semmelweis university 2 0 1 2 / 2 0 1 3

SEMMELWEIS UNIVERSITY / FACULTY OF PHARMACY
466
1. week (Lecture)
Basic concepts of ethics.
Descriptive ethics, normative ethics, metaethics.
General ethics and applied ethics.
Bioethics, medical ethics, health care ethics. Similarities and differences.
The role of bioethics in a pluralistic society.
The relationship between law and ethics.
Reasoning in ethics. The most common mistakes.
2. week (Lecture)
Normative theories of ethics. The basic principles of medical ethics.
Deontological theories of ethics. (The Golden Rule, Kant and the categorical imperative, the
principle of double effect, W.D. Ross and the prima facie duties,)
Teleological theories of ethics. (Act and rule utilitarianism.)
Theories of natural law.
Contractarian theories of ethics. (The theory of justice of John Rawls)
The principle of respect for autonomy.
The principle of non-maleficience.
The principle of beneficience.
The principle of justice.
Arguments against „principalism”.
3. week (Lecture)
Justice in Health Care .. Ethical questions of macro- and microallocation
Higher and lower level macroallocational problems.
The principles and practice of rationing in contemporary health care systems. (Soft and hard
rationing.)
Medical ethics and medical economics. Ethical questions of cost-benefit and cost effectiveness
analyisis.
The problem of right to health care. (The libertarian, the liberal and the socialist views about the
right to health care.)
The role of the market and that of the state in the health care system.
The concept of microallocation.
Ethical analysis of various selection criteria. (Medical benefit, psychological ability, supportive
environment, social value criterion, resources required criterion, age, ability to pay, random
selection, personal responsibility for the illness, etc.)
4. week (Lecture)
Informed consent and truth telling
Simple consent and paternalism in medicine.
The emergence of the doctrine of informed consent.
Standards for information disclosure for patients.
When is informed consent not necessary?
Standards of competence and incompetence.
The right to refuse medical treatment.
Some psychological and communicational aspects of informed consent.
The history of information disclosure to terminally ill patients.
Pros and cons for lying to terminally ill patients.
The weaknesses of the arguments in favour of lying.
The dying process according to E. Kübler-Ross.