EH1 Flashcards
Outline the historical origins of the medical profession, and in particular, the legacy of Hippocrates
Ancient Greece: was practiced by priests + temples. Culture relied on supernatural (magic, judgement from gods).
Hippocrates legacy:
- changed medical philosophy: introduced natural causation
- modern clinical method (symptoms -> diagnosis)
- introduced moral framework (hippocratic oath)
- teacher of medicine
Role of Dr in light of WHO definition of health
To practise patient-focused, socially accountable medicine; treating the whole person.
WHO health definition:
health is a state of complete physical, mental + social wellbeing, + not merely the abcence of disease or infirmity
Describe Evidence Based Medicine
Integration of best research evidence with clinical experience and patient values
Define + describe disease, illness + sickness
disease: clinically identifiable symptoms + signs from an underlying biological pathology (objective)
Illness: individual’s experience or disease or their response to symptoms (+/- underlying biological condition) (subjective)
Sickness: the role which those who are ill are expected to play (how they act; sick if can’t function normally)
Analyse differences between biomedical + social constructions of health
Biomedical:
- health is purely related to absence of disease / disability
Social:
- health is functional capacity within society
Define paternalism + critique its impact on clinical care
Belief that “doctor knows best” + can make decisions on behalf of a patient w/o involving them
- disempowers patient + limits their autonomy
- fosters distrust in HC system
- misses out on benefits of partnership (fostering self-healer, combining resources etc)
Describe patient-centred clinical interview
Unwellness = use both frameworks
1. disease framework: dr’s agenda - history, physical labs, investigation
= differential diagnosis
2. illness framework: patient’s agenda - ideas, concerns, expectations
= understanding patient’s unique experience of illness
=> integration
Cite the patient-centred clinical method
- Exploring the disease + illness (patient-centred interview)
- Understanding the whole person (person, proximal + distal contexts)
- Finding common ground: problems, roles, goals (mutual decision)
- Incorporating prevention + health promotion
- Enhancing dr-patient relationship
- Being realistic - time, teamwork, use of resources
Define ethics as it applies to healthcare
Standards of right or wrong that prescribe what humans ought to do
Morals – personal morals
Ethics – standards of profession / society
Involves rights, obligations, benefit to society, fairness, virtues
Describe the 4 ethical principles + their application to medical practice
Autonomy: patients right to choose Nonmalificence: do no harm Beneficence: do what's best Justice: fairness - social - distributive
Compare and contrast the terms obligation, duty and rights.
Right: privilige or entitlement; a claim; not always recognised by individuals or society
Duty: something you “ought” to do (usually a 2 way relationship)
Obligation: something you must do
Differentiate between legal and ethical issues in medical decision making
Ethics = standards of behaviour, not obligated to follow
Law = obligation, compels people to conform
Differentiate between legal and moral rights
Legal - obligated to follow since written in law.
Based on ethical argument: assumed to be accepted / respected by others
Discuss informed consent
3 elements:
threshold: competency of patient
Information element: appropriate disclosure, adequate comprehension
Consent element: voluntary + method of authorisation
