Ethics Rounds: Treating Self, Family & Friends

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Presentation transcript:

Ethics Rounds: Treating Self, Family & Friends Gary Viner MD Jan 13, 2016

Real Case Middle age woman (my wife) Awakens with me at 5:30 AM Wednesday “I have a terrible bladder infection - phone a Rx for me!” No fever and not otherwise unwell, rare episodes of UTI What do you do?

Sept 25, 2014

Six Ethical Principles: Autonomy –the right of a patient to make decisions about him/herself Beneficence – actions beneficial to the patient Confidentiality –all information relating to a patient Disclosure –truthful & provide all relevant information Equity – share finite resources fairly among patients First do no harm –choose the least harmful action

What are the issues? Compromised objectivity Preconceived notions / assumptions re: health/behaviour Avoidance of sensitive issues Pressure to provide care beyond expertise / habituating Rx Need for informed consent & patient autonomy Issues of confidentiality Avoidance of mandatory reporting

Physician Treatment of Self, Family Members & Others Draft CPSO Policy Defines family members & friends: If affect physician’s professional judgment providing Rx Rx is prohibited Prohibits Rx of selves / family members except minor condition & no alternative Advises MDs to consider friends & recognizes relationships evolve Rx of spouse/partner is sexual abuse under RHPA MDs prohibited from prescribing certain drugs for selves/family/friends in non-pt context

CPSO Draft Policy – Feedback sought Email: treatingself@cpso.on.ca Website: www.cpso.on.ca – Consultations Mail: Attn: Policy Department 80 College Street Toronto, Ontario M5G 2E2