1. Medical Ethics The study of moral values and judgments as they apply to medicine What is the right thing to do ?
Ben Sturgess

2. Code of medical ethics 400 BC - Hippocratic Oath
Declaration of Geneva
Good Medical Practice

3. Declaration of Geneva http://www. donoharm. org. uk/gendecl
Declaration of Geneva Revised 2005
I solemnly pledge to consecrate my life to the service of humanity;
I will give to my teachers the respect and gratitude that is their due;
I will practice my profession with conscience and dignity;
The health of my patient will be my first consideration;
I will respect the secrets that are confided in me, even after the patient has died;
I will maintain by all the means in my power, the honour and the noble traditions of the medical profession;
My colleagues will be my sisters and brothers;
I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;
I will maintain the utmost respect for human life;
I will not use my medical knowledge to violate human rights and civil liberties, even under threat;
I make these promises solemnly, freely and upon my honour

4. Normative Ethical Theories
Classifying actions as right or wrong
Virtue Ethics
Consequentialism
Utilitarianism vs Egoism
Deontology
Duty based Ethics

5. Virtue Ethics Ethical Theories
Plato, Aristotle, Thomas Aquinus
Virtues - the behaviours that allow a good life. Arête
Practical wisdom – the reasoning when two virtues are in conflict. Phronesis
E.g. Compassion vs Honesty
Flourishing – The outcome of practicing the wise and virtuous life. Eudiamonia

6. Virtue Ethics Are teleological – They involve ‘The meaning of life’ and so they are based in culture
Cardinal Western Virtues
Temperance
To act in moderation
Prudence
To judge between actions
Fortitude
To confront fear and pain
Justice
Moderation between self and others

7. Virtue Ethics Are teleological – They involve ‘The meaning of life’ and so they are based in culture
Christian
Faith, Hope and Charity (Love) Corinthians 13:13
Romans
Authority, Humour, Mercy, Dignity, Tenacity, Frugalness, Gravity, Respectability, Humanity, Industriousness, Dutifulness, Prudence, Wholesomeness, Sternness, Truthfullness
Buddist
Right Viewpoint, Values, Speech, Action, Livelihood, Effort, Mindfulness, Meditation
Samurai
Not to be outdone in Bushido,
Be use to one’s master,
Filial to ones parents,
Manifest great compassion

8. Utilitarianism Ethical Theories
Jeremy Bentham 1861
An action is determined solely by its contribution to overall utility – The Greatest Happiness
Act – Look at potential actions and chose that which promotes greatest happiness
Rule – Look at the rule that leads to action and chose the rule that if continually followed leads to the greatest utility – The rule of not killing people
Karl Popper 1945
Negative Utilitarianism
Do the Least Harm
The relief of suffering

9. Deontology – Duty Based Ethical Theories
Immanuel Kant –
Value of acts are not based on goodness or badness of outcomes.
Prerogatives – Agents do not always seek the best outcome
Constraints – Limitations on the actions that an agent can take
Contingent duties (circumstantial)
The Duties of a Doctor
GMC 2006
Categorical imperative (absolute)
Based on priori (independent of experience) reasoning about the nature of things.
“the duty to promote human freedom and rationality”

10. The Values of Medical Ethics
Benificence - Salus aegroti suprema lex
Make the care of your patient your first concern
Non-malificence - primum non nocere
First do no harm
Protect and promote the health of patients and the public
Double Effect – You can act if your intention is in the patients best interest but leads to his demise

11. The Values of Medical Ethics
Autonomy - Voluntas aegroti suprema lex
The patient has the right to choose or refuse treatment
Respect patients' right to reach decisions with you about their treatment and care
The right of self determination
Article Universal declaration of Human Rights
Justice
The distribution of scarce resources
Egalitarianism – The equal distribution of resources
Utilitarian Bioethics - QuALYs

12. The Values of Medical Ethics
Dignity
Treat patients politely and considerately
Respect patients' right to confidentiality
Honesty
Be honest and open and act with integrity
Informed Consent

13. Questions
Do you have any ?

14. Discussion

15. Summary Codes of Ethics – Duties of a Doctor Ethical Theories
Virtue
Utilitarianism - Bentham
Deontological – Kant
Values of Medical Ethics - Framework
Beneficence
Non-maleficence
Autonomy
Justice
Dignity
Honesty

16. Further Reading http://en.wikipedia.org/wiki/Ethics
Being Good – Simon Blackburn
Oxford Paperbacks ISBN-10:
Medical Ethics & Law: An introduction – Victoria Tippett
Radcliffe Publishing ISBN-10: