1. Ethics & decision-making Dr Barbara Hayes Palliative Care Physician Advance Care Planning Program Health decision dilemmas: Rights responsibilities and risk

2. Ethics & decision-making  Morals, ethics and the law  Ethical principles used in health  Shared decision-making

3. Morals, Ethics and the Law

4. Principlism  Autonomy  Beneficence  Non-maleficence  Justice Ethical Virtues Ethical principles – health Sanctity of Life Culture Spirituality/religion

5. It is not only WHAT we do that is ethically significant; but also HOW we do it.

6. Doing Good - Beneficence Professional autonomy Professional expertise / ethics Patient’s values Patient autonomy The best medical decision for THIS patient Science of medicine

7. Impaired autonomy - Beneficence Professional autonomy Professional expertise / ethics Patient’s values/ communication Patient best interests The best medical decision for THIS patient Science of medicine

8. Shared decision-making Patient / family Clinician / team Shared decision

9. Patient / family Clinician / team Shared decision Deliberative Interpretative Emanuel & Emanuel. JAMA, 1992