Beneficence
Performing actions that (are intended to) bring about good/valued effects for the recipients of the actions. To be altruistic is to regard for or prioritize the interests of others as equal to or more primary than one’s own interests. Cost-benefit analysis is the responsibility to strive for the greatest benefits deriving from the least cost expended.
Best Interest
Best interest decisions are decisions that are made based on a surrogate’s and/or a physician’s judgment about what is best for the patient under the present circumstances or what a hypothetical ‘reasonable patient’ would choose/value under the present circumstances.
Compassion
Demonstrating mercy, pity, or empathy for the pain, suffering, or harmful experience of others. Compassion is the opposite of cruelty. Compassionate persons neither enjoy nor are indifferent to the pain and suffering they cause or the pain and suffering caused by others. To be empathetic is to see into the stressful experience of and to align sacrificially with another person. Note — an empathetic person can be perceived as uncaring and also can be too deeply affected emotionally to benefit the suffering person. A humane person has dispositions and behavior distinguished by compassion, sympathy, or consideration for other human beings.
Goals of Care
Having to do with the quality of life that results from the care a patient receives. The goals of care are restorative when achieving a desired quality of life is feasible. The goals of care focus on managing the dying process when achieving a desired quality of life is not feasible.
Non-beneficial Treatment
Treatment that, in the best professional judgment of the treating physician(s), would not have a reasonable chance of benefitting the patient. Physicians are not ethically obligated to deliver care that is non-beneficial.
Non-maleficence
Harm has to do with any wrong or damage done to another (either to the person, to rights, or to property). Maleficence has to do with actions that (are intended to) bring about harmful effects for the recipients of the actions. Non-maleficence (i.e., ‘do no harm’) prompts one to act in ways that avoid harm or injury. In patient care, prioritizing this caution results in the least pain or suffering possible from efforts to achieve a beneficial outcome.
Palliative Care
Pain refers to measurable bodily discomfort of varying degrees of intensity from infections, diseases, wounds, injuries, traumas. Suffering refers to cognitive/psychological discomfort of varying degrees of intensity such as depression, anxiety, uncertainty, guilt, shame, grief, sadness, fear, anger, terror, alienation, loneliness. Symptom control is a responsibility in every patient case. Hospice is the last phase of this responsibility. When the decision is made to forego life-sustaining treatments, comfort measures should be continued. It may become necessary to provide treatments (including narcotics) with the sole purpose of alleviating symptoms and suffering, even at the risk of accelerating or contributing to death. When the decision is made to forego life-sustaining treatments, the emotional, physical, and spiritual care of the patient should continue. Withholding or withdrawing life-sustaining treatments in no way implies withholding or withdrawing care for the patient. Maintaining the patient’s dignity is paramount.
Scope of Services
The range of services a medical/surgical practice or a hospital is certified, credentialed, staffed, and resourced to deliver. Ethically justified treatment plans reflect and are consistent with the organization’s scope of services.
Standard of Care
Those acts performed or omitted that competent peers would have performed or omitted.