Professional Documents
Culture Documents
Bioethics 2017-8-28 FK S1
Bioethics 2017-8-28 FK S1
Gatot S Lawrence
Gatot S Lawrence 10
Pillars of Professionalism
Arnold and Stern, 2006
Professional Doctor
(Physician)
Professionalism
Accountability*
Humanism*
Excellence
Altruism *
Ethic
Autonomy
Competence
Gatot S Lawrence 10
MORALE PRINCIPLES IN MEDICAL ETHICS
(Beauchamp and Childress 1970; Gillon 1986; Lawrence 2008)
Gatot S Lawrence 08
CLINICAL ETHICS:
A Practical Approach in Ethical Decisions
1. Medical indications
2. Patient preferences
3. Quality of life, and
4. Contextual features, meaning the social,
economic, legal, and administrative
context in which the case occurs.
Gatot S Lawrence 08
1. Medical Indications
The Principles of Beneficence and Non-maleficence
1. What is the patient’s medical problem? history?
diagnosis? prognosis?
2. Is the problem acute? chronic? critical? emergent?
reversible?
3. What are goals of treatment?
4. What are the probabilities of success?
5. What are the plans in case of therapeutic failure?
6. In sum, how can this patient be benefit by medical
and nursing care, and how can harm be avoided?
Gatot S Lawrence 08
2. Patient Preferences
The Principles of Respect for Autonomy
1. Is the patient mentally capable and legally competent?
Is there evidence of incapability?
2. If competent, what is the patient stating about
preferences for treatment?
3. Has the patient been informed of benefits and risks,
understood this information, and given consent?
4. If incapacitated, who is appropriate surrogate? Is the
surrogate using appropriate standards for decision
making?
5. Has the patient expressed prior preferences, e.g.
Advance Directives?
6. Is the patient unwilling or unable to cooperate with
medical treatment? If so why?
7. In sum, is the patient’s right to choose being respected
to the extend possible in ethics and law. Gatot S Lawrence 08
3. Quality of Life
Gatot S Lawrence 08
Sudden lost of eye vision
• Ms. Obesto visited her routine physician, Dr. G due to
sudden lost of her left eye vision.
• She is 36 yr, H 165 cm; BW: 76 kg; BP 150/90 mmHg
• Often complaints nausea and ‘stomachache’
• History of frequent headache since high-school, the
condition gettting worse the last 2 months.
• She wears spectacles since elementary school (severe
myopia D=17)
• Ms. Obesto was given anti-emetic agent and admitted to
the hospital by Dr. G
• The next day she was consulted to an Opthalmologist in
the hospital.
• What is your opinion in the above scenario?
Gatot S Lawrence 08
“Wissen ist nicht
genug; wir müssen uns
bewerben.
Das Wollen ist nicht
genug; wir müssen tun”
“Knowing is not enough;
we must apply.
Willing is not enough;
Goethe
we must do.”
Gatot S Lawrence 08