Ethical Self-Evidence and the Principle of Proportionality: Two Fundamental Ethical Principles Applied to a Psychiatric Case Report

2011 ◽  
Vol 13 (1) ◽  
pp. 29-45 ◽  
Author(s):  
Barbara Andrade ◽  
Oscar Ugalde
Keyword(s):  
Mental Health ◽  
Practical Reasoning ◽  
Ethical Principles ◽  
Ethical Question ◽  
Patient Relationship ◽  
Ethical Problems ◽  
Medical Associations ◽  
Ethical Norms ◽  
Principle Of Proportionality ◽  
Ethical Systems

When confronting ethical problems, clinicians generally feel both unprepared as well as in need of orientation. Ethical norms issued by medical associations are necessary and helpful but insufficient: by definition, codes and norms arepreethical; that is, they establish guidelines before the truly ethical question even arises. To arrive at a clear ethical formulation and to bridge the gap between a set of rules and their application in particular cases are essential. This article discusses some problems with ethical systems and then demonstrates that it is possible to formulate two fundamental ethical principles—ethical self-evidence and the principle of proportionality—applicable to treatment situations in a process of effective practical reasoning. Such a process forms an integral part of the doctor–patient relationship and can be practiced individually, and in staff and treatment sessions. The principles and the reasoning process are valid in all medical and mental health fields. The example shown here is their application in psychiatry, specifically, in a case of Huntington’s disease.

Automated argument adjudication to solve ethical problems in multi-agent environments

2021 ◽  
Vol 12 (1) ◽  
pp. 310-335
Author(s):  
Selmer Bringsjord ◽  
Naveen Sundar Govindarajulu ◽  
Michael Giancola
Keyword(s):  
Ethical Problem ◽  
Propositional Content ◽  
Ethical Principles ◽  
Artificial Agents ◽  
Artificial Agent ◽  
Ethical Problems ◽  
Multi Agent

Abstract Suppose an artificial agent a adj {a}_{\text{adj}} , as time unfolds, (i) receives from multiple artificial agents (which may, in turn, themselves have received from yet other such agents…) propositional content, and (ii) must solve an ethical problem on the basis of what it has received. How should a adj {a}_{\text{adj}} adjudicate what it has received in order to produce such a solution? We consider an environment infused with logicist artificial agents a 1 , a 2 , … , a n {a}_{1},{a}_{2},\ldots ,{a}_{n} that sense and report their findings to “adjudicator” agents who must solve ethical problems. (Many if not most of these agents may be robots.) In such an environment, inconsistency is a virtual guarantee: a adj {a}_{\text{adj}} may, for instance, receive a report from a 1 {a}_{1} that proposition ϕ \phi holds, then from a 2 {a}_{2} that ¬ ϕ \neg \phi holds, and then from a 3 {a}_{3} that neither ϕ \phi nor ¬ ϕ \neg \phi should be believed, but rather ψ \psi instead, at some level of likelihood. We further assume that agents receiving such incompatible reports will nonetheless sometimes simply need, before long, to make decisions on the basis of these reports, in order to try to solve ethical problems. We provide a solution to such a quandary: AI capable of adjudicating competing reports from subsidiary agents through time, and delivering to humans a rational, ethically correct (relative to underlying ethical principles) recommendation based upon such adjudication. To illuminate our solution, we anchor it to a particular scenario.

scholarly journals Ethical issues relating to qualitative research

2005 ◽  
Vol 61 (1) ◽  
Author(s):  
J. Jelsma ◽  
S. Clow
Keyword(s):  
Qualitative Research ◽  
Health Research ◽  
Ethical Issues ◽  
Ethical Principles ◽  
Ethical Review ◽  
Paper Briefly ◽  
Ethical Problems ◽  
Scientific Rigour ◽  
Hands On

Qualitative research or naturalistic research has moved from the sidelines into the mainstream of health research and an increasing number of qualitative research proposals are being presented for ethical review Qualitative research presents ethical problems that which are unique to the intensive hands-on paradigm which characterises naturalistic research. This paper briefly outlines the most common methodologies used in this research. The four ethical principles of benevolence, non-maleficence, autonomy and justice will be used as a framework to explore specific ethical issues related to this form of inquiry. The need for scientific rigour will also be explored as research that is scientifically unsound can never be ethical.

Protecting privacy to protect mental health: the new ethical imperative

2019 ◽  
Vol 45 (9) ◽  
pp. 604-607 ◽  
Author(s):  
Elias Aboujaoude
Keyword(s):  
Mental Health ◽  
Electronic Medical Records ◽  
Psychological Health ◽  
Medical Records ◽  
Personal Data ◽  
Psychological Development ◽  
Clinical Implications ◽  
Patient Relationship ◽  
Ethical Imperative ◽  
The Individual

Confidentiality is a central bioethical principle governing the provider–patient relationship. Dating back to Hippocrates, new laws have interpreted it for the age of precision medicine and electronic medical records. This is where the discussion of privacy and technology often ends in the scientific health literature when Internet-related technologies have made privacy a much more complex challenge with broad psychological and clinical implications. Beyond the recognised moral duty to protect patients’ health information, clinicians should now advocate a basic right to privacy as a means to safeguard psychological health. The article reviews empirical research into the functions of privacy, the implications for psychological development and the resigned sentiment taking hold regarding the ability to control personal data. The article concludes with a call for legislative, educational and research steps to readjust the equilibrium between the individual and ‘Big Data’.

