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MCCQE1 > Ethical, legal + organizational medicine > Flashcards

Ethical, legal + organizational medicine Flashcards

1
Q

Responsibility for indigenous people’s services: federal or provincial?

A

Federal

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2
Q

Responsibility for licensing professionals: federal or provincial?

A

Provincial

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3
Q

Responsibility for public health investigations: federal or provincial?

A

Federal

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4
Q

What is autonomy?

A

The right that patients have to make decisions according to their beliefs and preferences

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5
Q

What is competence?

A

The ability to make a specific decision for oneself as determined legally by the courts

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6
Q

What is capacity?

A

The ability to make a specific decision for oneself as determined by clinicians

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7
Q

Reasons to breach confidentiality

A

Child abuse (report to local child welfare authorities (e.g. Children’s Aid Society)

Fitness to drive or fly a plane (report to provincial Ministry of Transportation)

Communicable disease

Coroner report

Duty to inform/warn

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8
Q

Statutory reporting responsibilities

A
  1. suspected child abuse or neglect – report to local child welfare authorities (e.g. Children’s Aid Society)
  2. Fitness to drive a vehicle or fly an airplane – report to provincial Ministry of Transportation
  3. communicable diseases – report to local public health authority
  4. i_mproper conduct of other physicians or health professionals_ – report to College or regulatory body of the health professional (sexual impropriety by physicians is required reporting in some provinces)
  5. vital statistics must be reported; reporting varies by province (e.g. in Ontario, births are required to be reported within 30 d to Office of Registrar General or local municipality; death certificates mustbe completed by a MD then forwarded to municipal authorities)
  6. reporting to coroners
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9
Q

The duty to protect/ warn is based on which case?

A

Tarasoff

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10
Q

Duty to protect/ warn applies when?

A
  1. there is an imminent risk
  2. to an identiable person or group
  3. of serious bodily harm or death
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11
Q

What is the principle of assent?

A

Patients found incapable to make a specic decision should still be involved in that decision as much as possible

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12
Q

What are the four basic elements of consent?

A
  • Voluntary
  • Capable
  • Specific
  • Informed
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13
Q

Criteria For Administration of Treatment for an Incapable Patient in Emergency Situations

A
  • Patient is experiencing extreme suffering
  • Patient is at risk of sustaining serious bodily harm if treatment is not administered promptly (loss of life or limb)
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14
Q

Treatment without consent is what in law?

A

Treatment without consent is battery (an offense in tort), even if the treatment is life-saving (excluding situations outlined in exceptions to Consent)

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15
Q

If a patient has an advanced directive saying they refuse artificial nutrition, can they be given iv fluids?

A

No according to Canada Q Bank

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16
Q

Is there a minimum age to prescribe contraception in Canada?

A

No

17
Q

Do you have to be specific about what role a resident surgeon will play in surgery in Canada when obtaining informed consent?

A

No, you just need to say the resident will play a role

18
Q

Are you protected in Canada if you respond to an emergency on a plane?

A

Yes by Good Samaritan laws. These apply in circumstances where you have no obligation to provide care.

19
Q

If a lawyer asks you for medical records as part of a complaint are you allowed to charge a fee to make copies?

A

Yes

20
Q

Landed immigrants have to wait a maximum of how long to get publicly funded coverage for health insurance?

A

Three months

21
Q

What are Living Wills for?

A

Specifying end of life care

22
Q

What type of advanced directive specifies a surrogate decision maker?

A

A durable power of attorney for health care

23
Q

When does a fetus have legal rights?

A

The fetus does not have legal rights until it is born alive and with complete delivery from the body of the woman

24
Q

Can a pregnant woman addicted to teratogenic substances be detained to protect the fetus?

A

No. Winnipeg Child and Family Services (Northwest Area) v. G. (D.F.), [1997] 3 S.C.R. 925)

25
Q

If a woman is competent and refuses medical advice, her decision must be respected even if the fetus will suffer- true or false?

A

True

26
Q

Can surrogate mothers receive payment in Canada?

A

Assisted Human Reproduction Act, 2004 Surrogate mothers cannot be paid or offered compensation beyond a reimbursement of their expenses

27
Q

What gave Canadian adults who are mentally competent and suffering intolerably and enduringly the right to a doctor’s assistance in dying?

A

Carter v Canada 2015

28
Q

Notifications to the coroner

A
  • Violence, negligence, misconduct
  • Pregnancy
  • Sudden or unexpected causes
  • Disease not treated
  • Cause other than disease
  • Suspicious circumstances
  • MAID
29
Q

What is CPSO Policy for Ending the Physician-Patient Relationship?

A

Discontinuing services that are needed is an act of professional misconduct unless done by patient request, alternative services are arranged, or adequate notice has been given

30
Q

When can a physician have a relationship with a patient in Canada? And which specialty is a complete exclusion?

A

In specified situations, physicians may have a personal relationship with a patient provided a year has passed since the last therapeutic contact

Physicians are permanently prohibited from personal relationships with patients whom they saw for psychotherapy

31
Q

CPSO Policy: Treating Self and Family Members

A

Physicians will not diagnose or treat themselves or family members except for minor conditions or in emergencies and then only if no other physician is readily available

32
Q

Can parents refuse life saving treatment for their children in Canada?

A

No

33
Q

Who is responsible for local sanitation, monitoring communicable disease notifications, water and food safety enforcement and local environmental risk assessment?

A

The Public Health Unit

34
Q

Basic Activities of Daily Living refer to what?

A

Self care

35
Q

When should you discuss DNR orders with patients?

A

When they are still in good health, according to Canada Q Bank.

36
Q

What are instrumental ADLs? Give some examples

A

ADLs that are not fundamentally essential for living but allow an individual to live independently Making a phone call Doing home repairs Making meals Doing laundry Taking medications Managing finances Driving using public transport Shopping for groceries Doing housework

37
Q

What is the leading cause of cancer death in Canada?

A

Lung cancer. 25% of all cancers. Then colorectal, then breast

38
Q

Best evidence for smoking cessation

A

Counselling + pharmacotherapy

39
Q

Reporting obligations for Live Births, Stillbirths, and Deaths

A

All live and stillbirths must be reported within 2 business days

Physicians must report if pt is suspected to have deceased from violence, misadventure, negligence, misconduct or malpractice or any cause other than disease; by unfair means; during pregnancy or postpartum from circumstances reasonably attributed to the pregnancy; suddenly and unexpectedly; from an illness not treated by a legally qualified medical practitioner; or under circumstances that may require investigation

• physicians must report all medically assisted deaths to the coroner

MCCQE1 (20 decks)

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