principles of biomedical ethics Essay Samples

principles of biomedical ethics

... rules: 1) tell the truth 2) respect the privacy of others 3) protect confidential info. 4) Obtain consent for interventions with patients 5) When asked, help others make important decisions. Complexities in Respecting Autonomy and Consent/Refusal ƒÞ The basic paradigm of autonomy in health care, research, politics, and other contexts is express consent. ƒÞ Tacit consent is expressed slightly or passively by omissions. ƒÞ Implied or implicit consent is inferred from actions. ƒÞ Consent should refer to an individual¡¦s actual choices, not to presumptions about the choices the individual would or should make. The Gatekeeping Function of Competence Judgments ƒÞ Has a role in health care by distinguishing persons whose decisions should be solicited or accepted from persons whose decisions need not or should not be solicited or accepted. ƒÞ Health care professionals¡¦ judgments of a person¡¦s incompetence may lead them to override that person¡¦s decisions, to turn to informal surrogates for decision making, to ask the court to appoint a guardian to protect his or her interests, and to seek involuntary institutionalization. ƒÞ When a court establishes legal incompetence, it appoints a surrogate decision maker with either partial or full authority over the incompetent individual. The Concept of Competence ƒÞ A single core meaning of the word competence is the ability to perform a task. ƒÞ It is best understood as specific rather than global: It depends not only on the person¡¦s abilities but also on how that person¡¦s abilities match the particular decision-making task he or she confronts. ƒÞ If a patient¡¦s competence level cannot be established, one must evaluate that patient¡¦s understanding, deliberative capacity, and coherence over time. ƒÞ Competence in decision making has close ties with autonomy. ƒÞ Patients are competent to make a decision if they have the capacity to understand the material info, to make a judgment about the info in light of their values, to intend a certain outcome, and to communicate freely their wishes to care givers. Standards of Competence ƒÞ In medical texts, a person is considered competent if able to understand a therapeutic or research procedure, deliberate regarding risks and benefits, and to make a decision in light of that deliberation. ƒÞ If a person lacks capabilities, then his or her competence to decide, consent, or refuse is thrown into doubt. Rival standards of incompetence 1) inability to express or communicate a preference or choice 2) inability to understand one¡¦s situation and its consequences 3) inability to understand re...

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