Ethics of Drug Giving and Drug Taking

1988 ◽  
Vol 18 (2) ◽  
pp. 195-200 ◽  
Author(s):  
Albert R. Jonsen
Keyword(s):  
Ethical Principles ◽  
Patient Relationship ◽  
Physician Patient Relationship ◽  
Ancient Greek ◽  
Therapeutic Application ◽  
Therapeutic Drugs ◽  
Physician Patient ◽  
Technical Terms

The activity of prescribing therapeutic drugs is one of the most significant features of the physician-patient relationship. This activity must be understood in moral, as well as technical terms. The ancient Greek word for drug had three meanings, providing the outline for an ethics of medication: remedy, poison and magical charm. Corresponding to these three meanings are three ethical principles: competence in therapeutic application, avoidance of harm and honesty.

The Frame Problem in Ethics

2020 ◽  
Vol 2 ◽  
pp. 53-73
Author(s):  
Sebastian Gałecki
Keyword(s):  
Artificial Intelligence ◽  
Moral Judgment ◽  
First Principles ◽  
Practical Reasoning ◽  
Ethical Principles ◽  
Frame Problem ◽  
Classical Philosophy ◽  
The Frame Problem ◽  
The Invisible

Although the “frame problem” in philosophy has been raised in the context of the artificial intelligence, it is only an exemplification of broader problem. It seems that contemporary ethical debates are not so much about conclusions, decisions, norms, but rather about what we might call a “frame”. Metaethics has always been the bridge between purely ethical principles (“this is good and it should be done”, “this is wrong and it should be avoided”) and broader (ontological, epistemic, anthropological etc.) assumptions. One of the most interesting meta-ethical debates concerns the “frame problem”: whether the ethical frame is objective and self-evident, or is it objective but not self-evident? In classical philosophy, this problem takes the form of a debate on the first principles: nonprovable but necessary starting points for any practical reasoning. They constitute the invisible but essential frame of every moral judgment, decision and action. The role of philosophy is not only to expose these principles, but also to understand the nature of the moral frame.

ETHICAL ISSUES AND THE CORONAVIRUS EPIDEMIC

2021 ◽  
pp. 9-16
Author(s):  
Oleg Letov ◽  
Keyword(s):  
Public Health ◽  
English Language ◽  
Ethical Issues ◽  
Biomedical Ethics ◽  
Ethical Principles ◽  
Precautionary Approach ◽  
Ethical Problems ◽  
Health Advice ◽  
Analytical Review

The article is an analytical review of English-language articles on contemporary ethical issues related to the coronavirus epidemic. Such principles of biomedical ethics as respect for the freedom of the patient, non-harm are analyzed. A precautionary approach is formulated, the main norms of which are practicality, impartiality, proportionality and justification. It is emphasized that public health advice and action should be part of a broader effort to gain and maintain confidence in the action taken. Reasonable trust requires a serious attitude to the ethical problems associated with the implementation of the intended ethical principles.

Sedação Paliativa, Perspetiva de Um Clínico

2018 ◽  
Vol 26 (52) ◽  
pp. 127-138
Author(s):  
Madalena Feio ◽  
Keyword(s):  
Double Effect ◽  
Palliative Sedation ◽  
Ethical Principles ◽  
First Line ◽  
Scientific Societies ◽  
Refractory Symptoms ◽  
Medical Associations ◽  
Line Drug

Palliative sedation does not have a universally accepted definition. It is used as a measure of last resort for the control of refractory symptoms in the last days of life. The ethical principles invoked in its use are those of double effect and proportionality. Its prevalence varies according to the place of care, type of study and country. The most frequent indications for its use are the control of dyspnea, delirium and pain. The recommended first line drug is midazolam. The studies performed do not diminish the survival of the patient. It is important that fami­ly support is maintained throughout the process. Several scientific societies and medical associations have defined guidelines that regulate their implementation.

The patient’s perspective

2020 ◽  
pp. 3-5
Author(s):  
Kay Redfield Jamison ◽  
Adam Ian Kaplin
Keyword(s):  
Mental Health ◽  
Information Technology ◽  
Health Information ◽  
Therapeutic Relationship ◽  
Patient Relationship ◽  
Patient’S Perspective ◽  
Clinical Encounters ◽  
Ultimate Outcome ◽  
The Moment ◽  
Mutual Communication

In addition to knowledge, a physician’s ability to engage and persuade through compassionate understanding and therapeutic optimism is an indispensable skill that may determine the ultimate outcome of their patient’s illness and health. From the moment a patient is first given a psychiatric diagnosis, they embark on a path to combat personal anguish, social isolation, and stigma in an effort to regain mastery of their life. The interaction between doctor and patient and the mutual communication and trust that underlie their therapeutic relationship are at least equal in importance to the efficacy of any medication that can be prescribed. As mental health information technology evolves and becomes ever more present during clinical encounters, the importance of understanding the patient’s perspective will be critical to physicians who want to preserve what is irreplaceable and therapeutically critical to the doctor–patient relationship.

Mental Health and Behavior Control

2017 ◽  
Author(s):  
Robert M. Veatch ◽  
Amy Haddad ◽  
E. J. Last
Keyword(s):  
Mental Health ◽  
Health Practice ◽  
Decisional Capacity ◽  
Ethical Problems ◽  
Risks And Benefits ◽  
Patient’S Autonomy ◽  
Harm To Others ◽  
Right To Refuse Treatment ◽  
The Right ◽  
And Behavior

This chapter focuses on the special challenges of ethical problems in mental health and behavioral health settings. The basic elements of informed consent, the special problems with decisional capacity, and the right to refuse treatment are examined in the light of mental health practice. The controversy that results from various understandings and meanings of the cause and treatment of mental illness are explored. Pharmacological and medical therapies such as electroconvulsive therapy and aversive therapy are discussed, with a focus on the parties who are in a position to judge the risks and benefits of such therapies. The interests of third parties are also explored as justification for overriding a patient’s autonomy because of potential serious harm to others.

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