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Ethical Principles

Ethical Principles. Autonomy and Beneficence. Autonomy. Right to make one’s own choices Respect for persons- not to interfere with choice of another, though persuasion permitted. Obligation to treat persons as capable of choice unless good evidence against. Features of Autonomy.

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Ethical Principles

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  1. Ethical Principles Autonomy and Beneficence

  2. Autonomy • Right to make one’s own choices • Respect for persons- not to interfere with choice of another, though persuasion permitted. • Obligation to treat persons as capable of choice unless good evidence against.

  3. Features of Autonomy • Free action: (1) Voluntary without coercion; (2) Intentional- informed and understand consequences. • Authentic choice- consistent with one’s beliefs, values and life plan. • Effective deliberation- aware of alternatives and consequences.

  4. Coercion-Definition • Agent intends to influence other person by presenting a severe threat which must be (a) credible and (b) irresistible.

  5. Manipulation Intentional and successful influence of a person by noncoercive altering of (a) choices available to the person or (b) perception of these choices.

  6. Beneficence • One ought to do or promote good. • Non-malficience- not to inflict harm or evil.

  7. Central Questions Must the help be active or passive? How does one know what is the good of the other?

  8. Proportionality Principle • What is the level of good intended or level of harm risked or permitted? • What is the probability of the good or harm? What are the actual causal influences?

  9. Proportionality Applied • Context: Applied only if not against individual autonomy and dignity. • There must be proportionate good to permit risk of harmful. • Are there alternatives?

  10. Paternalism • A is acting paternalistically toward S in and only if A’s behavior indicates that (1) The action benefits S; (2) The action involves violating a moral rule with regard to S; (3) The action does not have S’s present or forth-coming consent; and (4) S is competent to give consent.

  11. Informed Consent • Protect subject’s status as a human being (dignity rights) • Promote individual autonomy • Prevent fraud and duress Goals of Informed Consent Professional Obligation

  12. Informed Consent • Must be competent to consent. -able to rationally deliberate; to have adequate understanding and to give reasonable assessment of consequences. • Must be free from coercion or manipulation. • Must have adequate and relevant information- • Four standards: (1) Patient preference; (2) Professional custom; (3) Prudent (reasonable) person; and (4) Subjective substantial rule. Must be autonomous Effects on life, health, lifestyle, values, family, religious beliefs, friends and society.

  13. Informed Consent • Standard medical practice- • Primary exceptions: (1) Therapeutic privilege-withhold information to protect the health of the patient.- watch for paternalism • (2) Emergency conditions- unable to consent, life is in danger and immediate treatment is needed. • Major question- informed consent ever be over-ridden? Medical Practice Ethical Practice

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