2nd Year Public health/ Human factors/ Ethics Flashcards
Term in health economics to describe the true cost of a choice in terms of opportunities lost?
Opportunity cost
Term in health economics to describe time multiplied by quality?
Quality adjusted life year (QALY)
What does 1 QALY equal?
1 year in perfect health
Description for how well an intervention achieves a goal in relation to its cost?
Cost effectiveness (often measure cost in financial terms and benefits in QALY’s -> can therefore calculate the cost per QALY of different interventions)
What is the name of the ratio of the difference in cost to the difference in QALY’s?
Incremental cost effectiveness ratio (ICER)
Equation for ICER (incremental cost effectiveness ratio)?
ICER = difference in price/ difference in QALYs
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?
Clinical effectiveness
What should you check for if the patient no longer has capacity?(2)
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)
What is the only situation where it is acceptable to give treatment that might cause the patient’s death?
Under the doctrine of double effect
What does the doctrine of double effect explain?
Explains the permissibility of an action that causes a serious had ,such as death, as a side effect of promoting some good end
What is the basic rule in terms of using patient’s tissues for anything other than their own treatment or investigation?
It requires written permission
Can cadaveric tissue donation go ahead if the patient expressed no views or preference on the use of their tissues after death?
Yes, if those closest to the patient agree
What is the international framework for assessing ethical research?
WHO’s declaration of helsinki
What is the local framework for assessing ethical research?
Scottish government research governance framework
Which framework provides the rules for the collection, management and maintenance of personal and sensitive personal information?
Data protection act
Who must you speak to get access to patient records without individual consent?
Caldicott guardian
What are disability adjusted life years?
Measure of overall disease burden, expressed as the number of years lost due to ill health, disability or death
What is morbidity?
Number of people with a disease in a population
What is mortality?
Number of deaths in a given period due to a particular cause
Can a patient less than 16 years in Scotland consent for a procedure?
Yes (if deemed competent)
In Scotland, can parents authorise a treatment that a competent young person has refused?
No
What is the legal age for consent for sex?
16 years (13-16 years is a grey area with actions depending on circumstance, 12 years and under = illegal)
What are the 3 types of law?
Criminal law
Civil law
Other sources e.g. regulations, codes of practice, professional guidnace
Penalties of criminal law?
Fines or imprisonment
Penalties of civil law?
Financial
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?
True
What is another phrase to describe someone having capacity?
Legally competent
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?
Emergency treatment
If a father is on the birth certificate, does he have parental responsibility?
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
If parent’s are divorced, who has parental responsibility for the child?
both parents
Do the biological parents retain parental responsibility if they give their child up for adoption?
No, adoptive parents get parental responsiblity
If a child has been conceived by assisted reproduction, does the mother who gives birth to the child have parental responsibility?
Yes (at the time of birth)
Who has parental responsibility if a child is the subject of a care order?
Local authority shared with the parents
If a child is in care voluntarily, who has parental responsibility?
Parents
Can parental responsibility be delegated by the holders of it?
Yes e.g. to childminder to give consent in urgent medical treatment
Elimination of a disease?
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
Eradication of a disease?
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
Extinction?
Specific infectious agent no longer exists in nature or in the lab (no current examples)
Basic reproductive number of a disease?
Average number of secondary cases caused by an infectious individual over the course of their infectious period
Herd immunity?
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
