7864189 the Principles of Bioethics

8/6/2019 7864189 the Principles of Bioethics

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The principles of bioethicsCristina Gavrilovici, MD, MA, PhD

[email protected]
mailto:[email protected]:[email protected]


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1. Respect for Autonomy

2. Beneficence

3. Non maleficence

4. Justice


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Did you make any difficult choices recently?

If you visit a doctor, do you make treatmentdecision on your own or in discussion with otherfamily members and the doctor?

What are the limits to personal choice? (if any)


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rational agents are involved in making informed and

voluntary decisions.

in health care decisions, our respect for theautonomy of the patient would mean that the patienthas the capacity to act intentionally, with

understanding, and without controlling influences

this principle is the basis for the practice of "informedconsent" in the physician/patient transaction regardinghealth care.


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Respect for autonomy

autonomy = freedom + rationalityRights Duties


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In the US: Engelhard: autonomy = permission

European concept of autonomy: shaped by a

Kantian framework: autonomy is built on moralresponsibility, commitment and concern forother human being


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Is autonomy functioning as a leadingmoral principle in all societies?

4 models of patient-physician relationship:

paternalistic

informative

interpretative

deliberative


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What are the characteristicsof a society in which respect

for autonomy can override theother principles?

1. Patients would want to take decisions2. Patients would want to receive informations

3. Physicians would be able and willing to offer theinformation

4. Patients would need to understand the informationand remember it

5. Patients would appropiately debate the medical issues


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Respect for dignity

Dignity concerns the aspect of human life in whichautonomy is not enough to understand:

the emotions of the beginning and at the end oflife

the human body parts commercial


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Respect for integrity

This liberal concept states that no one is entitledto use ones body against ones will: all humans are

owner of the body (?).

If yes, are they entitled to sell parts of their

body if they wish to do so?


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Respect for vulnerability

Social constructed term

To what extent a vulnerable person canfreely and autonomously exercise his/her

rights?


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2. The Principle of

Nonmaleficence This principles requires of us that we not

intentionally harm or injury the patient,

either through acts of commission oromission.

we consider it negligence if one imposes a

careless or unreasonable risk of harm uponanother. In a professional model of care one maybe morally and legally blameworthy if one fails tomeet the standards of due care.


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2. The Principle of

NonmaleficenceThe legal criteria for determining negligence are

as follows:

1. the professional must have a duty to theaffected party

2. the professional must breach that duty

3. the affected party must experience a harm;and

4. the harm must be caused by the breach ofduty.


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3. The Principle of

Beneficence

Choose one example of atechnological advancement andidentify the benefits and risks of

this new technology!


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3. The Principle of

Beneficence

The ordinary meaning of this

principle is the duty of health careproviders to be of a benefit to thepatient, as well as to take positive

steps to prevent and to removeharm from the patient.


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3. The Principle of

Beneficence nonmaleficence is a constant duty, that

is, one ought never to harm anotherindividual.

beneficence is a limited duty.


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4. The Principle of

Justice Justice in health care is usually defined as

a form of fairness.

Distributive justice: some goods andservices are in short supply, there is not

enough to go around, thus some fair meansof allocating scarce resources must bedetermined.


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4. The Principle of

JusticeOur society uses a variety of factors as a

criteria for distributive justice, including thefollowing:1. to each person an equal share2. to each person according to need3. to each person according to effort

4. to each person according to contribution5. to each person according to merit6. to each person according to free-marketexchanges


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What can you do to make thesituation in the world betterfor others? Now and in the

future?

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7864189 the Principles of Bioethics