PVB-convept

Equal treatment of equals and the notion that all humans should be equally valued.

The capacity to self-govern and decide about one’s own mind or body without external interference.

Society considers human life to have a special value compared to animals.

Takes time and practice, starts with small things, requires daily effort and repetition, and resilience.

External social structures such as community and interpersonal relationships that can encourage or undermine autonomous decision making.

The ability of an individual to value their life (autonomy).

Self-interest, rule-based considerations, moral resources, and moral identity.

It promotes a person’s freedom and choice.

It has instrumental value in promoting best interests, intrinsic value of free will for human flourishing, and promotes patient respect.

Young children, individuals with congenital learning disabilities, and those with acquired disabilities like head injury or Alzheimer's.

Pre-conventional, conventional, and post-conventional stages.

Better advice, better decision making, better mutual understanding, better trust, and better adherence to plan.

Wisdom, empathy, integrity, justice, kindness, compassion, honesty.

Autonomy promotes a person’s subjective best interests, which may not align with best medical interests.

It refers to withholding certain technical information from the patient, even if they ask about it, due to concerns about their ability to handle or understand the information.

Due to a power imbalance between doctors and patients, feeling pressured to agree with the doctor, and being unwell or vulnerable.

Ability to understand info, ability to appreciate impact of current decision, ability to decide independently of parental and social influence.

Practical wisdom.

The request must be safe, clinically indicated, feasible considering the resources, and just considering the needs of other patients.

It helps increase understanding of health inequalities and identifies the needs of the population.

To underpin effective and sustainable interventions to tackle inequalities.

Because the health issue presentation is complex and requires support from multiple services.

Factors such as the best interest of the child, risks, altruism, societal duty, and professional guidance should be considered.

Emotional distress that can lead to a doctor opting out of giving a certain treatment under certain circumstances.

Value, not fact.

Equal rights, equal respect, maximizing capacity for autonomous decisions, and acting in the welfare and best interests of everyone.

1. Engage with people sleeping rough, 2. Support the workforce, 3. Prioritize relationships, 4. Tailor the local response, 5. Use full power of commissioning.

The right course of action is the action that a 'virtuous individual' would take.

Overriding autonomy may be consistent with acting in a child’s overall best interest.

A 15-year-old with leukaemia accepted autologous bone marrow transplant but refused blood product support, leading to a court ruling that he should receive blood.

They face significant health inequalities and poorer health outcomes.

Pregnancy doesn't change the mother's rights, so technically, the mother can act in any harmful way to the foetus and it'll still be 'lawful'.

Discriminatory.

It is the inner sense of right and wrong about one's own clinical actions, shaped by core values, beliefs, and experiences, such as religion.

Time, well-explained information, no judgement, and no pressure to make patients feel comfortable expressing what they really want.

7x more likely to die from HIV or hepatitis, 6x more likely to die from heart disease, 14x more likely to die from suicide, 20x more likely to die from drug use.

Logistical difficulties in accessing healthcare spaces, lack of follow-up, lack of joined-up care and communication, stigma from other healthcare workers, lack of understanding and confidence around working with homeless individuals, and difficulty in navigating the healthcare system.

Infectious disease, substance dependence, assault, etc.

Because these needs are closely interrelated.

Parental Rights vs. Child Welfare.

Some groups are privileged epistemologically, and knowledge from minority backgrounds is less likely to be seen as credible.

Faculty, StreetLink, Street Support, and 'My right to Healthcare Cards'.

Autonomy has both instrumental (promotes best interests) and intrinsic (essential aspect of individuals flourishing as humans) values.

The 'overall pleasure/happiness'.

Law considers individuals as adults at 18.

He committed suicide at 19 because he could not live with himself knowing that he accepted blood products.

Who will look after their child when they die.

Better meeting the needs of a diverse population, improving patient engagement, patient experiences, and addressing health inequalities.

Understanding information, forming values, and making decisions based on said information and values.

30 years below the general population (45 for men and 43 for women).

Paternalism is overriding or undermining a patient's autonomy based on the healthcare professional's view of the patient's best interests.

Parents have a duty to enable their child to reach autonomous adulthood and should not martyr their children to their values/belief system.

Equal capability to flourish in life, including food, shelter, and decent healthcare for all individuals.

Fairness and equity in the distribution of resources and treatment.

They imply a duty by the state and society to ensure these rights are protected.

Moral conflict, such as abortion, not a discriminatory one like race, sex, or religion.

Difficulty in articulation and expression of needs, the need for health professionals to hear and understand needs, and providing individualized care within an institutional setting.

What was in the baby's best interest.

A character trait a human needs to flourish and live well.

Just because something is morally permissible does not mean that the action is inherently good.

They may be assumed to lack capacity, and their autonomy is overridden.

There has been an increase in rough sleepers.

It increases duties for local authorities to assess, prevent, and relieve homelessness.

By giving space and time to speak, reflecting on unconscious bias, and offering an ally or advocate such as an interpreter, chaperone, nurse, relative, or second opinions.

Autonomy is only restricted in situations where people can be harmful to others, warranting 'sufficient harm' to others.

Individuals have a right to own personal values and beliefs, and therefore, should respect the personal views and values of others.

