of the patientsproblem, illness or condition
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The Principle of Confidentiality Based on loyalty and trust
Maintain the confidentiality of all personal,medical and treatment information
Information to be revealed only with
consent and for the benefit of the patient Except when ethically and legally required
Disclosure should not be beyond what is
required
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Patient gives a written and validconsent
To other participating professionals
Statutory requirements
Ordered by Court
Public interestApproved Research
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Sanctity/Inviolability of Life
Life is inviolable because it came
from God
Only God has complete control anddominion over life
Mans life is holy and has an eternaldestiny
Each individual, regardless of the
state of health, is not to be used asmeans, and is to be treated withdignity because he is valuable
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Dignity of the Human Person
Created in the likeness and image ofGod
Endowed with intelligence to knowand a free will to decide or choose
Called into existence in relation toGod
Each person is unique andirreplaceable
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Christian Ethical Principles
Stewardship/Accountability
Totality
Double EffectCooperation
Subsidiarity
SolidarityPersonalized Sexuality