Medical ethics - Revision history

wikademia>Eme at 21:23, 27 December 2009

2009-12-27T21:23:23Z

← Older revision		Revision as of 21:23, 27 December 2009
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	[[Category: Evidence-based Medicine\|*]]		[[Category: Evidence-based Medicine\|*]]
			[[Category:Ethics]]

wikademia>Wikademia: moved Medical Ethics to Medical ethics

2009-05-17T18:57:55Z

moved Medical Ethics to Medical ethics

← Older revision	Revision as of 18:57, 17 May 2009
(No difference)

wikademia>Wikademia at 20:19, 11 April 2009

2009-04-11T20:19:30Z

wikademia>Wikademia at 04:52, 8 April 2009

2009-04-08T04:52:23Z

← Older revision		Revision as of 04:52, 8 April 2009
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	* To list and describe the main theories and principles of medical ethics		* To list and describe the main theories and principles of medical ethics
	* To provide examples of ethical clinical practice		* To provide examples of ethical clinical practice
			{{ntnes}}
	== Medical Ethics ==		== Medical Ethics ==

wikademia>Wikademia at 06:06, 4 April 2009

2009-04-04T06:06:53Z

← Older revision		Revision as of 06:06, 4 April 2009
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	~~{{Robelbox\|theme=13\|title=Lesson Plan}}~~
	~~<div style="{{Robelbox/pad}}">~~
	'''Aims and Objectives:'''		'''Aims and Objectives:'''
	* To define medical ethics		* To define medical ethics
	* To list and describe the main theories and principles of medical ethics		* To list and describe the main theories and principles of medical ethics
	* To provide examples of ethical clinical practice		* To provide examples of ethical clinical practice
	~~{{Robelbox/close}}~~



	== Medical Ethics ==		== Medical Ethics ==
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	* [[wikipedia:deontology\|Deontology]] is an approach to [[ethics]] that focuses on the rightness or wrongness of actions themselves, as opposed to the rightness or wrongness of the consequences of those actions.<ref>Olson, Robert G. 1967. 'Deontological Ethics'. In Paul Edwards (ed.) ''The Encyclopedia of Philosophy''. London: Collier Macmillan: 343.</ref>		* [[wikipedia:deontology\|Deontology]] is an approach to [[ethics]] that focuses on the rightness or wrongness of actions themselves, as opposed to the rightness or wrongness of the consequences of those actions.<ref>Olson, Robert G. 1967. 'Deontological Ethics'. In Paul Edwards (ed.) ''The Encyclopedia of Philosophy''. London: Collier Macmillan: 343.</ref>

	~~{{Robelbox\|theme=2\|title=Clinical Example}}~~
	~~<div style="{{Robelbox/pad}}">~~
	''A doctor comes out of a room after witnessing a patient suffer a distressing death. The family approach the doctor and ask if he suffered. The doctor lies and says "He went peacefully".''		''A doctor comes out of a room after witnessing a patient suffer a distressing death. The family approach the doctor and ask if he suffered. The doctor lies and says "He went peacefully".''

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	'''Deontologist view''' - lying is fundamentally wrong and the family are entitled to the truth.		'''Deontologist view''' - lying is fundamentally wrong and the family are entitled to the truth.
	~~{{Robelbox/close}}~~


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	~~{{Robelbox\|theme=2\|title=Clinical Example}}~~
	~~<div style="{{Robelbox/pad}}">~~
	''A doctor has diagnosed an elderly lady with [[rheumatoid arthritis]] and wants to prescribe an [[Lesson:Non-steroidal Anti-inflammatory Drugs\|NSAID]] to relieve the pain and reduce the inflammation.'' - '''Beneficence'''		''A doctor has diagnosed an elderly lady with [[rheumatoid arthritis]] and wants to prescribe an [[Lesson:Non-steroidal Anti-inflammatory Drugs\|NSAID]] to relieve the pain and reduce the inflammation.'' - '''Beneficence'''

