Ben Sturgess

400 BC - Hippocratic Oath

1948 - Declaration of Geneva

2006 - Good Medical Practice

1.

I solemnly pledge to consecrate my life to the service of humanity;

2.

I will give to my teachers the respect and gratitude that is their due;

3.

I will practice my profession with conscience and dignity;

4.

The health of my patient will be my first consideration;

5.

I will respect the secrets that are confided in me, even after the patient has died;

6.

I will maintain by all the means in my power, the honour and the noble traditions of the medical profession;

7.

My colleagues will be my sisters and brothers;

8.

I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political

affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;

9.

I will maintain the utmost respect for human life;

10.

I will not use my medical knowledge to violate human rights and civil liberties, even under threat;

11.

I make these promises solemnly, freely and upon my honour

C

lassifying actions as right or wrong

V

irtue Ethics

C

onsequentialism Utilitarianism vs Egoism

D

eontology Duty based Ethics

P

lato, Aristotle, Thomas Aquinus

V

irtues - the behaviours that allow a good life. Arête

P

ractical wisdom – the reasoning when two virtues

are in conflict. Phronesis E.g. Compassion vs Honesty

F

lourishing – The outcome of practicing the wise

and virtuous life. Eudiamonia

C

ardinal Western Virtues Temperance

To act in moderation

Prudence

To judge between actions

Fortitude

To confront fear and pain

Justice

Moderation between self and others

Christian

Faith, Hope and Charity (Love) Corinthians 13:13

Romans

Authority, Humour, Mercy, Dignity, Tenacity, Frugalness, Gravity, Respectability, Humanity, Industriousness, Dutifulness, Prudence, Wholesomeness, Sternness, Truthfullness

Buddist

Right Viewpoint, Values, Speech, Action, Livelihood, Effort, Mindfulness, Meditation

Samurai

Not to be outdone in Bushido, Be use to one’s master, Filial to ones parents, Manifest great compassion

Jeremy

Bentham 1861

An action is determined solely by its contribution to overall utility – The Greatest Happiness

Act – Look at potential actions and chose that which

promotes greatest happinessR

ule – Look at the rule that leads to action and chose the

rule that if continually followed leads to the greatest utility – The rule of not killing people

Karl Popper 1945

Negative Utilitarianism Do the Least Harm The relief of suffering

Immanuel Kant

– 1724-1804V

alue of acts are not based on goodness or badness of outcomes.P

rerogatives – Agents do not always seek the best outcomeC

onstraints – Limitations on the actions that an agent can take

Contingent duties (circumstantial)

The Duties of a Doctor GMC 2006

Categorical imperative

(absolute) Based on priori (independent of experience) reasoning about

the nature of things. “the duty to promote human freedom and rationality”

B

enificence - Salus aegroti suprema lex

Make the care of your patient your first concern

N

on-malificence - primum non nocere

First do no harm

Protect and promote the health of patients and the public

Double Effect – You can act if your intention is in the

patients best interest but leads to his demise

Autonomy - Voluntas aegroti suprema lex

The patient has the right to choose or refuse treatment

Respect patients' right to reach decisions with you about their treatment and care

The right of self determination Article 19 - Universal declaration of Human Rights

Justice

The distribution of scarce resources Egalitarianism – The equal distribution of resources Utilitarian Bioethics - QuALYs

D

ignity Treat patients politely and considerately

Respect patients' right to confidentiality

H

onesty Be honest and open and act with integrity

Informed Consent

Do you have any ?

Codes of Ethics – Duties of a Doctor

Ethical Theories

Virtue Utilitarianism - Bentham Deontological – Kant

Values of Medical Ethics - Framework

Beneficence Non-maleficence Autonomy Justice Dignity Honesty

http://

en.wikipedia.org/wiki/Ethics

Being Good

– Simon Blackburn Oxford Paperbacks ISBN-10: 0192853775

Medical Ethics & Law: An introduction – Victoria Tippett

Radcliffe Publishing ISBN-10: 1857758943