Short Answer Paper.Ethics

Ethics in Healthcare 1) Define Medical Ethics and Ethical Dilemma? Ans.  Medical Ethics: o Medical ethics is crucial in establishing a framework (Principles and values) for responsible and compassionate patient care, as well as for addressing complex moral issues that may arise in medical practice. o These principles are designed to ensure the well-being and rights of patients, promote fairness and justice, and uphold the integrity and professionalism of healthcare practitioners.  Ethical Dilemma: o An ethical dilemma is a situation in which a person or a group of individuals face conflicting moral principles, making it challenging to determine the right course of action. o In an ethical dilemma, there is no clear, straightforward choice that aligns perfectly with all ethical principles, and any decision made may have both positive and negative ethical consequences. o For example, an ethical dilemma in healthcare could involve a terminally ill patient who expresses a desire to end their life to avoid further suffering. The medical team may grapple with respecting the patient's autonomy and reducing their pain while also adhering to the principles of nonmaleficence and upholding the sanctity of life. o In such cases, healthcare professionals often need to engage in careful ethical deliberation, seeking guidance from medical ethics committees or ethicists, and considering legal and cultural aspects before deciding. 2) Describe the difference between Law and medical Ethics? Ans. Aspect Law Medical Ethics Definition A system of rules and regulations established and enforced by a governing authority to maintain order and resolve disputes within a society or community. A set of moral principles and values that guide healthcare professionals in making decisions and conducting themselves in the field of medicine. Origin Derived from legislation, statutes, and legal precedents set by governments and judicial systems. Arises from a combination of moral, cultural, and professional values within the medical community.

Scope Applicable to all members of society, including healthcare professionals. Specifically tailored to guide healthcare professionals in their interactions with patients and colleagues. Enforcement Non-compliance can lead to legal penalties, fines, imprisonment, or other punitive measures. Non-compliance may lead to professional consequences, such as loss of medical license or damage to one's reputation within the medical community. Purpose To maintain social order, protect individual’s rights, and ensure justice and fairness in society. To ensure responsible and compassionate patient care, uphold professional integrity, and address complex moral issues in medical practice. Focus Primarily concerned with determining the legality or illegality of actions Primarily concerned with determining the morality and ethical appropriateness of actions. Decision- making tools Relies on statutes, court decisions, and legal precedent for interpretation. Relies on ethical principles such as autonomy, beneficence, nonmaleficence, justice, and veracity for guidance in decision- making. Conflict resolution Legal conflicts are often resolved through the court system. Ethical conflicts are addressed through careful deliberation, consultation, and often involve medical ethics committees or ethicists. Examples Criminal law, contract law, medical malpractice law. Informed consent, end-of-life decisions, patient confidentiality. 3) Evaluate ethical decisions made in a real life scenario from a Hospital? Ans. When I was working in hospital, India, I faced a situation where they were two critically ill patients in need of an organ transplant: Patient A, a 40-year-old single parent with two young children, and Patient B, a 65-year-old retired individual who has no immediate family. Unfortunately, there was only one available organ for transplantation, and both patients were eligible candidates. The hospital's transplant committee must decide about who will receive the organ. Evaluation of Ethical Decisions:

o Healthcare providers may be required by law to breach patient confidentiality in specific situations. o Reporting Notifiable Diseases: Healthcare professionals are legally obligated to report certain communicable diseases (e.g., tuberculosis, measles, Covid) to public health authorities to prevent further transmission and protect the public. o Reporting Abuse or Harm o Court Orders  Risk of Harm to Others: In cases where there is a clear and imminent risk of harm to others, healthcare providers may breach confidentiality to prevent harm. For example, duty to Warn: If a patient discloses plans to harm a specific individual, the healthcare provider may have a duty to warn the intended victim.  Consent and Sharing of Information: Confidentiality can be breached when patients provide explicit consent for their information to be shared with specific individuals or entities. Situations like referrals and consultations, family or Caregiver Involvement, Insurance and Billing Purposes. In the above situations, healthcare providers must balance the duty to protect patient confidentiality with the duty to promote the patient's well-being and the safety of others. They should follow applicable laws and ethical guidelines while considering the potential consequences of breaching confidentiality. Communication with the patient about the reasons for breaching confidentiality is also essential to maintain trust and transparency. 6) List the rights of patients who are receiving health care? Ans.  Right to Informed Consent  Right to Privacy and Confidentiality  Right to Access Medical Records  Right to Respect and Dignity  Right to Quality Care  Right to Second Opinion  Right to Refuse Treatment  Right to Pain Management  Right to Advance Directives  Right to Non-Discrimination  Right to be Informed of Hospital Policies  Right to Communication and Information 7) Discuss and debate three ethical dilemmas in today’s medical practice? Ans.  End-of-Life Decisions: With medical advancements, life-sustaining treatments can prolong the lives of terminally ill patients, but this can also lead to difficult end-of- life decisions. The ethical dilemma lies in balancing the principles of patient autonomy and beneficence.

Debate: o Some argue that patient autonomy should be paramount, and patients should have the right to refuse life-sustaining treatments, even if it means a shorter life, to preserve their dignity and control over their bodies. o Others contend that preserving life is a primary duty of healthcare providers, and they should provide all available treatments to extend life, regardless of the patient's wishes.  Genetic Testing and Privacy: Genetic testing has become more accessible, allowing individuals to gain insights into their health risks. However, this raises ethical concerns about privacy, confidentiality, and the potential use of genetic information by third parties, such as insurance companies and employers. Debate: o Some argue that individuals have the right to know their genetic information to make informed healthcare decisions, but this information must be protected from unauthorized access and misuse. o Others raise concerns about genetic discrimination and the potential for insurers or employers to use genetic information to deny coverage or employment opportunities, calling for strong legal protections.  Resource Allocation: Limited healthcare resources, such as organ transplants or critical care during public health crises, pose ethical dilemmas in deciding who should receive scarce resources. Debate: o One perspective emphasizes the principle of utilitarianism, which aims to maximize overall well-being by allocating resources to patients with the best chances of survival or those who can benefit the most. o Another viewpoint argues for a more egalitarian approach, where resources are distributed more evenly, focusing on factors like time on the waiting list or a lottery system, to ensure fair access for all patients. 8) Describe advance directives and its legal implication? Ans. Advance directives are legal documents that allow individuals to express their preferences and decisions regarding medical treatment in case they become unable to communicate or make decisions for themselves due to illness or incapacitation. These documents enable patients to maintain autonomy and control over their healthcare even when they are no longer able to participate actively in decision-making. Legal Implications:  Enforceability: o These requirements typically include being in writing, signed by the individual, and witnessed by competent adults who are not beneficiaries of the individual's estate.

o Confidentiality: Maintaining the privacy of patient information and respecting their right to confidentiality. o Veracity: Being honest and transparent with patients, providing accurate and truthful information about their medical condition and treatment options. 11) What is the general policy in modern medicine about truth telling? Assume that most patients do not want to know the full truth. It is impossible to anticipate every outcome, so always communicate the worst-case scenario first.   Physicians have a moral duty to be completely truthful about conditions and treatment Physicians only need to be completely truthful about the treatment options they think will work best. Ans. Physicians have a moral duty to be completely truthful about conditions and treatment 12) When may doctors be exempt from being completely truthful with their patients? a. When the doctor really doesn't want to give bad news. b. When the doctors feels like withholding truth might help the patient be happier. c. When the patient consciously states that they don't want to be told the full truth. d. Doctors are never exempt from being completely truthful. Ans. D) Doctors are never exempt from being completely truthful.