	''However, he does not want the patient to develop gastrointestinal bleeding, a common side-effect of [[Lesson:Non-steroidal Anti-inflammatory Drugs\|NSAIDs]], especially in the elderly'' - '''Non-maleficence'''		''However, he does not want the patient to develop gastrointestinal bleeding, a common side-effect of [[Lesson:Non-steroidal Anti-inflammatory Drugs\|NSAIDs]], especially in the elderly'' - '''Non-maleficence'''
	~~{{Robelbox/close}}~~



	=== Autonomy and Consent ===		=== Autonomy and Consent ===
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	'''[[wikipedia:autononmy\|Autonomy]]''' is the right of a patient to make an informed, uncoerced decision about their own health management. If this principle is disregarded by a medical professional because he/she believes another decision would be better for the patient, then it is termed [[wikipedia:paternalism\|paternalism]]. An autonomous decision should '''never''' be overruled by a medical professional, but not all decisions are autonomous. For patients to have autonomy, they must have the '''capacity''' to receive, retain and repeat the information that is given to them, provided the information is complete and given to them in a manner that they can understand.		'''[[wikipedia:autononmy\|Autonomy]]''' is the right of a patient to make an informed, uncoerced decision about their own health management. If this principle is disregarded by a medical professional because he/she believes another decision would be better for the patient, then it is termed [[wikipedia:paternalism\|paternalism]]. An autonomous decision should '''never''' be overruled by a medical professional, but not all decisions are autonomous. For patients to have autonomy, they must have the '''capacity''' to receive, retain and repeat the information that is given to them, provided the information is complete and given to them in a manner that they can understand.

	~~{{Robelbox\|theme=2\|title=Clinical Example}}~~
	~~<div style="{{Robelbox/pad}}">~~
	''A patient with breast cancer is told by her oncologist that there are two treatment options, a total mastectomy or a partial mastectomy with radiotherapy. The patient decides to have a total mastectomy'' - '''Autonomy'''		''A patient with breast cancer is told by her oncologist that there are two treatment options, a total mastectomy or a partial mastectomy with radiotherapy. The patient decides to have a total mastectomy'' - '''Autonomy'''

	''An oncologist decides that a patient with breast cancer should receive a total mastectomy'' - '''Paternalism'''		''An oncologist decides that a patient with breast cancer should receive a total mastectomy'' - '''Paternalism'''
	~~{{Robelbox/close}}~~



	'''Consent''' is an extension of autonomy and has many types. '''Implied consent''' is when a doctor assumes that certain actions or body language from a patient imply that the patient has consented to the planned action of the doctor. '''Expressed oral consent''' is when a patient has verbally given the doctor permission to proceed with the intended action. '''Expressed written consent''' is documented evidence that the patient has, usually with a signature, given consent to a procedure. Written consent should only be obtained after oral consent. '''[[wikipedia:informed consent\|Fully informed consent]]''' is consent given after being given all the information about the procedure. When possible, fully informed consent, both written and oral, should be obtained before any procedure, examination or treatment.<ref>M A Graber, J F Tansey. Autonomy, consent, and limiting healthcare costs. J Med Ethics 2005;31:424-426</ref>		'''Consent''' is an extension of autonomy and has many types. '''Implied consent''' is when a doctor assumes that certain actions or body language from a patient imply that the patient has consented to the planned action of the doctor. '''Expressed oral consent''' is when a patient has verbally given the doctor permission to proceed with the intended action. '''Expressed written consent''' is documented evidence that the patient has, usually with a signature, given consent to a procedure. Written consent should only be obtained after oral consent. '''[[wikipedia:informed consent\|Fully informed consent]]''' is consent given after being given all the information about the procedure. When possible, fully informed consent, both written and oral, should be obtained before any procedure, examination or treatment.<ref>M A Graber, J F Tansey. Autonomy, consent, and limiting healthcare costs. J Med Ethics 2005;31:424-426</ref>

