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2. Nonmaleficence avoiding the causation of harm 3. Beneficence providing & balancing benefits
against risks & costs
1. Autonomy
self-rule (Greek) right of individuals to make choices See that people are different Personal choices Respecting people as equal persons with their own set of values a duty to let people make their own choices corresponding responsibilities of individuals towards society
Autonomous action
We analyze autonomous action in terms of persons who act
Intentionally With understanding Without controlling influences that determine their action
Simple meanings
Self governance Liberty right Privacy Individual choice Freedom of the will
If you visit a doctor do you make treatment decisions on your own or in discussion with other family member, and the doctor
What factors could we use to make such decisions in our daily lives ?
When we make decisions for ourselves do we also have responsibility for what happens ?
2. Beneficence
Beneficence attempt to do good Balance doing good >< risk of doing harm Tools: - risk assessment
- cost-benefit analysis
Cases where beneficence >< autonomy?
Moralitas TIDAK HANYA kita menjamin autonomy dan menahan diri dari menimbulkan bahaya/ kerugian (harm), tapi juga harus memberi kontribusi bagi kesejahteraannya (welfare).
Pikirkan/ diskusikan tentang sebuah kasus dimana kita memerlukan keseimbangan antara benefit (kebaikan/ keuntungan) dari suatu tindakan yang membatasi autonomy seseorang untuk menentukan pilihan bebasnya. Pikirkan/ diskusikan tentang kemungkinan penggunaan sebuah teknologi kedokteran baru, dan identifikasikan benefits dan risks-nya.
3. Nonmaleficence
Precise outcome not always certain! Uncertainty risk of failure? chance of success? Try to minimize or avoid doing harm Failure to attempt to do good Form of doing harm Examples of risky technology?
Nonmaleficence vs beneficence
The principle of nonmaleficence asserts an obligation not to inflict harm intentionally. Principles of beneficence potentially demand more than the
Beneficence
One ought to prevent evil or harm
One ought to remove evil or harm One ought to do or promote good
Nonmaleficence
1. Do not kill 2. Do not cause pain
Dapatkah Anda pikirkan tentang sebuah teknologi yang diduga terlalu berisiko untuk digunakan sekarang ? Bila dapat, pikirkan pula teknologi mutakhir yang telah kita gunakan untuk hal yang sama. Ingat lagi ke belakang apakah teknologi mutakhir ini juga menimbulkan harm ?
4. Justice
Autonomy is limited by balancing desires with respect for the autonomy of other individuals Justice = fairness = equity equality in access to health care Problems: - Scarce resources/treatments for patients - Socioeconomic situation of patient & families - Healthcare system & healthcare budget