1.

Ethics:
Definition:
 Ethics is the branch of philosophy that examines moral principles guiding human actions.
In healthcare, ethics governs the relationships between healthcare providers, patients, and
society at large, ensuring that decisions made are not just medically sound but also
morally responsible.
Ethical Theories:
 Deontology:
 Developed by Immanuel Kant, deontological ethics focuses on duty, obligation,
and rules. According to deontology, an action is morally right if it is done in
accordance with a moral rule or duty, regardless of the consequences.
 Example in healthcare: A physician feels morally obligated to tell a terminally
ill patient the truth about their condition, even if this might cause emotional
distress. The doctor's duty to be honest takes precedence over the consequences of
that honesty.
 Key concepts: Categorical Imperative—Kant’s notion that one should act only
according to rules that could be universally applied.
 Criticism: Deontology can be inflexible, disregarding outcomes, which
sometimes leads to harsh or impractical decisions in healthcare, where the well-
being of patients often requires balancing various factors.
 Utilitarianism:
 Associated with Jeremy Bentham and John Stuart Mill, utilitarianism focuses on
outcomes and the idea that an action is morally right if it maximizes happiness or
benefits for the greatest number of people.
 Example in healthcare: In a pandemic, allocating scarce resources like
ventilators to patients most likely to survive rather than distributing them equally.
This maximizes the overall number of lives saved, prioritizing benefit over
individual equality.
 Key concepts: The “Greatest Happiness Principle”—the best action is the one
that results in the greatest good for the greatest number.
 Criticism: Utilitarianism can lead to morally questionable decisions, such as
sacrificing the well-being of a few individuals for the benefit of the majority (e.g.,
denying life-saving treatment to elderly or chronically ill patients because they are
less likely to survive).
 Virtue Ethics:
  Rooted in Aristotle’s philosophy, virtue ethics emphasizes the importance of
moral character rather than rules or consequences. It asks: “What kind of person
should I be?” rather than “What action should I take?”
 Example in healthcare: A nurse showing compassion and patience when caring
for a dying patient, not because of any rule or outcome but because kindness and
empathy are considered virtuous traits in a good healthcare provider.
 Key concepts: Eudaimonia, or human flourishing, is achieved by cultivating
virtues like honesty, compassion, courage, and wisdom.
 Criticism: Virtue ethics can be vague when it comes to specific moral dilemmas.
It focuses more on moral character development and less on giving clear guidance
in complex situations.

2. Morals:
Definition:
 Morals are the personal or societal values and beliefs regarding what is right and wrong.
They are often shaped by culture, religion, and personal experiences, guiding individual
behavior and decision-making.
Morality vs. Law in Healthcare:
 Morality: In healthcare, individual moral beliefs can shape how providers approach
treatment options. For instance, a doctor may personally believe that euthanasia is
morally wrong due to religious convictions, but professionally, they may be required to
respect a patient’s decision regarding end-of-life care if euthanasia is legally allowed.
 Law: Unlike morality, laws are codified rules established by governments or regulatory
bodies to ensure societal order and protection. In healthcare, laws are designed to protect
patients' rights, ensure fair access to care, and prevent malpractice.
Examples of conflicts between morality and law:
 Example 1: A doctor morally opposes performing abortions but works in a jurisdiction
where abortion is legally permitted and part of their professional obligations. The law
requires them to respect a patient’s legal right to choose an abortion, even though it
conflicts with their moral beliefs.
 Example 2: Jehovah's Witnesses refuse blood transfusions based on religious beliefs,
even when the transfusion could be life-saving. Legally, doctors must respect the patient's
decision, though it may conflict with their personal moral desire to save lives.
Moral Conflicts in Healthcare:
  Autonomy vs. Beneficence: One of the most common moral conflicts in healthcare is the
tension between respecting patient autonomy (the right of patients to make their own
decisions) and beneficence (the provider’s duty to act in the patient’s best interest). This
is seen in cases where patients refuse treatments that could save their lives.
 Example: A patient diagnosed with a disease but refuses injections or vaccines due to
personal beliefs, but the doctor knows it would likely cure the patient.

3. Jurisprudence:
Definition:
 Jurisprudence is the philosophy or science of law. It encompasses understanding how
laws are created, interpreted, and applied, particularly in the field of healthcare.
Jurisprudence helps healthcare professionals navigate legal regulations and understand
the limits of their practice within the legal system.
Legal Regulation of Healthcare Practice:
 Importance of Legal Knowledge: Healthcare professionals must have a solid
understanding of legal regulations to avoid violations that could lead to lawsuits, loss of
licensure, or criminal charges.
Key Areas of Healthcare Law:
1. Medical Negligence:
 If a healthcare professional provides substandard care, resulting in harm to a
patient, they may be liable for medical negligence. The law requires providers to
meet a standard of care that any reasonably competent professional would provide
in similar circumstances.
 Example: A surgeon fails to remove a surgical instrument after an operation,
causing complications. This could lead to a malpractice lawsuit.
2. Informed Consent:
 Informed consent laws require that patients be fully informed about the risks,
benefits, and alternatives to treatment before making a decision. Failure to obtain
informed consent could result in legal liability for the healthcare provider.
 Example: If a doctor performs surgery on a patient without explaining the risks,
and complications arise, the doctor may face legal action.
3. Confidentiality
  Confidentiality laws ensure that patient information remains private unless the
patient gives consent for its disclosure. Breaching confidentiality can lead to legal
consequences.
 Example: A nurse accidentally discloses a patient’s medical condition to a third
party without consent, which could violate confidentiality laws.

Lecture 2: The Role of Ethics in Clinical Practice

Case Study: Resource Allocation
Scenario: During the COVID 19 pandemic, the healthcare facility faces a shortage of ventilators.
Three patients were brought in and just two ventilators are available. The healthcare team must
decide which patients receive life-saving treatment.
Ethical Dilemma: Utilitarian principles (maximizing the benefit for the greatest number of
patients) may dictate allocating resources to patients most likely to survive, while deontological
ethics may argue that all lives have equal value and deserve the same access to resources.
Discussion: What criteria should guide these decisions—age, prognosis, or first-come-first-
served? Balancing fairness and effectiveness becomes critical.
Case Study 2:
A scenario where the law conflicts with a healthcare provider’s ethical duty? (HIV)