Ethics Terms

Advance Directive

Legal instrument which stipulates how health care decisions are to be determined for a patient who is not competent to make such decisions for oneself, and which would normally take the form of either a durable power of attorney for health care decisions or a living will.

Beneficence

To act with the intention to “do good” on behalf of, or to benefit, someone other than oneself.

Bioethics

The study of any moral or social issues that arise from either advances in knowledge or technological progress in any of the life sciences, which includes (but is not limited to) the field of medical ethics.

Case for Consultation

A case requested of the Ethics Committee whenever a physician, nurse, patient, patient surrogate/advocate, or any other member of the care team decides to solicit the expertise of any, or all, of the members of the Committee in order to obtain ethical guidance, advice, or recommendations for health care decision-making.

Case for Review

A case presented to the Ethics Committee for clarification and/or recommendations whenever any member of the medical staff and/or employees at Bayhealth Medical Center decides that the applicable ethics policy does not satisfactorily address the case in question.

Competent Patient

A patient who, by virtue of exhibiting most, if not all, of the following characteristics, simultaneously and consistently, can reasonably be said to have the capacity for health care decision-making for oneself: the ability to reason coherently; the ability to communicate, in some way, one’s own thoughts; the ability to make decisions on the basis of one’s own interests, goals, values, and expectations, all of which are reasonably steadfast; and the ability to appreciate the consequences of one’s own decisions.

Confidentiality

A moral (and legal) responsibility on the part of any medical professional to protect from dissemination (to anyone who is not involved in the care of the patient) any and all personal information, of any type, concerning the patient, that has been obtained, in the clinical context.

Durable Power of Attorney for Health Care Decisions

A legal instrument (a.k.a., a health care proxy) which authorizes someone, other than oneself (a.k.a., a health care agent), to make any and all health care decisions for oneself in the event that one becomes a patient who is not competent to make health care decisions for oneself.

Euthanasia

Any intervention in the medical course of treatment of a patient, who is reasonably considered to be terminally, or irreversibly, ill or injured, for the express purpose of causing the imminent death of that patient, normally for reasons of mercy.

Futile Medical Treatment

Any normally recommended medical treatment that, due to the health status of the patient, is expected to have no reasonably significant therapeutic effect.

Informed Consent

“…a patient’s agreement to, and approval of, upon obtaining an understanding of all relevant information, a recommended treatment or procedure that is intended to be of therapeutic value to the patient.” (S. C. Taylor, “Physician-Patient Relationship,” in Ethics (Revised Edition), ed. by John K. Roth (Pasadena: Salem Press, Inc., 3 vols., 2005), volume 2, pp. 1124-1126.)

Living Will

A legal instrument which stipulates precisely which types of medical treatment, usually of an extraordinary nature, one wishes to approve, or disapprove, for oneself in the event that one becomes a patient who is terminally, or irreversibly, ill or injured, and, simultaneously, who is not competent to make health care decisions for oneself.

Major Medical Ethics Issues

Any of a number of types of situations which arise in the clinical context and which raise significant questions of a moral nature (e.g., euthanasia).

Non-Maleficence

To act with the intention to “do no harm” to someone other than oneself.

Paternalism

(in the clinical context) “Whenever a physician [or any other medical professional] restricts, or otherwise impedes, a patient’s freedom to determine what is done, by way of therapeutic measures, to…[said patient], and attempts to justify such an intrusion by reasons exclusively related to the welfare or needs of the patient, the physician [or other medical professional] can be construed to have acted paternalistically. (S. C. Taylor, “Physician-Patient Relationship,” in Ethics (Revised Edition), ed. by John K. Roth (Pasadena: Salem Press, Inc., 3 vols., 2005), volume 2, pp. 1124-1126.)

Patient Surrogate

One who has no official affiliation with Bayhealth Medical Center, but who, without the need for an advance directive of any kind, has the legal standing to make health care decisions on behalf of the patient.  (In descending order of priority, a patient surrogate would have any one of the following relationships with the patient: a spouse, an adult child, a parent, an adult sibling, an adult grandchild, an adult niece or nephew, or an adult aunt or uncle.)

Patient Autonomy

A patient’s moral right to self-determination, i.e., the right of every patient to make one’s own decisions (either explicitly or by use of an advance directive) concerning one’s own health care, without being coerced by anyone.