Bioethics principles
Name one bioethics principle
- principle of autonomy
- principle of nonmalificence
- principle of beneficence
- principle of justice
Name of patient
Janet
What is a stakeholder?
Someone affected/involved in the case study
What does possible courses of action mean?
Paths the healthcare professional team can take after the ethical dilemma
What is the big emphasis of this case?
Informed Consent
What is the principle of autonomy?
upholding a patient's right to self-determination and to make their own informed decisions about their healthcare
What is the patient suffering from?
breast cancer
Who and what is the primary stakeholder?
Janet, someone whose health and life is directly affected by the decision made
Bystander course of action
Isalita follows on with Dr. Haverford's decision
What is the best final course of action?
- Isalita should initiate an open and respectful discussion with Dr. Haverford about Janet's expressed desire
What is the principle of non-maleficence in 3 words?
"Do no harm."
Conflict/Center of the Case Study
Informed Consent
Obligations of Dr. Haverford
- principles he needs to follow
Principle of Beneficence
Principle of Non-Maleficence
What are the consequences?
Isalita tells Janet herself and Janet confronts Dr. Haverford
- isalita is fired/removed
- janet is anxious and distressed -> stresses options and doesn't promote her wellbeing
What is Janet's expressed autonomy in this scenario? What would she want?
to be informed of the clinical trials, full transparency
Which principle takes precedence in this case?
autonomy
Who is Isalita?
Isalita, a third-year medical student on rotation, has spent three weeks by Janet’s bedside, and Janet has explicitly told Isalita that she values honesty and full disclosure from her physicians, even if the information is difficult to hear.
Hospital - Role as a Stakeholder
- what principles is it responsible for?
Principle of Justice
- legally responsible for her care
What fosters better courses of actions and better decisions?
Discussions, honest conversations, consultations
What cultural factors play into autonomy?
Western bioethics has a culture of 'independence'
What is the difference between the principle of nonmaleficence and beneficence?
Beneficence: obligation to act in the best interest of the patient and to promote their wellbeing
Justice: ensuring fairness in the distribution of healthcare resources and benefits
What is the conflict between Isalita and Dr. Haverford?
When Dr. Haverford discusses only palliative and conventional treatment options, Isalita feels that withholding information goes against Janet’s expressed wishes but she doesn’t want to challenge her superior. (and not the new clinical trials)
Who has the obligation to ensure informed consent?
Dr. Haverford, Isalita, the Hospital
What is the general course of action that most ethical conflicts take? (It was briefly mentioned!)
Ethics consultations
What are consequences in the case beyond ethical dilemmas and violations and ineffective treatments?