Jerry Menikoff, MD, JD Jerry Menikoff, MD, JD Associate Professor - - PowerPoint PPT Presentation

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Jerry Menikoff, MD, JD Jerry Menikoff, MD, JD Associate Professor - - PowerPoint PPT Presentation

Nov 11, 2023 169 likes •289 views

Jerry Menikoff, MD, JD Jerry Menikoff, MD, JD Associate Professor Associate Professor Department of History and Philosophy of Medicine Department of History and Philosophy of Medicine Ethical Principles Ethical Principles Ethical Principles

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Jerry Menikoff, MD, JD Jerry Menikoff, MD, JD

Associate Professor Associate Professor Department of History and Philosophy of Medicine Department of History and Philosophy of Medicine

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SLIDE 2

Ethical Principles Ethical Principles Ethical Principles

  • Autonomy

Autonomy

  • Beneficence

Beneficence

  • Nonmaleficence

Nonmaleficence

  • Justice

Justice

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SLIDE 3

Right to Refuse Care Right to Refuse Care

  • Karen Ann Quinlan (1975)

Karen Ann Quinlan (1975)

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SLIDE 4

Persistent Vegetative State

Higher Brain Lower Brain

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SLIDE 5

Right to Refuse Care Right to Refuse Care

  • Karen

Karen’ ’s Interest: Privacy s Interest: Privacy

  • State Interests:

State Interests:

  • 1. preserving life
  • 1. preserving life
  • 2. protecting ethical standards of
  • 2. protecting ethical standards of

medical profession medical profession

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SLIDE 6

Right to Refuse Care Right to Refuse Care

  • Rejected distinctions

Rejected distinctions

  • 1. extraordinary v. ordinary care
  • 1. extraordinary v. ordinary care
  • 2. medical Rx v. artif. food/fluids
  • 2. medical Rx v. artif. food/fluids
  • 3. withholding v. withdrawing
  • 3. withholding v. withdrawing
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SLIDE 7

Right to Refuse Care Right to Refuse Care

  • Elizabeth Bouvia (1986)

Elizabeth Bouvia (1986)

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SLIDE 8

Right to Refuse Care Right to Refuse Care

  • Bouie's Interest: Privacy

Bouie's Interest: Privacy

  • State Interests:

State Interests:

  • 1. preserving life
  • 1. preserving life
  • 2. preventing suicide
  • 2. preventing suicide
  • 3. protecting innocent 3
  • 3. protecting innocent 3rd

rd parties

parties

  • 4. protecting ethical standards of medical
  • 4. protecting ethical standards of medical

profession profession

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SLIDE 9

Decision Decision-

  • Making Capacity

Making Capacity

  • Older Concept: Competence

Older Concept: Competence (global) (global)

  • Newer: Capacity to make specific

Newer: Capacity to make specific decision decision

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SLIDE 10

Decision Decision-

  • Making Capacity

Making Capacity

  • Patient must have ability to:

Patient must have ability to:

  • 1.
  • 1. understand

understand info about condition info about condition

  • 2.
  • 2. appreciate

appreciate how info applies to them how info applies to them

  • 3.
  • 3. reason

reason, using info to weigh options , using info to weigh options