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Mario Malički

University of Split School of Medicine. Farmaceutska ETIKA. Mario Malički. MORAL. Ćudoređe oblik svijesti o: normama ponašanja, tj. ispravnosti ponašanja dobro vs. zlo "reakcija“ – pitanje djelovanja. Vrlina – moralna izvrsnost

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Mario Malički

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  1. Universityof Split School of Medicine FarmaceutskaETIKA Mario Malički

  2. MORAL Ćudoređe oblik svijesti o: normama ponašanja, tj. ispravnosti ponašanja dobro vs. zlo "reakcija“ – pitanje djelovanja

  3. Vrlina – moralna izvrsnost Pretpostavka je da farmaceut koji posjeduje vrline – dobar farmaceut Moralni stav ima iznimke – zakon nema Ljudsko ponašanje – pokušaj očuvanja konzistentnosti između slike o sebi i vlastitog djelovanja

  4. Ja ............ svečano izjavljujem: - svoje znanje i umijeće, uvijek ću primjenjivati, u skladu s načelima ovog Kodeksa, časno, savjesno i dostojanstveno; - poštivat ću ljudski život od njegovog početka do smrti, promicati zdravlje, sprečavati i liječiti bolesti; - pomoć ću pružati svakome bez obzira na dob, spol, rasu, narodnost, vjersko ili političko uvjerenje i društveni položaj, poštujući pri tome ljudska prava i dostojanstvo čovjeka; - prvenstvo ću uvijek davati interesu bolesnika pred osobnim interesom; - skrbit ću se za pravilnu, učinkovitu i sigurnu uporabu lijekova; - lijekove ću izrađivati i izdavati po najvišim standardima kakvoće; - čuvat ću povjerenu mi tajnu; - svojim učiteljima i kolegama iskazivat ću poštovanje i zahvalnost za znanje, umijeće i odgoj koje sam od njih primio; - svim svojim sposobnostima čuvat ću plemenite tradicije ljekarničkog poziva.”

  5. All human beings are born free and equal in dignity and rights.They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood Universal Declaration of Human Rights

  6. Trolley problem Phillipa Foot 1967 The New York Times; Illustration by Frank O’Connell

  7. Lawrence Kohlberg's stages of moral development Level 1 (Pre-Conventional) 3-7 y • Obedience and punishment • Self-interest orientation Level 2 (Conventional)highschool 3. Interpersonal conformity 4. Authority and social-order Level 3 (Post-Conventional) college 5. Social contract orientation 6. Universal ethical principles “I would cheat if I knew I wouldn't get caught” “I’ll let you copy my work, if you give me something in return” “I wont do it, cause I wont her to like me” “You cant do it as teacher said no” “There may be an exception to the rule” “You shouldn't lie as it violates the principle”

  8. Hamlin – Social evaluation by preverbal infants 2007 – helpersandhinderes

  9. Kanakogi 2013 - Rudimentary Sympathy in Preverbal Infants

  10. Warneken 2006-7 Altruistic helping in human infants and young chimpanzees

  11. Frans De Waal – empathy in animals

  12. Cruelty in animals chimpanzee civil war - Kibale national park in Uganda Tanzaina's Gombe Stream national park – split to two tribes

  13. http://www.pbs.org - Hominidae Family Tree

  14. Make love not war - Bonobos

  15. Immanuel Kant -"Perpetual Peace" 1795 democracy, trade and an international community are pacifying forces Bruce Russett and John Oneal. 2001. Triangulating Peace Steven Pinker The surprising decline of violence

  16. Lawrence Kohlberg's stages of moral development Level 1 (Pre-Conventional) 3-7 y • Obedience and punishment • Self-interest orientation Level 2 (Conventional)highschool 3. Interpersonal conformity 4. Authority and social-order Level 3 (Post-Conventional) college 5. Social contract orientation 6. Universal ethical principles “I would cheat if I knew I wouldn't get caught” “I’ll let you copy my work, if you give me something in return” “I wont do it, cause I wont her to like me” “You cant do it as teacher said no” “There may be an exception to the rule” “You shouldn't lie as it violates the principle”

  17. Thorndike – 1930s How much would you have to be paid to undergo the followingexperiences? • to have oneupper front tooth pulled out? • to have one little toe cutoff? • to eat a live earthworm six inches long? • to live the rest of your life on a farm in Kansas? • to choke a stray cat to death with your bare hands?

