Ethics, Law, Professionalism, and Policy in Health Sciences: Principles & Frameworks

Individuals who desire information regarding an ethics consultation at the
University of Illinois Medical Center (UIMC) should contact the following:

The Principle of Respect for Autonomy

Is the patient mentally capable and legally competent? Is there evidence of incapacity?

If competent, what is the patient stating about preferences for treatment?

Has the patient been informed of benefits and risks, understood this information, and given consent?

If incapacitated, who is the appropriate surrogate? Is the surrogate using appropriate standards for decision making?

Has the patient expressed prior preferences, e.g. Advance Directives?

Is the patient unwilling or unable to cooperate with medical treatment? If so, why?

In sum, is the patient's right to choose being respected to the extent possible in ethics and law?

from: Jonsen AR, Siegler M, winslade WJ. Clinical Ethics: a Practical Approach to Ethical Decisions in Clinical Medicine. 5th ed. New York, NY: McGraw-Hill;2002.

The Principles of Loyalty and Fairness

Are there family issues that ight influence treatment decisions?

Are there provider (physicians and nurses) issues that might influence treatment decisions?

Are there financial and economic factors?

Are there religious or cultural factors?

Are there limits on confidentiality?

Are there problems of allocation of resources?

How does the law affect treatment decisions?

Is clinical research or treatment involved?

Is there any conflict of interest on the part of the provicers or the institution?

from: Jonsen AR, Siegler M, winslade WJ. Clinical Ethics: a Practical Approach to Ethical Decisions in Clinical Medicine. 5th ed. New York, NY: McGraw-Hill;2002.

The Principles of Beneficence and Nonmaleficence

What is the patient's medical problem, history, diagnosis, prognosis?

Is the problem acute, chronic, critica., emergent, reversible?

What are the goals of treatment?

What are the probabilities of success?

What are the plans in case of therapeutic failure?

In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided?

from: Jonsen AR, Siegler M, winslade WJ. Clinical Ethics: a Practical Approach to Ethical Decisions in Clinical Medicine. 5th ed. New York, NY: McGraw-Hill;2002.

The Principles of Beneficence and Nonmaleficence and Respect for Autonomy

What are the prospects, with or without treatment, for a return to normal life?

What physical, mental, and social deficits is the patient likely to experience if treatment succeeds?

Are there biases that might prejudice the provider's evaluation of the patient's quality of life?

Is the patient's present or future condition such that his or her continued life might be judged undesirable?

Is there any plan and rationale to forgo treatment?

Are there plans for comfort and palliative care?

from: Jonsen AR, Siegler M, winslade WJ. Clinical Ethics: a Practical Approach to Ethical Decisions in Clinical Medicine. 5th ed. New York, NY: McGraw-Hill;2002.