This document contains just about EVERYTHING that you need to know regarding Ethics for your upcoming Medical School Interview!
It goes through all the aspects of medical ethics including the ethical pillars but also extra aspects that not many have considered, such as the Caldicott Principles.
Think about how the patient is feeling at every step
4 Pillars of Medical Ethics
Beneficence- acting in the best interest of your patient
Non-maleficence- not causing harm to the patient in any way
Autonomy- patient has the right of control over their own healthcare, they
have the right to refuse treatment
Justice- patients should be treated equally regardless of external factors
outlined in the Equality Act 2010
Structure your answer and making sense
Ethics are multi-layered problems and you have to break into mini questions
Can you jump into making a decision straight away?
What must your decision be based on?
What would you have to do after you made your decision?
“So firstly I need to ask myself, can I make a decision straight away”- said by
you to the interviewer in order to let them know that you are going to structure
your answer- this is called signposting
Ethics 1
, Liver Transplant case:
Q: You have to decide between 2 patients, a 33 yr old woman and a 13 yr old
boy, to give a healthy liver.
1. Can you jump into making a decision straight away?
No, as there is not a lot of information given in the question to begin with,
cannot judge to come to a final answer.
2. You must be a detective before you become a judge
Which patient would benefit more from the liver?
What would the decision be based on?
It would NOT be based on isolated factors highlighted within the Equality
Act 2010. Things like race, religion, ethnicity, lifestyle choices, sexuality etc.
Decisions must be based on clinical factors
Compatibility with the patient- will the organ be rejected if given to the
patient. The antibodies need to match with the patient, or it will be
destroyed by the patients immune system. Also, will the patient be put at
risk if they are put on immunoreppresant drugs.
Lifestyle choices- even though this was highlighted in the Equality Act
2010, you still need to consider, you cannot consider in isolation however,
but only in regards to clinical risk. For example, with the liver, if one is
drinking alcohol excessively, what are the chances that the liver will last?
Age- again, cannot be used in isolation, however, will a 99yr old benefit
from the liver transplant as well as a 20 yr old?
All of these factors affect QALY’s, which are Quality Adjusted Life Years, which
are used to quantify the decision. 1 QUALY would be 1 year of life in perfect
health, 0.5 QUALY’s would be 1 year in 50% health.
There are also non-clinical factors to take into consideration:
Interest of the patient- you have to ICE the patient out.
Ethics 2
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