ethics Flashcards
principles of medical ethics
- respect for autonomy
respect the dm capabilities and enable individuals to make reasoned decisions. this can include honesty, patient empowerment, and patient education
INFORMED CONSENT
the patient must be informed of the procedure,
doctors should explain the procedure including pros, cons, risks, and costs
explain the rights to refuse or change their mind
check to understand and answer any questions the patient has
offer the patient time to think about it
offer the right to seek a second opinion, by making a referral to a medical colleague
CAN LINK TO MEDICAL PATERNALISM where a doctor determines a ptients wish should not be honoured
- beneficence
act in a way that benefits the patient also includes principles of altruism, trust and acting in the patient’s interest - non-maleficence
should not harm the patient, all treatment involves some harm but should be minimal and benefits should be greater - social justice:
try to ensure equity and fair use of resources. patients in similar positions should be treated eqaully
CONFIDENTIALLY
not disclosing patient details to others
ethical issues
1.allocation of health resources
2. euthanasia, pregancy termination
3.cross cultural issues
4.gifts from patients
5. imparied colleagues
6.
answering ethic questions
example:
give a recap, establish the key issue, the facts, identify the values at risk, consult colleagues and experts, show open mindedness and sensitivity(cultural)
Dr harris recommends homeopathic medicine to his patients. there is no scientific evidence evidence or widely accepted theory to suggest that homeopathic medicine work and dr harris doesn’t believe them. He recommends homeopathic medicine to people with mild and non-specific symptoms such as fatigue, headaches, and muscle aches because he believes that it will do no harm, but will give them reassurance
1.what is wrong with way dr harris treats his patients
- the main issues present are here dr harris is violating the medical ethical principles of beneficence, non-maleficence and patient autonomy
- he is violating beneficence as he is not acting in the best interests of the patients abd the chance of possible harm to patients is greater than the benefits if there are any
he is violating non-maleficence by suggesting treatments that are not evidence and could cause greater harm to the patient than good
.the harm to the patient might cause the patient to look down upon the medical profession
he is also violating ifnormed consent as he is reassuring them of the these nonscientific based emdicine and is not respecting their decision to use or not use these medications
leading to medical paternialism where dr harris is not honouringhis patients wished or concerns
Dr harris recommends homeopathic medicine to his patients. there is no scientific evidence evidence or widely accepted theory to suggest that homeopathic medicine work and dr harris doesn’t believe them. He recommends homeopathic medicine to people with mild and non-specific symptoms such as fatigue, headaches, and muscle aches because he believes that it will do no harm, but will give them reassuranc
2.why do you dr harris does it
i think he does it to act in a paternialist, and he thinks they might bring good impacts in the patients imbing the mentality if the consequences are good then action is good, but however agian dr harris is not treating his patients as fully rational capable people and hence his ctions are unethcial
Dr harris recommends homeopathic medicine to his patients. there is no scientific evidence or widely accepted theory to suggest that homeopathic medicine work and dr harris doesn’t believe them. He recommends homeopathic medicine to people with mild and non-specific symptoms such as fatigue, headaches, and muscle aches because he believes that it will do no harm, but will give them reassurance
can you see any circumstances under which recommending a placebo might be an appropriate action?
yes, maybe when the patient is incompetent to make their own decision, then the doctor can adopt a paternalistic attitude, but in some cause a parent or guardian can be also be consulted, or no other real scientifica based medicine si availanle
and he has arefully more benefits than harm
Dr harris recommends homeopathic medicine to his patients. there is no scientific evidence or widely accepted theory to suggest that homeopathic medicine work and dr harris doesn’t believe them. He recommends homeopathic medicine to people with mild and non-specific symptoms such as fatigue, headaches, and muscle aches because he believes that it will do no harm, but will give them reassurance
what is the difference between this and dr harris practice?
the difference is that there is not much information to say that his patients are incompetent and cannot make a medical decisions by themselves and there is not missing information on wether there was other evidence based emdication available
Dr harris recommends homeopathic medicine to his patients. there is no scientific evidence or widely accepted theory to suggest that homeopathic medicine work and dr harris doesn’t believe them. He recommends homeopathic medicine to people with mild and non-specific symptoms such as fatigue, headaches, and muscle aches because he believes that it will do no harm, but will give them reassurance
what action would you take regrign dr harris?
i should first dicuss the issue with dr harris and then consulation to colleagues if approprat/college/medical board
you are a medical student sitting an exam, when you notice that a fellow student, Jeremy seems to be looking at notes in his packet. The examiner does not seem to notice that Jeremy is doing so and you know that the exam is supposed to be conducted under strict test conditions. You know that Jeremy is a well-respected medical student for being smart often answering difficult questions in class.
