Medical/Healthcare law and ethics Three key elements law professional codes and guidelines ethical theories and principles

Medical/Healthcare law and ethics Law –represents minimum standards –applies broad societal standards and expectations Codes and guidelines –set minimum professional standards – reinforced with sanctions by self-regulating professions Ethics –strives for maximum standards –provides framework for resolving health care dilemmas

Medical/Healthcare law and ethics Action may be legal + moral illegal + moral legal + immoral illegal + immoral

Medical/Healthcare law and ethics Ethical dilemmas –increased frequency & difficulty due to: increased technology –life-saving/life-sustaining procedures/treatments changing doctor-patient relationship –beneficence+paternalism → autonomy+justice+rights changing doctor-healthcare professional relationship –professional roles; specialisation; team care; shared-decision making

Issues that are not normally ethical dilemmas issues of medical etiquette legal problems inappropriate indications/treatment/discussion of treatment options problems of communication breakdown in relationships assessment of decision-making capacity obtaining informed consent

Medical/Healthcare law and ethics key ethical concepts –autonomy –respect for persons –consent –paternalism –beneficence –non-maleficence –futility –preservation of life –sanctity of life –quality of life –justice –rights –best interests –confidentiality

Medical/Healthcare law and ethics current issues Intervention-related issues consent beginning of life –human reproduction »abortion »infertility and assisted reproduction »childbirth death and dying –life-sustaining treatment –medical futility –quality of life –euthanasia/assisted suicide research Policy-related issues rationing and managing health care costs

Guiding principles when dealing with dilemmas respect for autonomy of the patient (self- determination) beneficence (do good) non-maleficence (do no harm) fidelity (truthfulness and confidentiality) veracity (honesty) justice (equitable distribution of benefits/burdens)

Issues of ethical rights Right to health care (?) Right to self determination Right to privacy (confidentiality) Rights of children and the unborn Right to life Right to die