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Basics Of Bioethics

by: Isabel Fergenson

Basics Of Bioethics CHS309 Ethical issues common in the helping professions

Isabel Fergenson
GPA 3.4
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About this Document

These notes cover the introduction to Bioethics as well as key terms related to this course. It includes information about an important case regarding bioethical dilemmas. It also includes a guide ...
Ethical Issues in Helping Professions
Dr.Dennis Hill
Class Notes
bioethics, care, health, Healthcare, Society, medical, medical ethics, medical sociology, ethics, Ethical issues, Ethical Issues and Life Choices, Ethical, Issues, In, Practical Ethics




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This 6 page Class Notes was uploaded by Isabel Fergenson on Thursday September 8, 2016. The Class Notes belongs to CHS309 Ethical issues common in the helping professions at University of Arizona taught by Dr.Dennis Hill in Fall 2016. Since its upload, it has received 31 views. For similar materials see Ethical Issues in Helping Professions in Care Health and Society at University of Arizona.

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Date Created: 09/08/16
The Basics of Bioethics Biologist Van Renssalear Potter defined bioethics as: The integration of Biology and values into a “science for  survival” In his book ‘Bioethics: Bridge to the Future.’ Bioethics is also known as Medical Ethics or Biomedical Ethics. This is related to Healthcare Ethics and Clinical Ethics.  Bioethics has roots in ancient Greek and Roman medicine.  Western medicine is often referred to as ‘Hippocratic Medicine’  Due to the influence of thppocrates. He wrote seventy treatises  on illness around the 5  century BCE. Modern doctors take the  Hippocratic Oath which instructs them to Do No Harm.  Doctors are held to a code of benevolence “to do good” and  nonmaleficence  “to cause no harm” Utilitarianism: An ethical theory of consequences. The end  justifies the means. All’s well that ends well. Deontology: An ethical theory of duty. The duty to help others  in ways you’re able.  Virtue: An ethical theory of virtue. A person’s actions are not as important to virtue ethics as their inherent moral character.  Core Principles of Bioethics Respect for Autonomy­ A person’s right to decide what happens to their body. Right to refuse treatment. Right to treatment.  Right to informed consent.  Nonmaleficence: To cause no harm to others.  Beneficence: To do good for others. Justice: Health Care is scarce due to limited resources and  goods related to healthcare, and limited availability of skilled  doctors to provide health services. Justice in health care refers to the fair distribution of care according to objective need. Autonomy: The power and right of an individual to decide what happens to them. A patient’s right to refuse treatment, or a  patient’s ability to make an informed, un­coerced decision.  Informed Consent: Permission granted in the knowledge of the possible consequences, typically by a patient to a doctor for  treatment with full knowledge of all possible and probable  outcomes. Including knowledge of possible risks and benefits. Casuistry: Prudence (cautiousness and discretion) or phronesis  (wisdom in determining ends and the means of attaining them)  Casuistry is the use of clever reasoning in each individual case.  Case­based reasoning. Situational Ethics: ethics can change according to  circumstance. Four box technique The four box method is a case­based approach to ethical  decision making.  The first box consists of Medical Indications: Based on principles of Beneficence and Nonmaleficence.  1. What is the patient’s medical problem? Is the problem  acute? Chronic? Critical? Reversible? Emergent?  Terminal? 2. What are the goals of treatment? 3. In what circumstances are medical treatments not  indicated? 4. What are the probabilities of success of various treatment  options? 5. How can this patient be benefited by medical and nursing  care, and how can harm be avoided? The second box consists of Quality of Life: Based on principles of Beneficence, Nonmaleficence, and  Respect for Autonomy. 1. What are the prospects, with or without treatment, for a  return to normal life, and what physical, mental, and social  deficits might the patient experience even if treatment  succeeds? 2. On what grounds can anyone judge that some quality of life would be undesirable for a patient who cannot make or  express such a judgement? 3. Are there biases that might prejudice the provider’s  evaluation of the patient’s quality of life? 4. What ethical issues arise concerning improving or  enhancing a patient’s quality of life? 5. Do quality­of­life assessments raise any questions  regarding changes in treatment plans, such as forgoing life­ sustaining treatment? 6. What are plans and rationale to forgo life­sustaining  treatment? 7. What is the legal and ethical status of suicide? The third box consists of Patient Preferences, which is based on  the principle of Respect for Autonomy. 1. Has the patient been informed of the benefits and risks,  understood this information, and given consent? (informed  consent) 2. Is the patient mentally capable and legally competent, and  is there evidence of incapacity? 3. If mentally capable, what preferences is the patient stating  in regards to their treatment? 4. Who is the appropriate surrogate to make decisions for the  incapacitated patient? 5. Is the patient unwilling or unable to cooperate with medical treatment? If so, why? The fourth box contains Contextual Features, and is based on  the principles of Justice and Fairness.  1. Are there professional, interprofessional, or business  interests that might create conflicts of interest in the clinical treatment of patients? 2. Are there parties other than clinicians and patients, such as  family members, who have an interest in clinical decisions? 3. What are the limits imposed on patient confidentiality by  the legitimate interest of third parties? 4. Are there financial factors that create conflict of interest in  clinical decisions? 5. Are there problems of allocation of scarce health resources  that might affect clinical decisions? 6. Are there religious issues that might affect clinical  decisions? 7. What are the legal issues that might affect clinical  decisions? 8. Are there considerations of clinical research and education  that might affect clinical decisions? 9. Are there issues of public health and safety that affect  clinical decisions? 10. Are there conflicts of interest within institutions or  organizations that may affect clinical decisions and patient  welfare?  Terri Schiavo­ diagnosed with Persistent Vegetative State due to a brain injury caused by a prolonged lack of oxygen. Her brain  functions were severely reduced to the point where she could not respond to stimuli voluntarily, or comprehend language, she  could not swallow without assistance, and she could not speak  or move from her bed.  Her parents were in favor of keeping her on life support even  though she had previously expressed her desire to not extend her life by artificial means. Her husband entered into a legal battle to have his wife’s wishes realized.  Eventually, her feeding tube was removed and her suffering was allowed to end.  Her parents were driven by Religious Ethics.  They believed that their religion called for the preservation of  life under any circumstances. Christian organizations referred to  her death as ‘murder’.  Her husband’s secular ethics lead him to  fight for the realization of his wife’s end­of­life wishes.


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