Dales GPEC

Medical Ethics

www.bradfordvts.co.uk

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Dales GPEC

Frameworks

• Variety of them exist.

• Will present three.

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Dales GPEC

Tavistock Principles• Rights.

– People have a right to health and health care.

• Balance.– Care of individual patients is central, but the

health of populations is also our concern.

• Comprehensiveness.– In addition to treating illness, we have an

obligation to ease suffering, minimise disability, prevent disease, and promote health.

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Dales GPEC

Tavistock Principles

• Cooperation.– Health care succeeds only if we

cooperate with those we serve, each other, and those in other sectors.

• Improvement.– Improving health care is a serious

and continuing responsibility.

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Dales GPEC

Tavistock Principles

•Safety.–Do no harm.

•Openness.–Being open, honest, and

trustworthy is vital in health care.

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Dales GPEC

Justice in Health Care

•Health.–Health systems should pursue

health as their primary goal.

•Access.–Health systems should provide

care primarily according to need rather than ability to pay.

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Dales GPEC

Justice in Health Care

•Accountability.–Consumers, providers, and

healthcare institutions must take responsibility for health and healthcare resources with which they are entrusted .

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Dales GPEC

Justice in Health Care • Choice.

– Consumers must have the real ability to choose their healthcare systems, providers, and treatments in order to seek the best value in health care for themselves.

• Education.– Education of consumers, providers, and

institutions regarding value and quality in health care is necessary for responsible and informed health choices.

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Dales GPEC

MDU

Beneficence Non-maleficence Justice Autonomy

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Dales GPEC Tavistock Principles

•Rights.•Balance.•Comprehensiveness.•Cooperation.• Improvement.•Safety.•Openness.

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Dales GPEC

Case to DiscussA doctor working in an NHS trust thinks it wrong that his patients will be denied a new treatment for cancer (the hospital formulary committee had decided that it should not be prescribed). Should he contact the local media? Should the trust punish him if he does?

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Dales GPEC Case to DiscussA health maintenance organisation in the United States considers investing in improvements in its system for caring for patients with AIDS. The vice president for marketing warns that such improvements may lead to selective enrolment of unprofitable membersnamely, those with HIV infection. Is the organisation ethically bound to improve its HIV care, even if that may reduce its financial viability?

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Dales GPEC

Case to Discuss

Managers of a health provider discover that one of their nurses is infected with HIV but has told nobody. Should they release the nurse's name to the media? Should they notify all those who may have been treated by the nurse even though the chances of anybody being infected are vanishingly small?

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Dales GPEC

Case to Discuss

A infertility specialist writes to ask if a patient of his can select the gender of a child because he has a patient who want a girl to balance their family.