Bioethics Flashcards
What are 3 conflicts of interest that may encountered in research?
financial
personal
academic
What is the guiding document in Canada for the ethical conduct of human research?
Tri-Council Policy Statement (TCPS)
what are 5 ethical principles impacting research in children?
Beneficence, Nonmaleficence, Distributive justice, respect for informed consent, respect for privacy and confidentiality
Beneficence- Applying evidence-based care generated from research specific to children
Nonmaleficence- Avoiding harmful therapies extrapolated from adult patient data or experience
Distributive justice- Allowing research benefits to be available to all populations
Respect for informed consent- Supporting developing autonomy in children considering research participation
Respect for privacy and confidentiality- Providing confidentiality within the limits of legal requirements
what are two indications for genetic testing in a child
If it provides timely medical benefit to the child
1) Genetic testing to confirm a diagnosis in a symptomatic child
2) to allow for adequate medical monitoring, prophylaxis or treatment in a child at risk for a genetic condition that will occur in childhood
what are 3 things required for informed consent
Informed consent requires that a decision maker:
- has capacity to make the decision
- is adequately informed (given all relevant information that a reasonable person would require to make a decision)
- the resultant decision must be voluntary and free of coercion
Emancipated minors
Emancipated minors- adolescents who live independently from parent or guardian or who are parents themselves
Mature minor
Mature minor- adolescents who have demonstrated decision making abilities in other areas of life and as per the mature minor rule are: “capable of fully appreciating the nature and consequences of medical treatment and can give legally effective consent”
What is the primary focus of medical decision making
minimizing harm
maximizing the patient’s best interests
what are the two forms of medical assistance in dying
Euthanasia: at the patients voluntary request, a practitioner administers medication that causes the patient’s death
Practitioner-assisted suicide: at the patient’s voluntary request, a practitioner prescribes or provides medication that a patient can self administer to cause their own death
what are the 4 criteria to qualify for medical assistance in dying
Being 18 yo and capable of making health decisions
Having a grievous and irremediable medical condition, being in an advanced state of irreversible decline in capability
Making a voluntary request for MAID
Being capable of giving informed consent
Before providing MAID what are 5 things the practitioner must do
Hold the opinion that a person meets all substantive criteria;
Ensure that a request for MAID is made in writing and that the document is witnessed, signed and dated after a person has been diagnosed with and informed by a practitioner as having a grievous and irremediable medical condition;
Ensure the person knows that a request for MAID can be withdrawn at any point;
Ensure that a second independent practitioner confirms in writing that all substantive criteria have been met;
Ensure a waiting period of at least 10 clear days between the date of a signed request and the date on which MAID is to be provided. A shorter waiting period is possible when both the practitioner and the independent practitioner share the opinion that the person’s death or loss of capacity to provide informed consent is imminent;
Offer the person the opportunity to withdraw their request and elicit their express consent to proceed immediately before MAID is provided.
what are the 4 ethical principles guiding medical education
Distributive justice: limits for number or times the kid volunteers
Autonomy and assent/consent: Dissent should be respected
Beneficience (to student, to society) and non maleficence (to patient)
Confidentiality
