Case Study

ETHICAL DECISION-MAKING:

1. Identify the relevant ethical issues at stake 2. Consider the key issues (eg requirements of

justice) from the perspective of one or more ethical theory

3. Clarify issue in relation to ethical principles & values:

4. Clarify issue in relation to professional requirements/ commitments:

5. Take into account the ethical requirements of the health care professional/patient relationship, eg:

Deontology Virtue Theory

Utilitarianism Egalitarianism

Natural Law Feminism

Libertarianism

Principles Virtues Beneficence Non-maleficence Justice Respect for Pt Autonomy Respect for Human Dignity Veracity/ honesty Respect Pt Confidentiality Principle of Double Effect

Professional codes of ethics

Professional codes of conduct

Legal Requirements

What are the goals of the health care intervention? Who benefits? Is the patient competent to consent? If so, does the patient understand the benefits & risks of intervention & of non- intervention? Has the patient actually consented? If incapacitated, who is the patient’s surrogate? Has the patient provided advance directives? What are the plans in case of therapeutic futility? Is the patient’s reasonable refusal of treatment respected? Is actual care assured? Are there any possible/ identifiable conflicts of interest at issue? Is the decision fair and, in other ways, just? Does the decision ensure loyalty to the patient? Is the patient’s dignity respected? In the case of transplant surgery, who is the patient? Are patients’ rights / dignity protected? What is owed to research participants?

Benevolence; kindness; fidelity Care; gentleness; patience Justice; compassion Humaneness; Honesty; consolation; empathy Respectfulness Considerateness Practical wisdom