Dales GPEC Medical Ethics 291101 Bruce Davies Dales

Dales GPEC Medical Ethics 29/11/01 Bruce Davies

Dales GPEC Frameworks • Variety of them exist. • Will present three. 29/11/01 Bruce Davies 2

Dales GPEC Tavistock Principles • Rights. – People have a right to health and health care. • Balance. – Care of individual patients is central, but the health of populations is also our concern. • Comprehensiveness. – In addition to treating illness, we have an obligation to ease suffering, minimise disability, prevent disease, and promote health. 29/11/01 Bruce Davies 3

Dales GPEC Tavistock Principles • Cooperation. – Health care succeeds only if we cooperate with those we serve, each other, and those in other sectors. • Improvement. – Improving health care is a serious and continuing responsibility. 29/11/01 Bruce Davies 4

Dales GPEC Tavistock Principles • Safety. – Do no harm. • Openness. – Being open, honest, and trustworthy is vital in health care. 29/11/01 Bruce Davies 5

Dales GPEC Justice in Health Care • Health. – Health systems should pursue health as their primary goal. • Access. – Health systems should provide care primarily according to need rather than ability to pay. 29/11/01 Bruce Davies 6

Dales GPEC Justice in Health Care • Accountability. – Consumers, providers, and healthcare institutions must take responsibility for health and healthcare resources with which they are entrusted. 29/11/01 Bruce Davies 7

Dales GPEC Justice in Health Care • Choice. – Consumers must have the real ability to choose their healthcare systems, providers, and treatments in order to seek the best value in health care for themselves. • Education. – Education of consumers, providers, and institutions regarding value and quality in health care is necessary for responsible and informed health choices. 29/11/01 Bruce Davies 8

Dales GPEC MDU Beneficence u Non-maleficence u Justice u Autonomy u 29/11/01 Bruce Davies 9

Dales GPEC • • Tavistock Principles Rights. Balance. Comprehensiveness. Cooperation. Improvement. Safety. Openness. 29/11/01 Bruce Davies 10

Dales GPEC Case to Discuss A doctor working in an NHS trust thinks it wrong that his patients will be denied a new treatment for cancer (the hospital formulary committee had decided that it should not be prescribed). Should he contact the local media? Should the trust punish him if he does? 29/11/01 Bruce Davies 11

Dales GPEC Case to Discuss A health maintenance organisation in the United States considers investing in improvements in its system for caring for patients with AIDS. The vice president for marketing warns that such improvements may lead to selective enrolment of unprofitable membersnamely, those with HIV infection. Is the organisation ethically bound to improve its HIV care, even if that may reduce its financial viability? 29/11/01 Bruce Davies 12

Dales GPEC Case to Discuss Managers of a health provider discover that one of their nurses is infected with HIV but has told nobody. Should they release the nurse's name to the media? Should they notify all those who may have been treated by the nurse even though the chances of anybody being infected are vanishingly small? 29/11/01 Bruce Davies 13

Dales GPEC Case to Discuss A infertility specialist writes to ask if a patient of his can select the gender of a child because he has a patient who want a girl to balance their family. 29/11/01 Bruce Davies 14