3. Ethical Issues in Health Care Flashcards
1
Q
is a claim or entitlement.
A
Right
2
Q
is a practice, a commodity, an approach, or a collective responsibility to ensure the wellness of a population.
A
Health care
3
Q
3 DISTRIBUTION ALLOCATION GROUPS
A
- Macro-allocation
- Meso-allocation
- Micro-allocation
4
Q
questions ask how big the health care budget will be, who will pay for it, what end it serves, whether there is a right to this care, and what standards will be used to determine these factors.
A
Macro-allocation
5
Q
questions ask how the health care budget will be divided, what health care needs will be addressed, how they will be prioritized, who will deliver these services, and what limits will best serve the efficient meso-allocation of health care.
A
Meso-allocation
6
Q
questions ask who should get what share of the health care budget, whether the present distribution is equitable, how rationing of services is determined, and what factors should be used in the triage of patient needs.
A
Micro-allocation
7
Q
In the 1940s, the patient’s needs came first regardless of the ____
A
cost
8
Q
By the ____, cost was becoming a greater concern and diagnostic related groups (DRGs) were developed to control resource allocation.
A
1960s
9
Q
DRGs
A
Diagnostic Related Groups
10
Q
In the ____, the prospective payment system (PPS) further expedited a fairer and more equitable system of health care distribution.
A
1980s
11
Q
PPS
A
Prospective Payment System
12
Q
HEALTH CARE DELIVERY MODEL
A
Managed Care
Patient-Focused Care
13
Q
may be described as a condition or frame of mind
A
Health
14
Q
an ongoing decision-making process in health care
A
Triage
15
Q
Prioritizing also know as
A
Triage
16
Q
is a system of
prioritizing that encourages the delivery of treatment
to those with the greatest opportunity for a positive
outcome
A
Triage
17
Q
is a health
care distribution theory that demands equal distribution
of equal opportunities and resources
A
Egalitarian Theory
18
Q
demands equal distribution of equal resources
A
Egalitarian Theory
19
Q
This system
believes every person is good and is equal
A
Egalitarian Theory
20
Q
it does not address the fact that persons may not have equal needs
A
Egalitarian Theory
21
Q
Whether egalitarian theory can be put into practice is ____
A
Uncertain
22
Q
is a health care distribution theory that demands equal distribution of equal opportunities and resources
A
Egalitarian Theory
23
Q
sees the distribution of health care resources as a system of contracts
A
Entitlement Theory
24
Q
is a system of contracts in which a patient has to pay for the contract.
A
Entitlement Theory
25
For this theory to work, a person must have a way to pay for the contract
Entitlement Theory
26
In addition, the theory seems to be grounded in the financial value of medical treatment
rather than its intrinsic value
Entitlement Theory
27
is a health care distribution theory that adjusts the equality of individuals with the inequality of their needs and resources
Fairness Theory
28
tries to tailor health care distribution to balance the dignity and
equality of all persons with the inequality of their needs and circumstances
Fairness Theory
29
The most important consideration in this theory is the ways in which advantaged and disadvantaged people receive care and who makes these decisions.
Fairness Theory
30
Within the ______ theory, the equality of patients as individuals is weighed against
differences in their needs and circumstances
fairness
31
difficulties arise in the determination of the
| degree of fairness theory to which a patient is _____
disadvantaged
32
is a health care distribution theory
| that calls for realizing the greatest good for the greatest number
Utilitarian Theory
33
recommends the provision of the greatest good (in this case, health care services) for the greatest number.
Utilitarianism
34
Under this theory, imaging departments look at patients as a group and not as individuals and seek to provide the most care for the most people.
Utilitarian Theory
35
A ______ would say that if a vascular laboratory can accommodate five uncomplicated procedures in one day, it should perform them instead of two long procedures.
utilitarianist
36
Individuals may have difficulty maintaining autonomy as the
| _______ is implemented.
utilitarian theory
37
Advantage of Egalitarian
All persons have equal access to all imaging services
38
Disadvantage of Egalitarian
Patients’ needs are different; scheduling and reimbursement would be
different
39
Advantage of Entitlement
All persons have needs
40
Disadvantage of Entitlement
Patients must be involved in a
contract to pay for services; theory more concerned with cost value of treatment instead of the intrinsic
value of the service to the patient
41
Advantage of Fairness
Balances dignity and equality
of all persons with the
inequality of their needs
and circumstances
42
Disadvantage of Fairness
Identifying the differences (inequality
of needs) can lead to subordinating
the dignity of the individual to the
convenience of the society
43
Advantage of Utilitarian
Recommends providing
| the greatest good for the greatest number of people
44
Disadvantage of Utilitarian
Identifies patients as a group rather than as individuals
45
is a health care distribution theory
that claims individuals
have a right to health care because of their human dignity and because society has an obligation to serve their needs
Rights theory
46
claims that individuals have a right to good health care because of their human dignity
Rights Theory of Justice
47
In recognition of this dignity, society has an obligation to care for all people
Rights Theory of Justice
48
This theory raises questions of rights and autonomy and the ways
in which they are implemented
Rights Theory of Justice
49
is a product of right reason or virtue ethics that includes a consideration of emotional factors and development of the reason balanced by consideration of the consequences for the individual in society
Practical wisdom
50
is accomplished through application of practical wisdom (right reason) to meet the demands of human dignity in the social circumstances of the time
Justice or distribution
51
involves respecting human dignity and satisfying human needs and recognizing human contributions within the system and in ways that are characteristic of the system
Justice
52
According to _________, there are six criteria —need, equality, contribution, ability to pay, effort, and merit —that will aid the health care professional in ethical problem solving when a fair distribution of scarce resources is required
Armstrong and Whitlock
53
seems to be an obvious and useful criterion; however, this is complicated by whose perception of need is used to make the distribution decision.
