This document provides an introduction to healthcare ethics, discussing key concepts like ethical issues, principles of biomedical ethics, and broad philosophical theories of ethics. It defines an ethical issue as when one has to judge right from wrong in making difficult choices between options. Some major ethical issues in healthcare discussed are respecting patient autonomy, beneficence, non-maleficence, justice, and distributing scarce resources fairly. It also outlines four key ethical principles - autonomy, beneficence, non-maleficence, and justice - and four ethical rules - veracity, privacy, confidentiality, and fidelity. Utilitarianism and deontology are presented as two broad philosophical approaches to ethics.

1. Ethics

2. Introduction to Ethics
• Our care for patients should be based on sound judgement (or evidence
based practice!!)
• ..some of this judgement is about having a strong sense of what is right or
wrong
• ...having a strong sense of what we should be doing and shouldn’t be doing
as clinicians
• ..having a strong sense of what our priorities ought to be

3. What is an ‘ethical issue’?
• When you have to judge what is right or wrong
• Choosing between options
• Deciding whether to do something or do nothing
• Should I or shouldn’t I?
• Weighing up the potential impact of your decisions or actions
• A dilemma – making a difficult choice

4. Ethical Issues in Health Care
• We usually think of the ‘big’ issues e.g. definition of life,
what is a person, quality of life, prolonging life, ending life,
human rights.
• But day to day ethical issues can involve:
Respecting people
Treating people with dignity
Treating people fairly
Supporting patient’s choices

5. Another source of ideas in Health Care Ethics
• Principles of Biomedical Ethics (Beauchamp and Childress, 2001)
• They discuss:
4 key principles
supplemented by 4 rules

6. 4 Key Ethical Principles
• autonomy
• beneficence
• non-maleficence
• justice

7. Autonomy
• Respect a person’s right to make their own decisions
• Teach people to be able to make their own choices
• Support people in their individual choices
• Do not force or coerce people to do things
• ‘Informed Consent’ is an important outcome of this principle

8. Beneficence (to do good)
• Our actions must aim to ‘benefit’ people – health, welfare, comfort, well-being,
improve a person’s potential, improve quality of life
• ‘Benefit’ should be defined by the person themselves. It’s not what we think that
is important.
• Act on behalf of ‘vulnerable’ people to protect their rights
• Prevent harm
• Create a safe and supportive environment
• Help people in crises

9. Non – Maleficence (to do no harm)
• do not to inflict harm on people
• do not cause pain or suffering
• do not incapacitate
• do not cause offence
• do not deprive people
• do not kill

10. Justice
• Treating people fairly
• Not favoring some individuals/groups over others
• Acting in a non–discriminatory / non-prejudicial way
• Respect for peoples rights
• Respect for the law

11. Justice
• Distributive Justice – sharing the scarce resources in society in a fair and just manner
(e.g. health services, professional time)
How should we share out healthcare resources?
How do we share out our time with patients?
Deciding how to do this raises some difficult questions
• Patients should get….
an equal share ?
just enough to meet their needs ?
what they deserve ?
what they can pay for ?

12. 4 Ethical Rules
• Veracity – truth telling, informed consent, respect for autonomy
• Privacy – a persons right to remain private, to not disclose
information
• Confidentiality – only sharing private information on a ‘need to know
basis’
• Fidelity – loyalty, maintaining the duty to care for all no matter who
they are or what they may have done

13. 2 Broad Philosophical Theories
1) consequentialism – taking the consequences of our actions
into consideration
2) deontology – basing our actions on a set of principles or duties

14. Consequentialism
• Actions are right or wrong according to the balance of their good and
bad consequences
• The right act is the one that produces the best overall result
• Utilitarianism (what action has the greatest utility -
use/benefit/positive outcome) is a type of consequentialism

15. Utilitarianism
• most prominent consequence-based theory
• based on the principle of utility
• actions ought to produce the maximal balance of positive value (e.g.
happiness) over disvalue (e.g. harm)

16. Deontology
• Duty or principle based theory
• An act is right if it conforms to an overriding moral duty
For example – do not tell lies, do not kill.
• e.g. Christian ethics – The Ten Commandments
But Christian ethics are not important for some people in the world so
moral duties vary between cultures and societies
• A moral duty or principle is one that is:
laid down by god / supremely rational being
or is in accordance with reason / rationality
or would be agreed by all rational beings

17. The Agency recognizes that issues of an ethical nature related to the
consumer, agency and the provision of services may develop.
It is the policy of the agency to provide care within an ethical framework
established by the professional disciplines provided by the agency,
established by the agency policy and procedures and as established by the
law and standards of care.
The agency recognizes that from time to time staff member’s personal values
and beliefs enter their ability to provide care.
Refusal of an individual staff member to participate in certain aspects of care
based upon personal values and beliefs will not disrupt the consumers care.
When the situations arise for care that conflicts with individual staff values
and beliefs there is an alternative method of care.
Individual performance evaluations will appropriately reflect the manager’s
considerations of motives related to participate based upon cultural values
or religious beliefs.