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MSHC > Doctor- Patient Relationship (M1) > Flashcards

Doctor- Patient Relationship (M1) Flashcards

1
Q

bioethics

A

broadly interdisciplinary field that addresses the application of the biomedical sciences to health and life

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2
Q

normative ethics

A

branch of moral philosophy that seems to identify moral standards of right and wrong conduct

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3
Q

moral theory

A

seeks to provide an overarching and systematic account of morality as a whole

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4
Q

practical ethics

A

attempts to justify a particular way off life and particular resolutions to moral conflict

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5
Q

utilitarianism

A

an ethical theory that focuses on the consequences of actions

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6
Q

deontology

A

an ethical theory that focuses on the rightness or wrongness of actions

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7
Q

categorical imperative

A

from Immanuel kant, the basic principle on which morality is based. the moral law is absolute (categorical) and must be followed under all circumstances (imperative)

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8
Q

prima facie

A

“at first sight”- prima facie rule is binding unless a competing moral obligation makes a stronger claim

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9
Q

virtue ethics

A

ethical theory that focuses on personal character

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10
Q

principle

A

broad action, guide, or rule of conduct

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11
Q

nonmaleficence

A

do no harm

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12
Q

beneficence

A

seek to benefit others

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13
Q

autonomy

A

self rule

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14
Q

justice

A

giving each his or her due; distributive justice; a fair distribution of benefits and burdens

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15
Q

specification

A

the process through which general principles are applied within specific cases; specification involves the discernment of specific rules that are relevant in a particular case

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16
Q

balancing

A

deliberation and judgement about the relative weight/ strength of norms in concrete cases

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17
Q

norm

A

culturally specific rule about how people ought to behave in a given situation

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18
Q

casuistry

A

case-based method for resolving moral conflict

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19
Q

narrative ethics

A

method of resolving moral conflict that relies on story use

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20
Q

supererogatory acts

A

acts that go beyond the call of duty- martyr

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21
Q

profession

A

occupation that involves specialized and prolonged academic training and that is aimed at providing a particular service to paying clients- typically include formal certifications and governing bodies

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22
Q

professionalism

A

activity that involves both the distribution of a commodity and the fair allocation of a social good, but that is uniquely defined according to moral relationships

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23
Q

autonomy

A

persons capacity for self rule, free from controlling influence by others (also empowered with knowledge for a fair decision)

24
Q

paternalism

A

when doctor acts like a father for the welfare of the patient, often ignoring or interfering with patient autonomy

25
Q

competence

A

ability to perform a task- discern from capacity

26
Q

informed consent

A

able to give when one is 1- competent to act, 2- receives a thorough disclosure, 3- comprehends the disclosure, 4- acts voluntarily, 5- consents to the intervention

27
Q

disclosure

A

transfer of information from medical professional to patient; professionals are obligated to disclose a core set of information that will allow the patient to make informed and autonomous decisions

28
Q

surrogate decision maker

A

someone authorized to make medical decisions for non autonomous/ doubtfully autonomous patients

29
Q

confidentiality

A

keeping a patient’s information secret and ensuring that only those authorized to have access do

30
Q

privacy

A

condition of being left along, hidden from others, and in control of information that is known about you

31
Q

privileged communications

A

verbal and written communication between patient and physician; these are protected from forced disclosure in court of law because they were made within a protected relationship

32
Q

fidelity

A

quality of being loyal and faithful

33
Q

fiduciary relationship

A

relationship of trust in which one, the fiduciary, has heightened responsibility toward the other

34
Q

dual loyalties

A

situations in which physicians are asked to fulfill a social duty that seems to conflict with basic moral commitments of medicine

35
Q

veracity

A

truthfulness

36
Q

informed consent

A 
one must be:
1-competent to act
2- receive disclosure
3-comprehend the disclosure
4-act voluntarily
5-consent to the intervention
37
Q

disclosure

A

transfer of info from professional to patient (required for autonomous decision

38
Q

voluntariness

A

presence of adequate knowledge, absence of psychological compulsion, and absence of external constraints

39
Q

influence

A

1-coercion=threat of force
2-persuasion=comes to believe through rhetoric and reasoning
3-manipulation= combo/ neither 1 or 2