How their lives should unfold and how their lives should end.

That healthcare professionals should do no harm to the patient, raising questions about potential risks and harms associated with treatment.

Limited time, limited transport, digital barriers, priorities, and limited trust in institutions and experts.

Local healthcare infrastructure, cultural diversity and healthcare access, local demographics, and geography.

The electronic shift from paperwork to online access and the need for help with forms and contact information.

A 14-month-old with biliary atresia who needs a liver transplant.

As a child matures, increasing weight should be given to their autonomous choices.

Virtue is a morally desirable character trait, e.g., honesty and compassion.

They suffer barriers in accessing healthcare.

It may reinforce prejudices against those with disabilities.

Until birth.

Gaps in knowledge, higher detention rates of black men with mental health conditions, higher maternal mortality rate for black women, and perpetuating stereotypes that lead to misdiagnosis.

Adults should make decisions based on the child's best interest and it is ethically appropriate to override a child's apparent autonomous decision if it is deemed not in the child's best interests.

Autonomous children have the same rights as autonomous adults, and adults make bad decisions all the time.

Ability to understand information and form values.

The obligation to act in the best interest of the patient, aiming to maximize their well-being.

Incentivise individuals to be vaccinated, penalise those who haven't, make vaccination compulsory, or work with local communities to identify barriers in getting vaccinated.

This is a philosophical question that prompts pondering about the nature of rights.

As long as the patient’s autonomy is not limited, and they can ask another clinician to do it.

Working with stakeholders using their experiences to identify healthcare priorities and address healthcare inequalities.

It leads to increased Covid death rates among adult black and Asian men due to overestimated oxygen levels in patients with darker skin pigmentation.

Determining whether an action is ethically right or wrong based on the consequences and the net benefit.

The right or responsibility of parents to make choices on behalf of their children.

Emotional involvement and personal views/beliefs.

Because it is only a problem due to society's inability to adequately support those with the disability.

People sleeping, about to bed down, or actually bedded down in the open air or in places not designed for habitations.

To target support to areas with the highest numbers of rough sleepers.

Emotional, physical, autonomy interests, family wishes and beliefs, previously held wishes prior to mental disability.

It is not clearly defined, especially in cases where the patient's best interests are uncertain.

Basic interest, developmental interest, autonomy interest.

Rights that involve what someone cannot do to you, such as killing or stealing.

Rights that involve what others must provide for you, such as education and healthcare.

Potential conflicts between autonomy and best interest.

To support without risking retraumatizing individuals.

The value of a parent may be different from the value of a health professional.

Basic/developmental interests necessary to reaching adulthood.

Autonomous choice involves understanding relevant information, forming values, and making decisions based on values of information provided.

It holds people to higher expectations than is realistic or normal.

By using phrases like 'suffer from downs' instead of 'experiences downs'.

Promote best interest of babies/infants.

6:1.

It represents finding the balance between too little and too much of a virtue.

It is transformed through the repeated practice of virtue.

The right of individuals to make decisions about their own lives, especially in matters concerning their health.

Vaccination rates were very different across different socioeconomic groups, with people in more deprived areas, non-white ethnic minorities, those infected with COVID, and those working outside of home for more than 5 days a week being less likely to receive a third vaccine.

Homelessness increases the risk of health issues, and health issues increase the risk of homelessness.

Justice mainly works on addressing structural barriers.

Familial obligations and the limits of individual autonomy.

Patients with darker skin pigmentation are 3 times more likely to experience pulse oximeter measurement errors, leading to medical bias in objective health parameters.

It could be used to justify heinous actions.

They thought that inevitable death was better than the pain and distress of a liver transplant.

It is crucial to respect children's choices to promote their autonomy and well-being.

When there are risks to physical/mental health of the woman/children, or to prevent grave/permanent injury to the mother.

The social stigma attached to disability rather than the physical limitations.

No, the dad has no legal rights during pregnancy, cannot ask for abortion, or require consultation before getting an abortion.

To make the right clinical decisions regarding hypoxemia.

It is morally bad to withhold information that is important to the patient, and it may lead to mistrust and a breach of autonomy.

Clinical conscience is about one's intrinsic feelings about certain clinical actions, shaped by personal values and beliefs, while hospital principles are more objective and based on institutional guidelines.

Differing values/beliefs lead to differing assessment of welfare, harm, and benefits, and good communication and reflection can improve trust and mutual understanding, making it easier to reach a compromise.

Some people have greater needs to achieve the same outcomes, and equity involves providing more or less resources depending on individual needs.

The full range of factors that influence a population's health and wellbeing.

Because equal value equals equal treatment, and denying healthcare based on disability implies less value and treatment.

Certain actions being right and wrong, irrespective of consequences, and following the rules.

Protecting individuals, especially those who are vulnerable or lack power/advocacy, and recognizing their rights.

Balance respect for autonomy with the need to protect child from 'bad decisions' to ensure they reach autonomous adulthood.

Because they know their children better than anyone else and have a unique love for them.

The conflict between what is best for the child and what is best for the other children in the family.

Due to barriers and stigma in accessing regular healthcare, they use the A&E 3x more than the typical person.

64%.