Ethical Principles: Application to an Obstetric Case (original) (raw)
Related papers
The ethical decision making model in obstetrics and gynaecology practice
International e-Journal of Science, Medicine & Education
This paper attempts to utilise clinical scenarios where ethical issues are embedded and requires appropriate application of the steps of the framework mentioned. A step by step sequential approach is adopted to illustrate how the 'ethical decision model 'can be used to resolve ethical problems to arrive at a reasonable conclusion. The UNESCO ethical method of reasoning is used as the framework for decision making. Physicianeducators should be competent to use ethical decision models as well as best available scientific evidence to be able to arrive at the best decision for patient care as well as teach health professional trainees how reasonable treatment decisions can be made within the perimeter of medical law and social justice.
Journal of Perinatal Education, 2009
This article discusses current ethical issues associated with childbirth in the United States. It provides a review of moral problems and ethical choices made by parents and health-care professionals during the prenatal, intrapartum, and postpartum periods. Ethical issues are identified and framed through a ''naturalized bioethics'' approach, as recommended by Margaret Walker and her colleagues, Hilde Lindemann and Marian Verkerk. This approach critiques traditional bioethics and gives attention to everyday ethics and the social, economic, and political context within which ethical problems exist.
The physician's moral obligations to the pregnant woman, the fetus, and the child
Seminars in Perinatology, 1998
The moral obligations and ethical duties of health care professionals responsible for the care of a pregnant woman, a fetus, and a child are complex and evolve with gestation and birth. Well-intentioned physicians and others concerned with the interests of pregnant women and their fetuses may disagree about the moral status of the fetus and the ethical duties owed to both the woman and fetus. This article lays out a framework for thinking about these issues from several perspectives.
2020
Analyzing a situation to define principles Deductive Application of principles to a situation Casuistry analysis Applies lessons from similar cases with established and accepted resolutions Relational ethics Explores empathy, compassion, and the importance of relationships present in a dilemma to define ethical goals Narrative ethics Considers how personal and public stories can examine moral values Principlism Analyzes a decision based on accepted values such as beneficence, non-maleficence, autonomy, and justice Deontological Defines rights and responsibilities (e.g. professional codes of conduct) Virtue ethics Considers the intention of each actor in a moral dilemma Consequentialism Defines an ethical act based on the goodness of the outcome
“Ethics surrounding the provision of abortion care”
Best Practice & Research Clinical Obstetrics & Gynaecology, 2017
The provision of abortion care represents a great ethical challenge to physicians, particularly in countries where the law states that abortion is a crime. The concept that it is a crime carries a stigma that is worse than that associated with other acts qualified by law as crimes. This stigma leads to at least two different kinds of unethical behavior. One is the refusal to provide safe abortion services to women who comply with the legal requirements, alleging conscientious objection, and the other is to discriminate against women consulting with complications of induced abortion. Both unethical behaviors may be associated with severe consequences for the health of women whose care was refused or delayed. Less attention is given to the ethical obligation to prevent induced abortion from recurring by offering post-abortion contraception, in order to comply with the ethical obligation of preventing harm to the patients for whose care they are responsible.
Ethical challenges of treating the critically ill pregnant patient
Best Practice & Research Clinical Obstetrics & Gynaecology, 2008
Most ethical issues in obstetrics, both in the critical care and non-emergency situations, hinge around the maternal-fetal relationship. With access to the necessary information and support, most women strive to improve their chance of having healthy babies. However, there could be situations where their interests do not correspond with fetal interests, thereby giving rise to conflict situations. At the centre of the debate about a possible conflict is the notion of the fetus as a patient. A pregnant woman's autonomy and informed refusal should be respected. Where she is not competent to make an informed decision, proxy consent should be obtained or the doctrine of substituted judgement be applied. A decision to withhold or withdraw treatment in the intensive care unit (ICU) should only occur once a definitive diagnosis of terminal illness is made. Standards for the management of the human-immunodeficiency-virus-positive woman in the obstetric ICU situtation should be no different from standards employed to manage a critically ill pregnant patient in ICU with a chronic medical disease.
Personal Values Required for Ethical Best Practice during Intrapartum Care
Africa Journal of Nursing and Midwifery, 2018
Women bring into the birthing unit values which include preferences, concerns and expectations that are involved in decision-making during intrapartum care. When midwives fail to meet the women’s values, they experience such care as being inhumane and degrading, thus affecting the childbirth outcomes. The inhumane and degrading care includes a lack of sympathy and empathy, as well as a lack of attention to privacy and confidentiality. Midwives’ possession of the required personal values and the ability to integrate women’s values are vital to enhance ethical best practice during intrapartum care. The aim of the study was to explore and to describe the midwives’ personal values that are required for ethical best practice during intrapartum care. The birthing unit at a public hospital in the Gauteng province of South Africa formed the context of the study. A qualitative research design that was explorative, descriptive and contextual in nature was used. The following personal values e...
Ethical and medico-legal issues
Women's Health Medicine, 2005
In obstetric anaesthetic practice, ethical and medico-legal problems revolve mainly around the ability of a woman in labour to give truly informed consent and the potential conflict between the best interests of the fetus and the mother. Consent Consent is a state of mind: a decision by a patient. The competent adult patient has a fundamental right under common law to give, or withhold, consent to examination, investigation or treatment. This is a basic principle of health care. 1 The elements of informed consent are shown in Figure 1. Can a woman in labour be 'competent'? In order to obtain valid consent, the anaesthetist must judge that the patient is competent. The usual limitations of mental ill-health, learning disability, age and Gillick competency apply. However, other issues arise in obstetric care. It has been suggested that a woman in labour, often under the influence of pain, fatigue and analgesic drugs is not 'competent'. Some evidence suggests that decision-making ability is compromised by the effects of analgesic drugs, pain or exhaustion. 2 However, general consensus is that labour alone does not limit competence, and women in labour are considered sufficiently competent in law to refuse elements of treatment (e.g. caesarean section, epidural analgesia). If a woman in labour is judged to be incompetent to give consent, emergency treatment of life-threatening illness can be undertaken, in her best interest, under common law. In this circumstance, where treatment is provided without consent, a note must be made in the medical records explaining the reasons for