	~~{{Robelbox\|theme=2\|title=Clinical Example}}~~
	~~<div style="{{Robelbox/pad}}">~~
	''A patient with tonsillitis is in the ENT ward and a doctor approaches with a syringe. The patient stretches out her left arm in the direction of the doctor. The doctor takes a sample of her blood.'' - '''Implied Consent'''		''A patient with tonsillitis is in the ENT ward and a doctor approaches with a syringe. The patient stretches out her left arm in the direction of the doctor. The doctor takes a sample of her blood.'' - '''Implied Consent'''

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	''Then the doctor asks the patient to consent for surgery by reading and signing a form consenting to a tonsillectomy after explaining to the patient the risks and benefits of the procedure. The patient reads and signs the document and expresses her wish to have the procedure.'' - '''Fully informed written and oral consent'''		''Then the doctor asks the patient to consent for surgery by reading and signing a form consenting to a tonsillectomy after explaining to the patient the risks and benefits of the procedure. The patient reads and signs the document and expresses her wish to have the procedure.'' - '''Fully informed written and oral consent'''
	~~{{Robelbox/close}}~~

	=== Truth-telling ===		=== Truth-telling ===
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	~~{{Robelbox\|theme=2\|title=Clinical Example}}~~
	~~<div style="{{Robelbox/pad}}">~~
	''A doctor informs a patient that he cannot drive because of his recent diagnosis of epilepsy. The patient agrees but, when driving to work one morning, the doctor sees the man driving. The doctor'' '''must''' ''inform the local driving authority due to concerns regarding public safety.''		''A doctor informs a patient that he cannot drive because of his recent diagnosis of epilepsy. The patient agrees but, when driving to work one morning, the doctor sees the man driving. The doctor'' '''must''' ''inform the local driving authority due to concerns regarding public safety.''
	~~{{Robelbox/close}}~~


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	~~{{Robelbox\|theme=13\|title=Lesson Summary}}~~
	~~<div style="{{Robelbox/pad}}">~~
	The ethical theories that apply to medicine are:		The ethical theories that apply to medicine are:
	* Consequentialism		* Consequentialism
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	* Preservation of life		* Preservation of life
	* Justice		* Justice
	~~{{Robelbox/close}}~~

	<center><big>'''[[Talk:Lesson: Medical Ethics\|Any Questions?]]'''</big></center>		<center><big>'''[[Talk:Lesson: Medical Ethics\|Any Questions?]]'''</big></center>

wikademia>Wikademia: 2 revisions

2009-03-30T18:13:27Z

2 revisions

← Older revision	Revision as of 18:13, 30 March 2009
(No difference)

116.76.199.217: /* Autonomy and Consent */

2009-03-30T09:26:53Z

Autonomy and Consent

← Older revision		Revision as of 09:26, 30 March 2009
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	'''Consent''' is an extension of autonomy and has many types. '''Implied consent''' is when a doctor assumes that certain actions or body ~~languages~~ from a patient imply that the patient has consented to the planned action of the doctor. '''Expressed oral consent''' is when a patient has verbally given the doctor permission to proceed with the intended action. '''Expressed written consent''' is documented evidence that the patient has, usually with a signature, given consent to a procedure. Written consent should only be obtained after oral consent. '''[[wikipedia:informed consent\|Fully informed consent]]''' is consent given after being given all the information about the procedure. When possible, fully informed consent, both written and oral, should be obtained before any procedure, examination or treatment.<ref>M A Graber, J F Tansey. Autonomy, consent, and limiting healthcare costs. J Med Ethics 2005;31:424-426</ref>		'''Consent''' is an extension of autonomy and has many types. '''Implied consent''' is when a doctor assumes that certain actions or body language from a patient imply that the patient has consented to the planned action of the doctor. '''Expressed oral consent''' is when a patient has verbally given the doctor permission to proceed with the intended action. '''Expressed written consent''' is documented evidence that the patient has, usually with a signature, given consent to a procedure. Written consent should only be obtained after oral consent. '''[[wikipedia:informed consent\|Fully informed consent]]''' is consent given after being given all the information about the procedure. When possible, fully informed consent, both written and oral, should be obtained before any procedure, examination or treatment.<ref>M A Graber, J F Tansey. Autonomy, consent, and limiting healthcare costs. J Med Ethics 2005;31:424-426</ref>