ACADEMIC INTEGRITY-TRUST , honeslty–MEDICLA PROFESSION
what would you do in this situation?
if expeleld, is it fair
say it is fair, if not valid reason, for example
if some personal issues, where he is not able to put hif ull full effor, a second chance warning may be given
- I would first take action, but before i would ensure that what I had seen is verified and see Jeremy after class, and ask him whether he was cheating in a nonconfrontation manner
and try to understand why he was cheating in the first place and might be due to academic pressure or personal issues, then i would inform him that is cheating is not tolerated and inform if he does not hand himself to his academic supervisor i would do it
you notice a necklace has gone missing and you recall your friend admiring the necklace and you remeber as teenagers you shoplifted, your friend class you thanking you, what do you say?
recap, identify the main issue
i would not make an assumption and just assume my friend stole it just because she admired it or once shoplifted when a teenager,
i would try to gather more information and remain calm and look for it in the house and then when called, appreciate for staying with us, i would let her know i misplaced and ask her is she knows it and communicate to her in a nonjudgemental way to ensure i am upholding my friendship, we can trace our steps back together, eg maybe at the restaurant,
but if she does admit to taking my necklace I would ask in a confrontational manner why she took it and say I would and know that her behavior is unacceptable and how it can affect eh trust we have and let if she wanted to use , she could have just asked
in summary, i would ask her that i…
as a nurse a patient confesses to you that she has not been taking the epileptic mediation that her doctor prescribed, as it makes her drowsy and woozy, and not to telle dr singgh as her licence may be supsent
recap, the issue is that patient safety and health and others on the road(pedestrians and drivers)
i would not make assumptions and try to gather more information on the issue
i would gather a full history of the patient, her symptoms, medications, when prescribed and any side effects into detail and the frequency fo these side effects and look into her medical history to gain a full understanding and look up on the latest guidelines for evidence-based guidelines to treat patients with epilepsy and people with epilepsy driving
i will talk to patient that her health and safety is important and also stress the importance of sharing this info to dr singh who is more experience that me and stress that i cannot prescribe my course fo action as it is outside my scope of practice, or if she agrees we can talk to dr singh to together and open and honest conversation can take place, both dr singh and her patient can formulate a plan, that both optimize her health and does not involve her driving privileges taken
but if the patient refuses then i will to speak to dr singh myself about the information i have heard from her , but put the patient interest first and inform him of the potential harm to my patients and others on the road members and also inform her that im an informing dr singh, because her action can impact others safety and wellbeing and is it ok to break patient confidentiality as the public is at risk or consider the report to state licensing
through this actions, i hope the patient will work with dr singh and myself to create a new treatment pan, and try to minimize to the patient and others
ms parker a 21-year-old woman, is not able to understand
recap issue
i would have a private conversation, i would inform her fully of the prom risks, consn benefits of the recommended treatment and perhaps try to lessen the concern she may have on potential side effects, i would ensure and tell her this is based on scientific research adne evidence. i would ensure she understands the information e she presented to her, i will consider working together with miss poker to develop a treatment plan
nd high likelihood of success, if she is interested in a second opinion, i would refer to knowledgeable colleague
if i find that she is struggling emotionally i would express my understanding and make she sure i am there to support and encourage her to seek support from her family and i would also refer to additional support groups and additional counseling
i also want to make sure that parkers decision to pusrue treatment is her own and also not clouded by her emotional state, but she does not involve her family I would respect that
if she still wishes to pursue natural remedies I will have to respect her wishes as she is 21 years old which sis deemed competent to make a medical decision, and able to respect patient autonomy
you a senior associate in a law firm ans working alone and a person comes to talk to lawyer of a specific gender and will not talk to you
recap of the situation, not make assumptions, and ensure that person at the front door does not have a gender preference, if Taylor does in fact have a gender preference, I would ask if Taylor would be comfortable discussing why
she was
and see why she prefers a decision
I would determine if it is a conscious decision such as past history of sexual assault I, would apologize for proving this and contact Jordan for if it is possible to accommodate Taylor without having an impact on the other client, perhaps I could cover for john for another client and perhaps schedule tailored and Jordan for another date. if Taylor refuses to tell me anything, then I would respect and do the same as she might have personal issues such as …
and give her the benefit of doubt
however, if she has cultural or religious id still try my best o accommodate Taylor and ask if her matter is urgent
However, if she says thinks female lawyers are less capable i would still try to help tailor and suggest the possibility of coming another day and seeing the urgency of case which could be cases of domestic violence in a simple intolerant e
summary
patient says the opiod pain killers he is using is using
-listen attentivelu on patient concer and look after patient welfare
-gather as much information for them and check medical history and do physical examinations
–would ask concerns regarding opiod use and what patient knows
-will rovide my knowledge and ensure understanding
-dicuss risk benefits of emdical marijuana and asses if they are eligible and would beenfit
-if allowed collaborate
-SOLUTIONS-
if deemed elegible encoruage regular checkups to ensure set plan is correct
-othewrise soltuiosn such as physio, excercise.
shoudl medical students be considered a higher regard than other professions?
1.yes everyoen equal
2.doctor-patient relationship(vulnerable)–other transaction
