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HSC 310 Nursing Ethics > Bioethical Principles > Flashcards

Bioethical Principles Flashcards

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1
Q

What is autonomy?

A

“The right and the ability to make meaningful choices about oneself”

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2
Q

What is nonmaleficence?

A

“One ought not to inflict evil or harm”

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3
Q

What is beneficence?

A

“One ought to prevent evil or harm”
“One ought to remove evil or harm”
“One ought to do or promote good”

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4
Q

What is justice?

A

“Fair, equitable and appropriate treatment”

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5
Q

What are the four biomedical/moral principles?

A

Autonomy
Nonmaleficence
Beneficence
Justice

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6
Q

What are the four components of autonomy?

A

Self-determination
Freedom
Desire fulfillment
Independence

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7
Q

What is self-determination?

A

Makes choices related to their own will, doing what they want in accordance to their values.

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8
Q

What are some complications of self-determination?

A

What do they want
Difficulty deciding
Decisions impacted by lack of info or wrong info
Conflict with other opinions
Choice may cause harm to themselves or others
Do you have the comprehension and capacity to make decisions

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9
Q

What are the three main aspects of informed consent?

A

Voluntariness
Capacity
Comprehension

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10
Q

What is voluntariness (related to informed consent)?

A

Make decisions without coercion

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11
Q

What is capacity (related to informed consent)?

A

Ability to understand what you are told

Need cognitive development

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12
Q

What is comprehension (related to informed consent)?

A

Ability to understand what is being told

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13
Q

What are some essential elements to share in order for the patient to make informed decisions?

A 
Provide information in layman terms
Treatment options
Effect of treatment options and research results
Risk/benefits
Alternative options
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14
Q

What does it mean to have “unencumbered” informed consent?

A

Persons have full authority and autonomy to make decisions regarding their care. Can include: right to refuse, live at risk, live with neglect, self-neglect

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15
Q

What does it mean to have “encumbered” informed consent?

A

Person’s decisions made by someone else because they don’t have the ability to comprehend or have the capacity to make decisions.

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16
Q

Who are allowed to make decisions on behalf of patients who are unable to make decisions?

A

Court appointed committee (for incapable adult)
Patient designated representatives (difference between POA and PDR)
And advanced directive
Temporary substitute decision maker

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17
Q

What is the difference between power of attourney (POA) and patient designated representatives (PDR)?

A

POA has power over finances

PDR has power over medical decisions

18
Q

What is a patient designated representative (PDR)?

A

Patient chooses in advance who will make decisions if they are unable to (difference between POA and PDR)

19
Q

What is an advanced directive?

A

Make a directive in advance of a situation which can be followed by health care team if patient is unable to make the decisions. ID terms in directive: how do you define: heroic measures, no intubation

20
Q

What are temporary substitute decision makers (TSDM)?

A

If no one has been previously assigned, the HCT chooses in order: spouse, child’s parent, sibling, grandparent, grandchild, other relative, close friend

21
Q

What is freedom (related to autonomy)?

A

Ability to make their own decision without coercion or constraint.

22
Q

What is desire fulfillment (related to autonomy)?

A

Getting what we most want

23
Q

What is indepedence (related to autonomy)?

A

Ability to do things ourselves.

Our decisions about self often impact others.

24
Q

What is the definition of nonmaleficence?

A

“One ought not to inflict evil or harm”

25
Q

What are the rules of nonmaleficence?

A

Do not kill, cause pain/suffering, incapacitate, offense deprive others of the goods of life. Rule of the double effect.

26
Q

What is the rule of the double effect?

A

Act must be good or at least morally neutral.
Moral agent must intent only the good effect.
Bad effect must not be the means of bringing about the good effect.
Good effect and bad effect must be proportional.

27
Q

What is the definition of beneficence?

A

One ought to prevent evil or harm
One ought to remove evil or harm
One ought to do or promote good

28
Q

What is the definition of justice?

A

Give fair, equitable and appropriate treatment

29
Q

What are some complications of justice?

A

What impacts whether or not treatment can be obtained?
How do you treat all cases alike?
How do you decide who gets the transplant organ?

30
Q

What is distributive justice?

A

Allocation of resources

31
Q

What is fairness justice?

A

Making unbiased decisions

32
Q

What is veracity?

A

Truth telling

33
Q

What are our obligations of veracity?

A

Disclosure, trust, clarity of terms

34
Q

What is the definition of paternalism?

A

Interference with another person, against that person’s will & is justified that the person interfered with will be better off or protected from harm
Ie. Limits freedom or autonomy

35
Q

What is soft paternalism?

A

Justified to interfere when trying to determine if the person is acting voluntarily of knowledgeably. I.e. is the person aware, is it an intentional act?

36
Q

What is hard paternalism?

A

Justified to intervene if person is going to harm himself even if the person is aware. I.e. if harm to oneself - its okay to intervene and stop this action.

37
Q

What is broad paternalism?

A

Specifically concerned with any paternalistic action including: state, institution, or individual

38
Q

What is narrow paternalism?

A

Only concerned with state coercion i.e. legal coercion

39
Q

What is weak paternalism? (on exam)

A

It’s okay to interfere if the end justifies the means. i.e; protecting encumbered from harming themselves. Able to explain and argue with respect.

40
Q

What is strong paternalism? (on exam)

A

We may intervene to clarify if there is a confusion regarding values vs. facts. We can intervene if there is confusion regarding facts but not values. We can interfere with the encumbered and unencumbered with the belief that the individual will be subsequently grateful, will be “better off”

41
Q

What are the 7 concepts of paternalism from Browne and Sweeney?

A 
Risk
Competency
Mental illness
Emotional states
Influence
Information
Interference
42
Q

What are the 4 conditions for interference (concept of paternalism)

A

Must be effective
Must not generate other and greater evils
Must be the mildest possible to control the evil in question
Must not be discriminatory

HSC 310 Nursing Ethics (10 decks)

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