	{{Robelbox\|theme=2\|title=Clinical Example}}		{{Robelbox\|theme=2\|title=Clinical Example}}

116.76.199.217: /* Autonomy and Consent */ missing word

2009-03-30T09:25:58Z

Autonomy and Consent: missing word

← Older revision		Revision as of 09:25, 30 March 2009
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	{{Robelbox\|theme=2\|title=Clinical Example}}		{{Robelbox\|theme=2\|title=Clinical Example}}
	<div style="{{Robelbox/pad}}">		<div style="{{Robelbox/pad}}">
	''A patient with breast cancer is told by her oncologist that are two treatment options, a total mastectomy or a partial mastectomy with radiotherapy. The patient decides to have a total mastectomy'' - '''Autonomy'''		''A patient with breast cancer is told by her oncologist that there are two treatment options, a total mastectomy or a partial mastectomy with radiotherapy. The patient decides to have a total mastectomy'' - '''Autonomy'''

	''An oncologist decides that a patient with breast cancer should receive a total mastectomy'' - '''Paternalism'''		''An oncologist decides that a patient with breast cancer should receive a total mastectomy'' - '''Paternalism'''
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	''Then the doctor asks the patient to consent for surgery by reading and signing a form consenting to a tonsillectomy after explaining to the patient the risks and benefits of the procedure. The patient reads and signs the document and expresses her wish to have the procedure.'' - '''Fully informed written and oral consent'''		''Then the doctor asks the patient to consent for surgery by reading and signing a form consenting to a tonsillectomy after explaining to the patient the risks and benefits of the procedure. The patient reads and signs the document and expresses her wish to have the procedure.'' - '''Fully informed written and oral consent'''
	{{Robelbox/close}}		{{Robelbox/close}}



	=== Truth-telling ===		=== Truth-telling ===

116.76.199.217: /* Ethical Principles */ grammar

2009-03-30T09:24:14Z

Ethical Principles: grammar

← Older revision		Revision as of 09:24, 30 March 2009
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	=== Beneficence and Non-maleficence ===		=== Beneficence and Non-maleficence ===

	'''Beneficence''' is the act of "doing good" while '''non-maleficence''' is the act of "not doing bad". In practical terms, medical practitioners have an ethical responsibility to strive to do what is in the best interests of their patients. However, it is important to remember than some medical interventions may seem beneficial but may also carry with it the possibility of causing harm. In fact, nearly all medical treatments and procedures, it could be argued, harm the patient in some way, but it is more to do with the magnitude of the benefit versus the magnitude of potential risks.<ref>R Gillon. Medical ethics: four principles plus attention to scope. BMJ 1994;309:184</ref>		'''Beneficence''' is the act of "doing good" while '''non-maleficence''' is the act of "not doing bad". In practical terms, medical practitioners have an ethical responsibility to strive to do what is in the best interests of their patients. However, it is important to remember than some medical interventions may seem beneficial but may also carry with them the possibility of causing harm. In fact, nearly all medical treatments and procedures, it could be argued, harm the patient in some way, but it is more to do with the magnitude of the benefit versus the magnitude of potential risks.<ref>R Gillon. Medical ethics: four principles plus attention to scope. BMJ 1994;309:184</ref>

116.76.199.217: sp.

2009-03-30T09:23:11Z

sp.