  18. Utilitarianismrevisited • 1. 74 000 $ • 2. 4,500 $ • 3. 100,000 $ • 4. 300 000 $ • 5. 164 000 $

  19. Reason is weaker then situation • David Hume 1738: “Reason is, and ought only to be the slave of the passions, and can never pretend to any other office than to serve and obey them.” StanelyMilgram experiment 1961 -1963

  20. The bystander effect blog.lib.umn.edu

  21. Disgust as Embodied Moral Judgment • fartsprayexperisments (2005; 2008): • legalization of marriage between first cousins (Marriage), approval of sex between first cousins (Sex), moral judgments of driving rather than walking to work (Driving), and approval of a studio’s decision to release a morally controversial film (Film). • abortion, pornography, premarital seks, homosexualrelationship or sex

  22. Moral Universals/Foundations theory – Johnathan Haidt • Care/harm • Fairness/cheating – Reciprocity - The Golden Rule, • Liberty/oppression • Loyalty/betrayal - Ingroup community • Authority/subversion - hierarchy • Sanctity/degradation - Purity – sex, food,

  23. 23,684 subjects

  24. Trolley problem Phillipa Foot 1967 The New York Times; Illustration by Frank O’Connell

  25. PRISTUPI RJEŠAVANJA MORALNIH DVOJBI UTILITARISTIČKI PRISTUP – korisnost tj. posljedice DEONTOLOŠKI PRISTUP – pravila KAZUISTIČKI PRISTUP – prema već postojećim slučajevima PRISTUP PREMA VRLINAMA – unutarnji motiv za djelovanjem PRISTUP SKRBI – Odnos pojedinaca PRISTUP DRUŠTVA – Posljedice na društvo

  26. BIOETIČKA NAČELA 1. Autonomija - Autonomy 2. Neškodljivost - Non maleficence 3. Dobročinstvo - Beneficence 4. Pravednost - Justice

  27. 1. Autonomija • Poštivanje autonomije znači da osoba ima sposobnost voljnog djelovanja, uz razumijevanje okolnosti i informacija, a bez utjecaja koji bi govorili protiv slobodnog i dobrovoljnog čina.

  28. Primjer: • Na hitni prijem doveden je 35-godišnjak nakon prometne nezgode. U prometnoj nezgodi mu je amputirana noga. Pri svijesti je, i naglašava liječniku kako je on Jehovin svjedok, te kako odbija mogućnost transfuzije krvi, bez obzira na posljedice.

  29. 2. Neškodljivost • Nećemo namjerno stvoriti bespotrebnu štetu ili ozljedu pacijenta, ni djelom ni propustom

  30. 3. Dobročinstvo • Primjer: kod hitnih stanja; kad je pacijent onesposobljen težinom ili prirodom ozljede ili bolesti, pretpostavit ćemo da bi razumna osoba željela da je se liječi energično, žurno ćemo joj pružiti odgovarajuće liječenje i skrb.

  31. 4. Pravednost • Pravedna raspodjela raspoloživoga.

  32. Physician Payment Sunshine Act Charitable contribution Royalty or license Grant Compensation for services other than consulting Current or prospective ownership or investment interest • Consulting fees • Honoraria • Gift • Entertainment • Food • Travel • Education • Research

  33. Ispovijestoptuženihliječnika: 'Put u Berlin nijemito’ • “Potpuno je normalno da farmaceutska tvrtka liječnicima plaća seminare” • 'Farmalovi lijekovi su jeftiniji i zato smo ih propisivali‘ • “Legalno je da plate kotizaciju jer je to način na koji sudjelujemo na kongresima.” • “Dođu i donesu bon za Uskrs ili Božić, kažu da će dati neku opremu za ordinaciju... Ne smatram da je to mito. Jer svaki lijek koji sam potpisala pacijentu je trebao, bio je strogo indiciran.”

  34. Ljekarnica iz Dugog Rata odbila izdati antibebi pilule jer joj to brani katolička vjera!

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