40
Q

strong activist influences on bioethics

A
  • feminists
  • disability advocates
  • bioethics is relatively new, origins= hippoc
41
Q

competence

A

relative to the decision and the person

-judgement issues= may lead professionals to override patient’s personal judgements

42
Q

autonomy

A

2 conditions needed= liberty and agency

  • kant= (deontology) respect for autonomy flows from recognition that all people have unconditional worth- capacity to determine moral destiny
  • mill= (utilitarian) “individuality”- society should let them develop autonomously as long as they don’t interfere with freedom expression in others
43
Q

philosophy

A

“love of wisdom”; breaks into aesthetics, epistemology, metaphysics, and ethics (right/ wrong, good/bad)

44
Q

normative ethics

A

branch of moral philosophy that seeks to identify moral standards of right/ wrong conduct (large collection thinks it)

45
Q

moral theory

A

seeks to provide overarching account of morality/ comprehensive theory
-should provide:
1- formal, systematic account of what morality is and how it works
2- theoretical framework for case analyses
3- decision procedure
4-ground for justification (objective backing of opinion)

46
Q

practical ethics

A

seeks to justify particular way of living and particular resolutions to moral conflict

47
Q

utilitariansim

A

actions are justified or not based on yielded consequences

  • first systematized by John Stuart Mill (1806-1873) and Jeremy Bentham
  • evaluates actions based on principles of utility (often understood as happiness)
  • strengths and weaknesses= emergency rationing, torture, and organ harvesting
48
Q

deontology

A

nature of actions themselves- right/wrong

  • Immanuel Kant (1724-1804)- categorical imperative= absolute truths (full of contradictions)
  • W.D. Ross’s prima facie rules- lots like it always applies but other duties can override= fixed absolute duty problem with Kant
  • strengths and weaknesses= torture and lying
  • every life is valuable and must maintain dignity, no matter how many it saves (organ harvest)
49
Q

virtue ethics

A

focuses on personal traits of character that lead to moral or immoral behavior

  • aristotle (western) assoc.
  • about living and seeking self improvement
  • strengths and weaknesses= action guidance (holistic rather than detail oriented), and complete well being
50
Q

confucian

A

emphasis on relationships- growth in relations characterized by trust, mutual concern, deference, and independence

51
Q

bioethical principles (Beauchamp and Childress)

A
  • nonmaleficence
  • beneficence
  • respect for autonomy
  • justice (formal- consistent and material distribution of benefits/ burdens)
52
Q

Hippocratic oath (mod. vs ancient)

A

-individualism
-patient centered/preventative (surgery)
-equality/ politically conscious
-tech advancement
-pluralism of values and diversity
-religion
Old= no euthanasia/ abortion, no surgery, deities, family/ mentor relation, no sex with patients, no remuneration
new= no discrimination on race/ gender, informed consent, patient autonomy, best interests of patient, do not breech scope of knowledge, public health

53
Q

3 core elements of medical professionalism

A
  • devotion to medical service= drives improvement- fiduciary role- preventing personal/ moral beliefs from influencing treatment- ensures patient’s interest and life is 1st
  • public profession of values= psychological motivation/ accountability, policing other doctors
  • negotiation regarding public values= what treatment is allowed/ vaccines, public education, homosexuality, etc
54
Q

activism levels

A

1- routine advocacy= advocating patient and health care values
2- internal dissent= internal to group/ institution- fighting policies that undermine HC, without breaking rules
3- public dissent=organize community support, op-ed, following rules but clear unhappiness
4-direct disobedience
5-indirect disobedience
6- principled exit from practice

55
Q

informed consent definitions

A

1- autonomous authorization= individual, moral right to choice= moral deals or an ideal world
2- social rules of consent- legal/ burreaucratic structures build ground for consent formation
**disambiguation of informed consent before priority rule- tells us which to follow or adhere to

56
Q

stages of informed consent

A

1- competence; 2- voluntariness= do you have autonomous agent and are they able to give informed consent
3-disclosure; 4-recommendation; 5-understanding= recommendation from expert is required for complete understand from patient
6- decision= epistemological; 7- strictly moral- the go-ahead for the doctor to accept the duty and responsibility

57
Q

influence

A

1-coercion= intended threat of harm
2- persuasion= reasons (disclosure of certain info); or emotion (editing style of information)
3- manipulation= combo of both- broad misrepresentation/ withholding

MSHC (10 decks)

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