← Older revision		Revision as of 09:23, 30 March 2009
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	[[wikipedia:Medical Ethics\|Medical Ethics]] is the study of moral values and judgments as they apply to medicine. Ethical principles heavily govern the practice of medicine<ref>http://gmc-uk.org</ref><ref>http://ama-assn.org</ref>and ethical theories form the basis of ethical argument. With high profile cases regarding [[wikipedia:medical malpractice\|malpractice]] of doctors and the recent medical advances in technology, more and more clinical practices are coming under the scrutiny of both the media and the general public. For example, [[hand-washing]] was once a common courtesy, but now it could be deemed unethical to not do so. This is a result of the discovery of "[[wikipedia:antibiotic resistance\|'''superbugs''']]" (e.g. [[wikipedia:mrsa\|MRSA]]), which are potentially fatal due to their resistance to available antibiotics,<ref>{{cite journal \|author=Soulsby EJ \|title=Resistance to antimicrobials in humans and animals \|journal=BMJ \|volume=331 \|issue=7527 \|pages=1219–20 \|year=2005 \|pmid=16308360 \|doi=10.1136/bmj.331.7527.1219 \|url=http://www.bmj.com/cgi/content/full/331/7527/1219}}</ref>and the public demand for health services to improve their standards.		[[wikipedia:Medical Ethics\|Medical Ethics]] is the study of moral values and judgments as they apply to medicine. Ethical principles heavily govern the practice of medicine<ref>http://gmc-uk.org</ref><ref>http://ama-assn.org</ref>and ethical theories form the basis of ethical argument. With high profile cases regarding [[wikipedia:medical malpractice\|malpractice]] of doctors and the recent medical advances in technology, more and more clinical practices are coming under the scrutiny of both the media and the general public. For example, [[hand-washing]] was once a common courtesy, but now it could be deemed unethical to not do so. This is a result of the discovery of "[[wikipedia:antibiotic resistance\|'''superbugs''']]" (e.g. [[wikipedia:mrsa\|MRSA]]), which are potentially fatal due to their resistance to available antibiotics,<ref>{{cite journal \|author=Soulsby EJ \|title=Resistance to antimicrobials in humans and animals \|journal=BMJ \|volume=331 \|issue=7527 \|pages=1219–20 \|year=2005 \|pmid=16308360 \|doi=10.1136/bmj.331.7527.1219 \|url=http://www.bmj.com/cgi/content/full/331/7527/1219}}</ref>and the public demand for health services to improve their standards.

	However, medical ethics is not an exact science. In certain situations it may be difficult to know what is ethically "correct". Ethical debates commonly arise on medical wards, therefore, a comprehensive knowledge of medical ethics is paramount to deciding the best course of action.		However, medical ethics is not an exact science. In certain situations it may be difficult to know what is ethically "correct". Ethical debates commonly arise on medical wards; therefore, a comprehensive knowledge of medical ethics is paramount to deciding the best course of action.

	== Ethical Theories ==		== Ethical Theories ==
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	== Ethical Principles ==		== Ethical Principles ==

	The ethical principles that govern medical practice should act as a framework when making medical decisions. When ethical dilemmas arise the best approach is to think through ~~theses~~ ethical principles logically and methodically.		The ethical principles that govern medical practice should act as a framework when making medical decisions. When ethical dilemmas arise the best approach is to think through these ethical principles logically and methodically.

← Older revision		Revision as of 20:19, 11 April 2009
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	'''Deontologist view''' - lying is fundamentally wrong and the family are entitled to the truth.		'''Deontologist view''' - lying is fundamentally wrong and the family are entitled to the truth.




	== Ethical Principles ==		== Ethical Principles ==

	The ethical principles that govern medical practice should act as a framework when making medical decisions. When ethical dilemmas arise the best approach is to think through these ethical principles logically and methodically.		The ethical principles that govern medical practice should act as a framework when making medical decisions. When ethical dilemmas arise the best approach is to think through these ethical principles logically and methodically.



