Ethical Principles 2018-01-30T16:37:10+08:00
  • Autonomy
    • Individuals have a right to self-determination free from coercion or coaxing
    • Capacity under the Mental Health Act is defined as the ability to do all of the following:
      • Understand information relevant to the decision making process
      • Retain that information
      • Use or weight the information as part of the decision making process
      • Communicate that decision, by any interpretable means
    • Assessment of capacity is a two-step act:
      • Is the patient suffering from an impairment of the mind or the brain?
      • Does that impairment impede the patient’s mental capacity?
    • Principles when making a decision for someone who lacks capacity:
      • Every patient has the capacity to make decisions until proven otherwise
      • A patient cannot be assumed to lack capacity unless all practical steps which are taken to help him make a decision are unsuccessful
      • An unwise decision does not equate to a lack of capacity
      • Any decision made on behalf of the patient who lacks capacity must be in his best interests
      • There must be consideration as to how a decision made on behalf of a person can be achieved in a way which is least restrictive to his rights
    • Formal assessment of mental capacity can only be done by medical practitioners who have undergone training and whose names are registered with the Office of the Public Guardian
  • Beneficence
    • Promoting what is best for the patient
  • Confidentiality
    • Protects trust between doctor and patient
    • Notifiable diseases and conditions under the ID Act specify circumstances where confidentiality may be broken
  • Do no harm / non-maleficence
    • Balance the risk of harm of an intervention against the benefit
  • Equitable care / justice
    • Resources are limited
    • Priorities must be set such that in allocating resources, patients in similar situations should have the same access to the care provided
    • For example:
      • Is what the patient asking for fair?
      • Will it lead to a burden on others?

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