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    Medical Ethics and Professional Practice Yr III and IV - Lecture III

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    Mwanja Moses
    The document outlines a lecture presentation on medical ethics and professional practice. It discusses several topics including quality of life at end of life and factors in determining optional or obligatory treatment. It also addresses withholding life sustaining treatment, euthanasia, physician assisted suicide, and issues around resource allocation in healthcare. Strategies for setting priorities in resource allocation include cost-effectiveness analysis and democratic processes, though both have drawbacks. Equitable access to a minimum healthcare package and cost control are recommended approaches.

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    Medical Ethics and Professional Practice Yr III and IV - Lecture III

    Uploaded by

    Mwanja Moses
    35 views11 pages
    The document outlines a lecture presentation on medical ethics and professional practice. It discusses several topics including quality of life at end of life and factors in determining optional or obligatory treatment. It also addresses withholding life sustaining treatment, euthanasia, physician assisted suicide, and issues around resource allocation in healthcare. Strategies for setting priorities in resource allocation include cost-effectiveness analysis and democratic processes, though both have drawbacks. Equitable access to a minimum healthcare package and cost control are recommended approaches.

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    The document outlines a lecture presentation on medical ethics and professional practice. It discusses several topics including quality of life at end of life and factors in determining optional or obligatory treatment. It also addresses withholding life sustaining treatment, euthanasia, physician assisted suicide, and issues around resource allocation in healthcare. Strategies for setting priorities in resource allocation include cost-effectiveness analysis and democratic processes, though both have drawbacks. Equitable access to a minimum healthcare package and cost control are recommended approaches.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    35 views11 pages

    Medical Ethics and Professional Practice Yr III and IV - Lecture III

    Uploaded by

    Mwanja Moses
    The document outlines a lecture presentation on medical ethics and professional practice. It discusses several topics including quality of life at end of life and factors in determining optional or obligatory treatment. It also addresses withholding life sustaining treatment, euthanasia, physician assisted suicide, and issues around resource allocation in healthcare. Strategies for setting priorities in resource allocation include cost-effectiveness analysis and democratic processes, though both have drawbacks. Equitable access to a minimum healthcare package and cost control are recommended approaches.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 11

    Medical Ethics and

    Professional Practice
    Yr. III and IV
    DR MARTIN M. NSUBUGA
    SENIOR LECTURER

    12/22/2020 KING CEASOR UNIVERSITY 1


    Presentation outline
    •Quality of life
    •End of life issues including withholding life sustaining treatment;
    •Euthanasia; physician assisted suicide
    •Resource allocation

    12/22/2020 KING CEASOR UNIVERSITY 2


    Quality of Life
    •As it pertains to End of life issues
    •Helps determine whether treatment is optional or obligatory
    •When quality of life is sufficiently low and an intervention produces
    more harm than benefit for the patient, caregivers may justifiably
    withhold or withdraw treatment
    •Benefits and burdens here need to be objectively evaluated in order
    to avoid arbitrary judgements that endanger patients’ lives.

    12/22/2020 KING CEASOR UNIVERSITY 3


    Withholding life sustaining treatment
    •Treatment that is painful and uncomfortable may be withdrawn if it
    is considered futile. This is safest if the wishes of the patient were
    known in advance.
    •If the patient’s wishes are not expressed or known/ascertainable –
    family can be consulted. The doctor may oblige if it is deemed that
    the decision taken is in the best interest of the patient. If there are
    varying opinions the decision can be escalated to an ethical
    committee or court

    12/22/2020 KING CEASOR UNIVERSITY 4


    Euthanasia
    •Also known as ‘Mercy Killing’.
    •It is the practice of intentionally ending life to relieve pain and
    suffering.
    •It is illegal in Uganda up to today.
    •Is there sufficient justification for Euthanasia? Do you see potential
    abuse of the practice? Can/should doctors kill? How does it affect
    patient trust?

    12/22/2020 KING CEASOR UNIVERSITY 5


    Resource allocation
    •Through Justice we recognise the right to health
    •There are however practical difficulties in safeguarding that right
    given the fact that resources are limited and health challenges are
    not uniform necessitating the need for Resource Allocation.
    •As resources are allocated something else has to be foregone – there
    is competition among befitting priorities! Opportunity cost!
    •This necessitates the setting of priorities

    12/22/2020 KING CEASOR UNIVERSITY 6


    Resource allocation (cont’d)
    •Strategies for setting priorities:
    • Cost-effectiveness analysis – health benefits are measured in terms of
    anticipated health gains, and costs are measured in terms of
    expenditures of resources. Utilitarian goal: the greatest health benefits
    for the money expended.
    • Here benefits are quantified and attempt is made to incorporate the
    outcome directly into public policy by measuring the impact of
    interventions on both length and quality of life.

    12/22/2020 KING CEASOR UNIVERSITY 7


    Resource allocation (cont’d)
    •Strategies for setting priorities (cont’d):
    oC-E analysis: Drawbacks –
    i. Discriminates against infants, the elderly and the disabled
    ii. How do you judge gains in quality of life – open to subjectivity
    oDemocratic legitimacy – seek for the public’s views, what do they want?
    Chants of ‘our right to die’ in the corona pandemic control interventions
    even going to court!
    Drawback – difficult to solicit and aggregate preferences – referendum? Parliament?
    Majority preference may not necessarily be just!

    12/22/2020 KING CEASOR UNIVERSITY 8


    Resource allocation (cont’d)
    •Viable approach to resource allocation is a decent minimum of health
    care for all – minimum healthcare package!
    •Secondly there is need for cost consciousness and cost control – only
    then are we able to reach everybody.
    •Thirdly – if one has to ration, be fair not to violet the decent minimum
    e.g. a new vaccine! A new critical drug – can you reach everyone?
    •Fourth is implement incrementally to avoid being disruptive of what
    already exists.

    12/22/2020 KING CEASOR UNIVERSITY 9


    Resource allocation (cont’d)
    •Rationing scarce treatments to Patients:
    oTwo approaches:
    i. Maximal benefit to patients and society – prioritise the one who will derive
    maximum benefit (Utilitarian strategy)
    ii. Equal worth of persons and fair opportunity (egalitarian strategy)
    Decision making should embrace the two. The two may however conflict!

    12/22/2020 KING CEASOR UNIVERSITY 10


    We continue from here tomorrow.

    12/22/2020 KING CEASOR UNIVERSITY 11

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