William L. Allen, M.Div., J.D.
ETHICAL PRINCIPLES AND CONCEPTS
1. Define the following terms in relation to the patient and physician-patient
relationship: “beneficence,” “nonmaleficence,” and “respect for autonomy.”
& The concept that the physician will contribute to the welfare of the patient
through the recommended medical interventions
& An obligation for the physician not to inflict harm upon the patient
& The obligation of the physician to honor the patient’s right to accept or refuse a
recommended treatment, based on respect for persons
2. What is fiduciary duty?
A duty of trust imposed upon physicians requiring them to place their patients’ best interests
ahead of their own interests.
3. What is conflict of interest?
A situation in which one or more of a professional’s duties to a client or patient conflicts wi
the professional’s self interests, or when a professional’s roles or duties to more than one
patient or organization are in tension or conflict.
4. How should conflicts of interest be addressed?
Avoided, if possible
Disclosed to institutional officials or to patients affected
Managed by disinterested parties outside the conflicted roles or relationships
5. What is conscientious objection?
Objection to participation in or performance of a procedure or test grounded on a person’s
sincere and deeply held belief that it is morally wrong.
6. What is a conscience clause?
A provision in law or policy that allows providers with conscientious objections to decline participati
in activities to which they have moral objections, under certain conditions and limitations.
7. Describe futility.
The doctrine that physicians are not required to attempt treatment if there will be no medical
benefit from it. This has become a very controversial term in recent times, in part because of
inconsistency in definition and usage. In its clearest sense, it is not so controversial. For
example, when the substance laetrile, derived from apricot pits, was rumored to be a cure
for cancer in the early 1970s, desperate cancer patients besieged their physicians to give them this drug. Most physicians in this country declined to do so on the grounds that such a
treatment would be futile and the exercise of professional autonomy warranted refusal of their
patients’ requests in this case. Futility is sometimes inappropriately invoked when the chance
of a treatment’s efficacy is significantly limited, but not zero, and the physician determines that
minimal chance of efficacy to be “futile.”
INFORMED CONSENT
8. How should one request “consent” from a patient?
Consent is not a transitive verb. Sometimes a medical student or resident is instructed to
“go consent the patient.” This implies that consent is an act that a health professional
performs upon a passive recipient who has no role in the action other than passive acceptance.
A health professional seeking consent from a patient should be asking the patient for either an
affirmative endorsement of an offered intervention or a decision to decline the proposed
intervention.
9. What is consent or mere consent?
Consent alone, without a sufficiently robust level of information to justify the adjective
“informed.” Although “mere consent” may avoid a finding of battery (which is defined as
physical contact with a person without that person’s consent), it is usually insufficient
permission for the physician to proceed with a procedure or treatment.
10. What is informed consent?
Consent from a patient that is preceded by and based on the patient’s understanding of the
proposed intervention at a level that enables the patient to make a meaningful decision about
endorsement or refusal of the proposed intervention.
11. What are the necessary conditions for valid informed consent?
- Disclosure of relevant medical information by health care providers
- Comprehension of relevant medical information by patient (or authorized representative)
-Voluntariness (absence of coercion by medical personnel or institutional pressure)