Need
54
is not always the best criterion to use
| in allocation dilemmas
Need
55
rarely serves well as an effective criterion for allocating health care resources.
Equity
56
Each imaging patient may require a different type and number of imaging examinations depending on his or her health
Equity
57
requires a determination of what an individual might be expected to give to society at a future date
Contribution
58
Decisions based on ______ are of limited benefit in making allocation decisions based on the individual situation
Ability to Pay
59
may be considered a compelling criterion for consideration when decisions involve elective treatment and the imaging patient was able to choose his or her health plan
Ability to Pay
60
may be a useful criterion for patients who fail to heed medical advice or do not make an effort to help themselves
Patient effort
61
may be a controversial criterion because of the complexity of withholding and limiting resources
Patient effort
62
The best criterion on which an imaging professional could base an ethical allocation determination
Merit
63
is the potential to benefit from the additional investment of limited health care resources
Merit
64
requires that decisions be based on data or evidence
Merit
65
are useful in dealing with ethical dilemmas in allocating
| imaging resources
Preceding criteria
66
They raise important questions when choices are necessary, and they
provide the imaging professional with an awareness of what imaging administrators face
when solving distribution dilemmas
Preceding criteria
67
allows patients to choose their own physicians and facilities for health care services; however, a patient must be able to pay for those services
Traditional care
68
provides high-quality health care for those with traditional insurance coverage and those who can
pay for these services, but uninsured persons and those unable to pay find it difficult to
obtain high-quality services
Traditional care
69
is any type of delivery and reimbursement system that monitors or controls types, quality, use, and costs of
health care
Managed care
70
is an all-encompassing term that includes
| any type of system to coordinate the care and treatment of patients
Managed care
71
is designed to provide better access, improved outcomes, more efficient use of resources, and controlled costs for the patient
Managed care
72
The aim is to reduce unnecessary or inappropriate care
| and reduce costs
Managed care
73
is having an impact on the ethical dilemmas faced by imaging professionals. It complicates the imaging professional’s problem solving by adding questions concerning the needs of patients (both inside and outside the system), the medical
community, and managed care corporations
Managed care
74
will remain an
| integral part of the health care distribution system for some time to come
Managed care
75
is a health care distribution model that calls for decentralization of patient care services and cross training of health care
professionals
Patient-focused care
76
plays a significant role in the imaging professional’s changing environment.
Patient-focused care
77
were traditionally
| designed to meet the fiscal needs of the organization
Health care organizations and imaging services
78
The primary objectives of patient-focused care are
to move hospital care services
| closer to the patient’s bedside and decentralize hospital services, including radiology services
79
seeks to implement teams of multiskilled cross-trained
| health care professionals (including imaging professionals) to provide patient care
Patient-focused care
80
may require
imaging professionals to perform functions that were previously performed by other health
care professionals such as nurses and medical technologists
Cross-training
81
imaging professionals must remain continually aware of the problems and opportunities of health care service distribution
Funding round
82
Imaging professionals may be employed by institutions that conduct research on human beings
Biomedical Research
83
Imaging professionals have an obligation to the profession to maintain current knowledge and be critically aware of future technology and trends
Imaging Professionals' Obligation to Research
84
Imaging procedures in all modalities require interpretation
Ethics of Interpretation of Imaging Procedures and Testing
85
Imaging professionals may find themselves involved with patients and families awaiting organ transplants; they may also have contact with donors and their families
Ethical Dilemmas of Transplants
86
CONSIDERATIONS IN TRANSPLANT ETHICS
* Obtaining of appropriate informed consent
* Respectful empathy for the precarious emotional state of patients and families
* Provision of high-quality care to donor and recipient
87
Ultrasonographers tend to be more involved with the ethical dilemmas presented by new reproductive methods than are other imaging specialists
New Reproductive Methods
88
is an advanced level radiologic technologist who works under the supervision of a radiologist to enhance patient care by assisting the radiologist in a diagnostic imaging environment
Radiologist Assistant
89
is a fusion of the two functions that historically were regarded as separate, the financing of
medical care and the delivery of medical services
Managed care
90
HMO
Health Maintenance Organization
91
ERISA
Employee Retirement and Security Act
92
may result from improved efficiency, empowerment of employees,
and sensible delegation of duties
Cost effectiveness
93
may be improved by flattening schedules
| through elimination of peaks and filling in of low-use time
Efficiency
94
Wise application of automation also may improve _____
efficiency
95
THEORIES OF DISTRIBUTION
Egalitarian theory,
Entitlement theory,
Fairness theory,
Utilitarian theory
96
DISTRIBUTION DECISION-MAKING CRITERIA
```
Need,
Equity,
Contribution,
Ability to pay,
Patient effort,
Merit
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