	=== Beneficence and Non-maleficence ===		=== Beneficence and Non-maleficence ===

	'''Beneficence''' is the act of "doing good" while '''non-maleficence''' is the act of "not doing bad". In practical terms, medical practitioners have an ethical responsibility to strive to do what is in the best interests of their patients. However, it is important to remember than some medical interventions may seem beneficial but may also carry with them the possibility of causing harm. In fact, nearly all medical treatments and procedures, it could be argued, harm the patient in some way, but it is more to do with the magnitude of the benefit versus the magnitude of potential risks.<ref>R Gillon. Medical ethics: four principles plus attention to scope. BMJ 1994;309:184</ref>		'''Beneficence''' is the act of "doing good" while '''non-maleficence''' is the act of "not doing bad". In practical terms, medical practitioners have an ethical responsibility to strive to do what is in the best interests of their patients. However, it is important to remember than some medical interventions may seem beneficial but may also carry with them the possibility of causing harm. In fact, nearly all medical treatments and procedures, it could be argued, harm the patient in some way, but it is more to do with the magnitude of the benefit versus the magnitude of potential risks.<ref>R Gillon. Medical ethics: four principles plus attention to scope. BMJ 1994;309:184</ref>



	''A doctor has diagnosed an elderly lady with [[rheumatoid arthritis]] and wants to prescribe an [[Lesson:Non-steroidal Anti-inflammatory Drugs\|NSAID]] to relieve the pain and reduce the inflammation.'' - '''Beneficence'''		''A doctor has diagnosed an elderly lady with [[rheumatoid arthritis]] and wants to prescribe an [[Lesson:Non-steroidal Anti-inflammatory Drugs\|NSAID]] to relieve the pain and reduce the inflammation.'' - '''Beneficence'''
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	'''[[wikipedia:autononmy\|Autonomy]]''' is the right of a patient to make an informed, uncoerced decision about their own health management. If this principle is disregarded by a medical professional because he/she believes another decision would be better for the patient, then it is termed [[wikipedia:paternalism\|paternalism]]. An autonomous decision should '''never''' be overruled by a medical professional, but not all decisions are autonomous. For patients to have autonomy, they must have the '''capacity''' to receive, retain and repeat the information that is given to them, provided the information is complete and given to them in a manner that they can understand.		'''[[wikipedia:autononmy\|Autonomy]]''' is the right of a patient to make an informed, uncoerced decision about their own health management. If this principle is disregarded by a medical professional because he/she believes another decision would be better for the patient, then it is termed [[wikipedia:paternalism\|paternalism]]. An autonomous decision should '''never''' be overruled by a medical professional, but not all decisions are autonomous. For patients to have autonomy, they must have the '''capacity''' to receive, retain and repeat the information that is given to them, provided the information is complete and given to them in a manner that they can understand.


	''A patient with breast cancer is told by her oncologist that there are two treatment options, a total mastectomy or a partial mastectomy with radiotherapy. The patient decides to have a total mastectomy'' - '''Autonomy'''		''A patient with breast cancer is told by her oncologist that there are two treatment options, a total mastectomy or a partial mastectomy with radiotherapy. The patient decides to have a total mastectomy'' - '''Autonomy'''

	''An oncologist decides that a patient with breast cancer should receive a total mastectomy'' - '''Paternalism'''		''An oncologist decides that a patient with breast cancer should receive a total mastectomy'' - '''Paternalism'''


