Ethics and Professionalism

TEST TAKING TIP

ETHICS

PRINCIPLES

What is respect for autonomy?

• When the patient has the capacity to act intentionally, with understanding, and without controlling influences that would mitigate against a free and voluntary act, surgeons ought to respect patient decisions, even when those decisions are different from the surgeon's recommendations.

What is beneficence?

• The duty of health care providers is to benefit the patient and to bring about good for the patient.

What is nonmaleficence?

• Health care providers may not intentionally create a needless harm or injury to the patient, through acts of commission or omission. In addition, health care providers ought to take positive steps to remove harm from the patient.

What is justice?

• In our context, it is defined as a form of fairness. This implies the fair distribution of goods and services in society, which are in short supply; thus, some fair means of allocating scarce resources must be determined.

DECISION MAKING—SFNO APPROACH

What is the SFNO approach?

• So Far No Objections = Stakeholders, Facts, Norms, Options

What are the 3 major sources of uncertainty in medical ethics decisions?

1. Different people are involved who have competing interests.

2. Uncertainty or disagreement exists about relevant facts.

3. Uncertainty, conflict, or disagreement exists regarding ethical norms.

Who are the stakeholders?

• Those who will be affected by the decision made. It helps to state why people are stakeholders or how they are affected.

What are the facts?

• They are factual issues that might generate disagreement or are relevant to a solution.

• It may be helpful to refer to the experts or the literature.

What are the norms?

• They are ethical principles (see above), norms, or values that are at stake. Some may be relevant and others only appear to be. For assistance, reference can be made to professional ethical codes or regulations. Advice of colleagues should be sought when it is not clear what ethical principle or principles apply.

What defines the options?

• They are actions or policies as well as compromises that deserve consideration for potential solutions. They may be best arrived at by group brainstorming with others.

JUSTIFYING ETHICAL DECISIONS

How do I justify an ethical decision?

• It depends on the source of the disagreement.

If the source of the disagreement involves the competing ...