2nd Year Public health/ Human factors/ Ethics

Question 1

Term in health economics to describe the true cost of a choice in terms of opportunities lost?

Answer 1

Opportunity cost

Question 2

Term in health economics to describe time multiplied by quality?

Answer 2

Quality adjusted life year (QALY)

Question 3

What does 1 QALY equal?

Answer 3

1 year in perfect health

Question 4

Description for how well an intervention achieves a goal in relation to its cost?

Answer 4

Cost effectiveness (often measure cost in financial terms and benefits in QALY’s -> can therefore calculate the cost per QALY of different interventions)

Question 5

What is the name of the ratio of the difference in cost to the difference in QALY’s?

Answer 5

Incremental cost effectiveness ratio (ICER)

Question 6

Equation for ICER (incremental cost effectiveness ratio)?

Answer 6

ICER = difference in price/ difference in QALYs

Question 7

What is the name for the application of the best knowledge, derived from research, clinical experience and patient preferences, to achieve optimum processes and outcomes for care of patients?

Answer 7

Clinical effectiveness

Question 8

What should you check for if the patient no longer has capacity?(2)

Answer 8

If there is a legal proxy to make decisions
If the patient made legally binding advance decision or directive
(if there are neither of these than you must make a decision based on what you think is best for the patient - talk to family, friends and other members of the team)

Question 9

What is the only situation where it is acceptable to give treatment that might cause the patient’s death?

Answer 9

Under the doctrine of double effect

Question 10

What does the doctrine of double effect explain?

Answer 10

Explains the permissibility of an action that causes a serious had ,such as death, as a side effect of promoting some good end

Question 11

What is the basic rule in terms of using patient’s tissues for anything other than their own treatment or investigation?

Answer 11

It requires written permission

Question 12

Can cadaveric tissue donation go ahead if the patient expressed no views or preference on the use of their tissues after death?

Answer 12

Yes, if those closest to the patient agree

Question 13

What is the international framework for assessing ethical research?

Answer 13

WHO’s declaration of helsinki

Question 14

What is the local framework for assessing ethical research?

Answer 14

Scottish government research governance framework

Question 15

Which framework provides the rules for the collection, management and maintenance of personal and sensitive personal information?

Answer 15

Data protection act

Question 16

Who must you speak to get access to patient records without individual consent?

Answer 16

Caldicott guardian

Question 17

What are disability adjusted life years?

Answer 17

Measure of overall disease burden, expressed as the number of years lost due to ill health, disability or death

Question 18

What is morbidity?

Answer 18

Number of people with a disease in a population

Question 19

What is mortality?

Answer 19

Number of deaths in a given period due to a particular cause

Question 20

Can a patient less than 16 years in Scotland consent for a procedure?

Answer 20

Yes (if deemed competent)

Question 21

In Scotland, can parents authorise a treatment that a competent young person has refused?

Answer 21

No

Question 22

What is the legal age for consent for sex?

Answer 22

16 years (13-16 years is a grey area with actions depending on circumstance, 12 years and under = illegal)

Question 23

What are the 3 types of law?

Answer 23

Criminal law
Civil law
Other sources e.g. regulations, codes of practice, professional guidnace

Question 24

Penalties of criminal law?

Answer 24

Fines or imprisonment

Question 25

Penalties of civil law?

Answer 25

Financial

Question 26

All people aged 16 and over are presumed in law to have the capacity to consent to treatment unless there is evidence to the contrary. True or false?

Answer 26

True

Question 27

What is another phrase to describe someone having capacity?

Answer 27

Legally competent

Question 28

If a child is deemed not legally competent, consent will need to be obtained from someone with parental responsibility. What is the one contra-indication to this?

Answer 28

Emergency treatment

Question 29

If a father is on the birth certificate, does he have parental responsibility?

Answer 29

If birth registered after 4th May 2006 in Scotland, yes (even if parents not married)
If before 4th May 2006, only has parental responsibility if married to child’s mother

Question 30

If parent’s are divorced, who has parental responsibility for the child?

Answer 30

both parents

Question 31

Do the biological parents retain parental responsibility if they give their child up for adoption?

Answer 31

No, adoptive parents get parental responsiblity

Question 32

If a child has been conceived by assisted reproduction, does the mother who gives birth to the child have parental responsibility?

Answer 32

Yes (at the time of birth)

Question 33

Who has parental responsibility if a child is the subject of a care order?

Answer 33

Local authority shared with the parents

Question 34

If a child is in care voluntarily, who has parental responsibility?

Answer 34

Parents

Question 35

Can parental responsibility be delegated by the holders of it?

Answer 35

Yes e.g. to childminder to give consent in urgent medical treatment

Question 36

Elimination of a disease?

Answer 36

Reduction to zero of the incidence of a specified disease in a defined geographical area as a result of deliberate efforts - requires continued intervention measures

Question 37

Eradication of a disease?

Answer 37

Permanent reduction to zero of the worldwide incidence of infection caused by a specific agent as a result of deliberate efforts; intervention measure are no longer needed e.g. smallpox

Question 38

Extinction?

Answer 38

Specific infectious agent no longer exists in nature or in the lab (no current examples)

Question 39

Basic reproductive number of a disease?

Answer 39

Average number of secondary cases caused by an infectious individual over the course of their infectious period

Question 40

Herd immunity?

Answer 40

Indirect protection from infection of susceptible members of a population, and the protection of the population as a whole, which is brought about by the presence of immune individuals