Ethics

Question 1

Autonomy

Answer 1

Right of individuals to make their own decisions

Question 2

Beneficence

Answer 2

Doing the right thing for the patient

Question 3

Nonmaleficence

Answer 3

Do no harm

Balance helping pt through care vs hurting them

Question 4

Justice

Answer 4

Acting fairly

Provide similar TX to pts in similar situations

Question 5

Court case - Quinlan 1976

Answer 5

Pts have right to terminate medical care because individual has right of autonomy

Question 6

Court case - cruzan 1991

Answer 6

1. Nutrition and hydration are considered medical care and thus can be terminated based on wishes of pt

Question 7

Hunger in terminal illness

Answer 7

Low to nonexistent

Ice chips and lip moisturizer reduced thirst and dry mouth

Growing evidence that pts don’t suffer and may benefit from reduced hydration

Question 8

Cultural influences (ABCDE)

Answer 8

A - attitudes of pt/fam within culture

B- beliefs (religious, traditions)

C- content (personal hx, economics, emigration, role of food in family)

D- decision making style within family and culture

E- environment (interpreters of culture and language )

Question 9

Patient centered focus

Answer 9

A- identify ethical question

B- define context of situation

C- ID family/pt issues ex: values, living will, substitute decision making

D- review law and policies

E- search for options

F- choose and explain those options AKA work with your patients