	'''Consent''' is an extension of autonomy and has many types. '''Implied consent''' is when a doctor assumes that certain actions or body language from a patient imply that the patient has consented to the planned action of the doctor. '''Expressed oral consent''' is when a patient has verbally given the doctor permission to proceed with the intended action. '''Expressed written consent''' is documented evidence that the patient has, usually with a signature, given consent to a procedure. Written consent should only be obtained after oral consent. '''[[wikipedia:informed consent\|Fully informed consent]]''' is consent given after being given all the information about the procedure. When possible, fully informed consent, both written and oral, should be obtained before any procedure, examination or treatment.<ref>M A Graber, J F Tansey. Autonomy, consent, and limiting healthcare costs. J Med Ethics 2005;31:424-426</ref>		'''Consent''' is an extension of autonomy and has many types. '''Implied consent''' is when a doctor assumes that certain actions or body language from a patient imply that the patient has consented to the planned action of the doctor. '''Expressed oral consent''' is when a patient has verbally given the doctor permission to proceed with the intended action. '''Expressed written consent''' is documented evidence that the patient has, usually with a signature, given consent to a procedure. Written consent should only be obtained after oral consent. '''[[wikipedia:informed consent\|Fully informed consent]]''' is consent given after being given all the information about the procedure. When possible, fully informed consent, both written and oral, should be obtained before any procedure, examination or treatment.<ref>M A Graber, J F Tansey. Autonomy, consent, and limiting healthcare costs. J Med Ethics 2005;31:424-426</ref>
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	The ethical principle of '''Truth-telling''' is the process in which a doctor gives the patient all known information about their health. It allows the patient to be fully-informed and, therefore, allows for the ethical principles of autonomy and consent. A point of note that always needs to be considered is the fact that some patients do not want the information. Therefore it is important to ask the patient if they want to know or not. The only other (extremely rare) occasion when it is acceptable not to tell the patient the truth is when the patient may come to harm when being told, e.g. "If you tell me I have cancer I will kill myself!".<ref>D Kirklin. Truth telling, autonomy and the role of metaphor. Journal of Medical Ethics 2007;33:11-14; doi:10.1136/jme.2005.014993</ref>		The ethical principle of '''Truth-telling''' is the process in which a doctor gives the patient all known information about their health. It allows the patient to be fully-informed and, therefore, allows for the ethical principles of autonomy and consent. A point of note that always needs to be considered is the fact that some patients do not want the information. Therefore it is important to ask the patient if they want to know or not. The only other (extremely rare) occasion when it is acceptable not to tell the patient the truth is when the patient may come to harm when being told, e.g. "If you tell me I have cancer I will kill myself!".<ref>D Kirklin. Truth telling, autonomy and the role of metaphor. Journal of Medical Ethics 2007;33:11-14; doi:10.1136/jme.2005.014993</ref>



	=== Confidentiality ===		=== Confidentiality ===

	The ethical principle of '''confidentiality''' ensures that the medical information held about a patient is accessible only to those to whom the patient has given access via autonomous and full-informed consent. In order to achieve trust between medical professionals and their patients, confidentiality must be maintained. Confidentiality may be broken if information shared by the patient refers to a potential danger to public safety or if it is ordered by a court.<ref>Debashis Singh. Confidentiality, consent, and the media. studentBMJ 2000;08:45-88 March ISSN 0966-6494</ref>		The ethical principle of '''confidentiality''' ensures that the medical information held about a patient is accessible only to those to whom the patient has given access via autonomous and full-informed consent. In order to achieve trust between medical professionals and their patients, confidentiality must be maintained. Confidentiality may be broken if information shared by the patient refers to a potential danger to public safety or if it is ordered by a court.<ref>Debashis Singh. Confidentiality, consent, and the media. studentBMJ 2000;08:45-88 March ISSN 0966-6494</ref>


	''A doctor informs a patient that he cannot drive because of his recent diagnosis of epilepsy. The patient agrees but, when driving to work one morning, the doctor sees the man driving. The doctor'' '''must''' ''inform the local driving authority due to concerns regarding public safety.''		''A doctor informs a patient that he cannot drive because of his recent diagnosis of epilepsy. The patient agrees but, when driving to work one morning, the doctor sees the man driving. The doctor'' '''must''' ''inform the local driving authority due to concerns regarding public safety.''


	=== Preservation of life ===		=== Preservation of life ===
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	Clinical prioritisations of healthcare for the aged--professional roles		Clinical prioritisations of healthcare for the aged--professional roles
	J. Med. Ethics, September 1, 2008; 34(5): 332 - 335.</ref>		J. Med. Ethics, September 1, 2008; 34(5): 332 - 335.</ref>


	The ethical theories that apply to medicine are:		The ethical theories that apply to medicine are: