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RT 205 > 2. The Practice of Medicine > Flashcards

2. The Practice of Medicine Flashcards

1
Q

Can include suspension and revocation of license

A

Administrative Law

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2
Q

Deals with licensing and regulation

A

Administrative Law

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3
Q

Can include fines, restitution, community service, and incarceration

A

Criminal Law

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4
Q

Addresses wrongs against the state

A

Criminal Law

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5
Q

Can include monetary damages to compensate for loss and to punish

A

Civil Law

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6
Q

Addresses wrongs committed by one party harming another

A

Civil

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7
Q

is a body of rules of action or conduct prescribed by controlling authority and
having binding legal force

A

The law

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8
Q

The basis for the controlling authority of the law in the
United States includes common law from _______ but has been molded by statutes and
judicial decisions (case law) since the birth of the United States.

A

England

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9
Q

encompasses

principles and rules based on ancient usages and customs

A

Common Law

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10
Q

is the only state in

which English common law does not form the basis for current law.

A

Louisiana

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11
Q

is all the laws

and statutes put into place by elected officials in federal, state, county, and city governments

A

Legislation

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12
Q

may interpret the statutes and therefore further refine their application.

A

Judicial decisions

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13
Q

may reinforce common law principles or change them to match

the changes in society

A

Judicial decisions

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14
Q

Common law + Statutes and judicial decisions

a product of common law, statutory law, and judicial decisions

A

Current Law

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15
Q

may create such a duty

A

Statute

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16
Q

includes all laws enacted by federal, state, county, and city governments

A

Statutory law

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17
Q

are previous cases that either interpret statutes or adopt and adapt common law principles

A

Judicial Decisions

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18
Q

the standard that a physician must disclose to a patient information that a reasonable medical practitioner similarly situated would disclose.

A

Physician-based standard

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19
Q

the physician must disclose information that a reasonable patient needs to make an informed decision

A

Reasonable patient standard

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20
Q

are components of the legal system that have an impact on the medical imaging sciences

A

Administrative law, criminal law, and civil law

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21
Q

determines the licensing and regulation of the practice of imaging professionals and regulates some employer-employee relations

A

Administrative law

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22
Q

seeks to redress wrongs against the state

A

Criminal law

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23
Q

attempts to compensate for wrongs committed by one party resulting in harm to another party

A

Civil law

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24
Q

Lawsuits involving the medical imaging sciences are generally brought under _____,
a subdivision of civil law

A

tort law

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25
Q

is filed to recover damages for personal injury or property damage occurring from negligent conduct or intentional misconduct

A

tort action

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26
Q

The types of torts that imaging professionals might encounter include

A 
assault, 
battery, 
false imprisonment, 
defamation, 
negligence, 
lack of informed consent, and breach of patient confidentiality
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27
Q

The tort most often involving imaging professionals is

A

Negligence

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28
Q

is generally composed of a pleading phase, discovery phase, and trial

A

Lawsuit

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29
Q

statute of limitation set forth the time periods after the cause of the complaint in which lawsuits can be brought against a physician or other health professional

A

Lawsuit

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30
Q

a complaint is lodged and an answer is given

A

Pleading Phase

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31
Q

the attorney seeks facts of the case by questioning the involved parties

A

Discovery Phase

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32
Q

case is presented to a judge or jury for decision

A

Trial Phase

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33
Q

Facts sought in several ways,
Written questions: requests for information, including interrogatories, request for admissions, request for production of documents, e-mail, audio and video information

A

Discovery Phase

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34
Q

Decision may be reversed or reviewed

A

Post decision appeal process

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35
Q

can only be found if a duty exist

A

Negligence

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36
Q

that interpret the statues may further refine the details surround physician disclosure

A

Judicial decisions

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37
Q

in a state’s courts form the basis of physicians in that state

A

Previous Judicial decisions (or precedents)

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38
Q

a person may perform an act that has evil effects or risk such effects as long as 4 conditions are met

A

Principle of double effect

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39
Q

4 conditions of the principle of double effect

A

1) The action must be good or morally indifferent in itself.
e.g. proposed imaging procedure must help the patient or at least not cause harm.
2) The agent must intend only the good effect and not the evil effect. That is,
the imaging technologist must intend for the imaging to aid in the health care
process, not injure the patient or cause pain.
3) The evil effect cannot be a means to the good effect.
e.g. patient thinks the procedure is evil but has good effects.
4) Proportionality must exist between good and evil effects. The good of the
procedure must at least balance with the unintended pain or discomfort.

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40
Q

Performance of Good Acts

A

Beneficence

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41
Q

May encompass many aspects of goodness, promoting good action &
preventing evil or harm

A

Beneficence

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42
Q

Requires the action of an imaging professional to do good or prevent harm

A

Beneficence

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43
Q

avoidance of evil

A

Non maleficence

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44
Q

hinges on a system of weighting

A

Non maleficence

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45
Q

Goal is to do good

A

Beneficence

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46
Q

Achieved through active process

A

Beneficence

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47
Q

Secondary in importance to Non maleficence

A

Beneficence

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48
Q

Goal is to do no harm

A

Non maleficence

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49
Q

Achieved through passive omission

A

Non maleficence

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50
Q

Primary responsibility of the heath care provider

A

Non maleficence

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51
Q

Medical Indications Involving Principles of Beneficence and Nonmalefiecence

A
  1. What is the patient’s medical problem (what brings the patient to the imaging department)? History? Diagnosis? Prognosis?
  2. Is the problem acute? Chronic? Emergent? Reversible? How will this affect the imaging procedure?
  3. What are the goals of the treatment or imaging procedure?
  4. What are the probabilities of a successful imaging exam?
  5. What are the plans in case of therapeutic failure or the inability to complete the exam?
  6. In sum, how can this patient benefit by the medical and imaging care? How can the imaging professional avoid harm to the patient?
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52
Q

Principle of fairness

A

Justice

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53
Q

performance of an appropriate procedure only after informed consent has been granted

A

Justice

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54
Q

is permission, usually in writing given by a patient agreeing to the performance of a procedure

A

Informed consent

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55
Q

Resources + Needs

A

Limited choices

56
Q

If the patient is incompetent, either the best interests of the patient or the rational choice principle should be used

A

Surrogate obligations

57
Q

help provide for patient autonomy

A

Verbal and Contractual Agreements

58
Q

commands that the surrogate choose what the patient would have chosen when competent and after having considered all available relevant information and the interests of the relevant others

A

The rational choice principle

Contractual Agreements

59
Q

They are general agreements; other

processes of informed consent may be required as specific procedures are scheduled.

A

Contractual Agreements

60
Q

the imaging professional must be aware of the obligations to do good and avoid harm

A

Imaging Professional’s Role

61
Q

Patients participate in protecting their own good and avoiding their own harm by gathering information about the imaging procedure they will be undergoing

A

Patient’s Role

62
Q

The degree of skill or care practiced by a reasonable professional practicing in the same field.

A

Standard of care

63
Q

is a function of the
whole person in which
concern for the growth and well-being of another is expressed in an integrated
application of the mind,
body, and spirit that seeks to maximize positive outcomes

A

Caring

64
Q

Refer to the therapy and other services they (Health Care Professionals) provide in their practices

A

Care

65
Q

is shown to the patient through appropriate communication

A

Care

66
Q

is compassion arising from an awareness of common bonds of humanity and common expressions, fates, and feelings

A

Existential Care

67
Q

is the ability to recognize and to some extent share the emotions and state of mind of another and to understand the meaning and significance of that person’s behavior

A

Empathy

68
Q

is not sympathizing or feeling sorry for the patient. It is a constructive and objective
response that allows the imaging professional to provide high-quality patient care

A

Empathy

69
Q

is a symbolic interaction: when one person says something to another and that person responds

A

Communication

70
Q

There has to be at least one response to ___ initiation, creating
a tie of communication

A

one

71
Q

is a subset of human communication that is concerned with how individual in a society seek to maintain health and ideal with health-related issues

A

Health Communication

72
Q

Transactional and affective in nature.

A

Communication

73
Q

Obstacles To Caring

A
  • Scarcity of time
  • Technical priorities
  • Impact of personal life
  • Lack of training in caring for patients who are critically or terminally ill
  • Lack of communication
  • Lack of faith in self
  • Societal pressures
74
Q

are intertwined with the obstacles to caring

A

Obstacles to Communication

75
Q

Obstacles to Communications

A
  • May come from the sender or to the receiver
  • Patient or imaging professional is thinking about other things
  • Noise temperature or other distractions in the imaging environment distance and the inability to see or hear
  • Relationship between the patient and imaging professional as it is affected by roles, personalities, values, and ethical differences.
76
Q

is characterized by the application of the knowledge of a professional discipline, including its science, theory, practice, and art

A

Professional care

77
Q

It is complementary to human caring

A

Professional care

78
Q

involves an appreciation of the universal patterns of human experience

A

Caring in the imaging science

79
Q

caring, values, and ethical problem solving give meaning to professional practice, create the possibility of ever-improving care, and enhance patient comfort and feeling of safety

A

Caring in the imaging science

80
Q

is an important key to improving communication between the imaging professional and the patient

A

Active listening

81
Q

requires not only hearing the patient, but also watching the patient’s body language, observing the patient’s physical presentation, asking open-ended questions, and waiting for responses
and feedback from the patient

A

Active listening

82
Q

Steps in Improving Communication

A
  • Must want to objectively evaluate and change their communication styles.
  • Trying to change
83
Q

Clinician-Patient Communication Problem Involved in Malpractice Lawsuits

A
  • Explanation of diagnosis is inadequate
  • Explanation of treatment is inadequate
  • Patient feels ignored
  • Patient feels rushed
  • Clinician fail to understand perspective of patient or relative
  • Clinician discounts or devalues views of patients or relative
84
Q

set forth the time period after the cause of the complaint in which lawsuits can be brought against a physician or other health professional

A

Statutes of limitation

85
Q

is begun when a plaintiff files a complaint against a defendant with the court

A

Lawsuit (Pleading Phase)

86
Q

this complaint may allege that the defendant has failed to provide
treatment, has provided inadequate treatment, or has committed misconduct.

A

medical negligence lawsuit

87
Q

is to ascertain the truth concerning the incident

A

The purpose of discovery

88
Q

questions may be asked of any of the parties (including employees and students of a party) either in writing (interrogatories, requests for admission, and requests for production of documents) or orally (depositions)

A

Discovery phase

89
Q

After the discovery phase is complete, the lawsuit advances to

A

Trial

90
Q

Negotiations can be through correspondence, telephone calls, and informal or formal meetings

A

Trial phase

91
Q

is the system for identifying,

analyzing, and evaluating risks and selecting the most advantageous method for treating them

A

Risk management

92
Q

Its goal is to maintain high-quality

patient care and conserve the facility’s financial resources

A

Risk management

93
Q

An effective risk management program has three primary goals:

A
  1. Elimination of the causes of loss experienced by the hospital and its patients,
    employees, and visitors
  2. Reduction in the operational and financial effects of unavoidable losses
  3. Coverage of inevitable losses at the lowest cost
94
Q

seeks to maintain high-quality patient care and the safety and security of the facility’s patients, employees, visitors, and property

A

Risk management

95
Q

is a process to assess quality of patient care that uses hospital committees to
oversee the quality of various hospital functions

A

Quality assurance

96
Q

focuses more narrowly on patient care than does risk management

A

Quality assurance

97
Q

It is broader than risk management, however, in that it considers a wide
range of quality concerns and uses hospital committees to oversee the quality of various hospital functions

A

Quality assurance

98
Q

the action should not infringe against

the good of the individual. There also has to be a proportionate good to justify the risk of an evil consequence

A

principle of proportionality

99
Q

The following questions may be used to define proportionality:

A

Are alternatives with less evil consequences available? Might another procedure produce the same diagnosis with less pain? For example, might magnetic resonance imaging (MRI) be used instead of mammography?

What are the levels of good intended and evil risked? What will be gained from the procedure? For example, can a contrast media fluoroscopic examination of a first trimester pregnant woman be justified?

What is the probability that the good or evil intended will be achieved, and what action and influence do the health care team and patient have? What gains to the patient are possible, and will the imaging specialist have to convince the patient or
surrogate that the patient should undergo the procedure?

100
Q

Beneficence and nonmaleficence differ in the degree of force each possesses. The stronger action of the two is ______, or the avoidance of harm; ______, or the
performance of good, is weaker

A

nonmaleficence,

beneficence

101
Q

states that, “granted informed
consent, the physician should do what is medically indicated such that from a medical
point of view, more good than evil will result.”

A

medical indication principle

102
Q

help provide patient autonomy

A

Verbal and written contractual agreements

103
Q

the doing of good and avoidance of harm —are incorporated into the duty of a health
professional to do no harm and ______

A

provide reasonable care to the patient

104
Q

encompasses the obligation of health care professionals to do no harm and their duty to provide reasonable patient care

A

standard of care

105
Q

The most basic legal parameter in health care is the _____

A

standard of care

106
Q

Each profession establishes _____ to define the parameters within which that profession is obligated to practice

A

standards of care

107
Q

is the degree of skill or care employed by a reasonable professional practicing in the same field

A

legal standard

108
Q

are important because they are recognized as the authoritative basis of a profession

A

Practice standards

109
Q

On ______, JCAHO approved the 2006 National Patient Safety Goals.
Almost every one of these goals has a place in the imaging profession.

A

May 25, 2005

110
Q

In addition to the professional standard of care to which imaging professionals are held, other standards apply that come from a variety of sources. One source is _______

A

institutional and departmental policies and procedures

111
Q

can be found based on the failure

to follow the written policies of the institution

A

Liability

112
Q

provided guidelines governing almost every aspect of hospital operation which is another source for standard of care

A

Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

113
Q

National Patient Safety Goals examples:

A

• Patient identification
• Communication among caregivers
• Medication safety (with regard to contrast media, radiopharmaceuticals, and other medications used in the imaging department)
• Elimination of wrong site, wrong patient, wrong procedure surgery (this goal
was designed for surgeries, but the principles apply to imaging, particularly digital
radiography, since marking of orientation is sometimes done after exposure,
although this is not recommended)
• Reduction in the risk of health care –associated infections
• Reduction in the risk of patients’ falls
• Encouragement of the active involvement of patient care as a patient safety
strategy

114
Q

NATIONAL PATIENT SAFETY GOALS

A

Goal 1 Improve the accuracy of patient identification.
Goal 2 Improve the effectiveness of communication among caregivers.
Goal 3 Improve the safety of using medications.
Goal 4 Eliminate “wrong site, wrong patient, wrong procedure” surgery.
Goal 5 [Goal was retired in 2006]
Goal 6 Improve the effectiveness of clinical alarm systems.
Goal 7 Reduce the risk of health care –associated infections.
Goal 8 Accurately and completely reconcile medications across the continuum
of care.
Goal 9 Reduce the risk of patient harm resulting from falls.
Goal 10 Reduce the risk of influenza and pneumococcal disease in institutionalized older adults.
Goal 11 Reduce the risk of surgical fi res.
Goal 12 Implement applicable National Patient Safety Goals and associated
requirements at the component and practitioner site levels
[Networks].
Goal 13 Define and communicate the means for patients to report concerns
about safety and encourage them to do so [Assisted Living, Disease Specific Care, Home Care, Laboratory].
Goal 14 Prevent health care –associated pressure ulcers (decubitus ulcers).

115
Q

An unintentional tort involving duty, breach of

duty, injury, and causation

A

Negligence

116
Q

is the degree of care a reasonable person, similarly situated, would use.

A

Reasonable care

117
Q

Reasonable care may be determined by

the applicable standard of care, by statute, or by previous judicial decisions, called _____

A

precedents

118
Q

A breach of the health care provider’s duty to follow the applicable standard of care, which results in harm to the patient

A

Medical Negligence

119
Q

A health care provider’s failure to follow the

appropriate standard of care is therefore a special type of negligence called _____

A

medical negligence

120
Q

medical negligence is sometimes referred to under the general term

A

medical malpractice

121
Q

Latin term meaning “the thing speaks for itself.”

A

res ipsa loquitur

122
Q

It is a legal concept invoked
in situations in which a particular injury could
not have occurred in the absence of negligence.

A

res ipsa loquitur

123
Q

complaint also called

A

a claim or a petition, depending on the court in which it is brought

124
Q

Expressions of caring include:

A 
feelings of compassion and concern, 
a philosophy of commitment, 
an ethical approach to problems, 
altruistic acts, 
conscious attention to the needs and wishes of others, 
protection of the well-being of others, 
nurturing of growth, and 
empathy and advocacy
125
Q

Such activities as _______ are expressions of caring.

A

listening, providing information, helping, communicating, and showing respect

126
Q

is a universal phenomenon,

although expressions, processes, and patterns may vary among cultures.

A

Caring

127
Q

Other caring activities include

A

touching, nurturing, supporting, and protecting

128
Q

EXPRESSIONS OF CARING

A 
Advocacy, 
Altruism, 
Commitment,
Compassion,
Concern, 
Courage,
Ethical behavior, 
Monitoring, 
Nurturing, 
Protection
129
Q

is how an individual interacts with

another

A

Human communication

130
Q

This may be through symbolic interaction or language or both. It is transactional
and affective in nature.

A

Communication

131
Q

is not static, and it involves human feelings and attitudes, as well as the delivery of information.

A

Communication

132
Q

Philosophically, ____ is an ideal analogous to beauty, truth, and justice; although it is
sought after, it can never be fully attained or perfect in human expression.

A

Care

133
Q

One danger in discussing ideals is viewing them as achievable and measurable commodities; this leads to the idea that those who fall short of achieving ideal care should be _____

A

ashamed

134
Q

is the application of the knowledge of a discipline, including its science, theory, practice, and art

A

Professional care

135
Q

Imaging programs can use a variety of means to instill a desire to increase caring
skills in students:

A

• Communications classes that address body language and the importance of listening
• Critical thinking classes that focus on recognizing, analyzing, and evaluating ethical
dilemmas
• Discussions of films that illustrate caring scenarios (e.g., The Doctor )
• Empathy rotations that require students to become patients for a day and participate in a variety of imaging patient activities
• Role modeling by instructors and staff technologists, including student evaluation
• Discussions among classmates about experiences with hospitalization and health
care providers, emphasizing the ways in which caring influences outcomes
• A review of patient interviews in which care needs are identified and the department’s response to those needs is evaluated
• Review and discussion of educational and professional materials dealing with issues
of caring

136
Q

strives to recognize and understand the patient’s needs

A

true active listener

137
Q

is imperative in the ongoing

improvement of communication in imaging

A

Investment of time and effort

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