Ethics & decision-making

1. Health decision dilemmas: Rights responsibilities and risk Ethics & decision-making Dr Barbara Hayes Palliative Care Physician Advance Care Planning Program

2. Ethics & decision-making • Morals, ethics and the law • Ethical principles used in health • Shared decision-making

3. Morals, Ethics and the Law

4. Principlism Autonomy Beneficence Non-maleficence Justice Ethical principles – health Sanctity of Life Culture Ethical Virtues Spirituality/religion

5. It is not only WHAT we do that is ethically significant; but also HOW we do it.

6. Doing Good - Beneficence Patient autonomy Professional autonomy Science of medicine Patient’s values Professional expertise / ethics The best medical decision for THIS patient

7. Impaired autonomy - Beneficence Patient best interests Professional autonomy Science of medicine Patient’s values/ communication Professional expertise / ethics The best medical decision for THIS patient

8. Shared decision-making Clinician / team Patient / family Shared decision

9. Patient / family Clinician / team Shared decision Deliberative Interpretative Emanuel & Emanuel. JAMA, 1992