Вы находитесь на странице: 1из 32

Major Bioethical Principles

Respect for a Person


Importance of free and

informed consent Principles of Justice Beneficence Inviolability of Life Non-Maleficence

Respect for a Person


Respect as value-

Principle of true and Informed Consent

Principle of autonomy
Any notion of moral decision making

assumes that rational agents are involved in making informed and voluntary decisions. In health care decisions, our respect for the autonomy of the patient would, in common parlance, mean that the patient has the capacity to act intentionally, with understanding, and without controlling influences that would mitigate against a free and voluntary act.

This principle is the basis for the practice of

"informed consent" in the physician/patient transaction regarding health care.

Importance of free and informed consent


Informed Consent- Informed consent is the

process by which a fully informed patient can participate in choices about her health care. It originates from the legal and ethical right the patient has to direct what happens to her body and from the ethical duty of the physician to involve the patient in her health care.

Patients right to information- awareness is

important Proxy consent- is the process by which people with the legal right to consent to medical treatment for themselves or for a minor or a ward delegate that right to another person. There are three fundamental constraints on this delegation:

1.The person making the delegation must

have the right to consent. 2.The person must be legally and medically competent to delegate the right to consent. 3.The right to consent must be delegated to a legally and medically competent adult.

Elements of full informed consent


1. Competence-the nature of the

decision/procedure 2. Disclosure-reasonable alternatives to the proposed intervention 3. Comprehension- assessment of patient understanding 4. Voluntariness- the acceptance of the intervention by the patient

Principles of Justice
Justice in health care is usually defined as a

form of fairness, or as Aristotle once said, "giving to each that which is his due." This implies the fair distribution of goods in society and requires that we look at the role of entitlement.

The question of distributive justice also

seems to hinge on the fact that some goods and services are in short supply, there is not enough to go around, thus some fair means of allocating scarce resources must be determined.

Criteria for justice:


to each person an equal share

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-market

exchanges

Neigborly relations

Types of Justice
Utilitarianism is a form

of consequentialism, where punishment is forward-looking. Justified by the ability to achieve future social benefits resulting in crime reduction, the moral worth of an action is determined by its outcome.

Retributive justice
regulates proportionate response to crime

proven by lawful evidence, so that punishment is justly imposed and considered as morally correct and fully deserved. The law of retaliation(lex talionis) is a military theory of retributive justice, which says that reciprocity should be equal to the wrong suffered; "life for life, wound for wound, stripe for stripe."[7]

Restorative justice
is concerned not so much with retribution

and punishment as with (a) making the victim whole and (b) reintegrating the offender into society. This approach frequently brings an offender and a victim together, so that the offender can better understand the effect his/her offense had on the victim.

Distributive justice
is directed at the proper allocation of

things wealth, power, reward, respect among different people.

Oppressive Law
exercises an authoritarian approach to

legislation that is "totally unrelated to justice", a tyrannical interpretation of law is one in which the population lives under restriction from unlawful legislation.

Beneficence
The ordinary meaning of this principle is

the duty of health care providers to be of a benefit to the patient, as well as to take positive steps to prevent and to remove harm from the patient

These duties are viewed as self-evident and

are widely accepted as the proper goals of medicine. These goals are applied both to individual patients, and to the good of society as a whole.

For example, the good health of a particular

patient is an appropriate goal of medicine, and the prevention of disease through research and the employment of vaccines is the same goal expanded to the population at large.

Inviolability of Life
Crimes against human life: SUICIDE- is the direct, willful destruction

of ones own life. - An easy and painless death

Causes of suicide
Religious

Cultural
Personal problems

Financial
Social reasons

Mutilation

Drug addiction

Sterelization
Is also a form of contraception insofar as its

purpose is the prevention of conception Use of artificial methods by cutting off the sexual capacity in a man or woman. Defined as the mutilation of sexual power in a man or woman so as as to render conception.

Types of Sterelization
Involuntary is that which a persons will

and requests that the procedure be done on himself and herself. Voluntary is that which is done by order of the public authority use!

Euthanasia

Alcoholism

Abortion and others:

Non-Maleficence