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NUr1085 > Ethics > Flashcards

Ethics Flashcards

1
Q

Who is affected by homelessness?

A

anyone
trauma
lack of employment
abuse
mental illness

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2
Q

strategies for caring for the homeless population

A

meet them where they are
no judgment
continuation of care strategies

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3
Q

Major Global Health Issues

A

Poverty
Hunger
Clean drinking water
Tobacco
HIV/AIDs
malaria

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4
Q

Global Inequities

A

life expectancy
child mortality
universal primary education
gender equality
maternal health
environmental sustainability

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5
Q

Ethical Issues associated with Global Health

A

Resource Allocation
Drug Development
Vulnerability
Short Term v Long Term Issues

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6
Q

Resource Allocation

A

global health initiatives compete for attention/ scarce resources

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7
Q

Drug Development

A

developing countries do not have resources to dedicate to drug development for region specific disease
developed countries do not have incentive to develop those same drugs

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8
Q

Vulnerability

A

developed counties are at the whim of developed countries in regard to research, infrastructure, and employment which increases risk of exploitation.

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9
Q

Distributive Justice

A

the perceived fairness of resource allocation

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10
Q

Voluntourism Ethical Issues (Select All) 1

A

Purpose and underlying motivation for participating in this specific volunteer experience

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11
Q

Voluntourism Ethical Issues (Select All) 2

A

Language and the importance of communication in relation to cultural differences and attitudes
cultural competence

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12
Q

Voluntourism Ethical Issues (Select All) 4

A

Burden, waste, and disruption of local services
anticipation of experience and acting beyond qualifications/ training
participation in unsustainable medical practices in avoiding harm to patients

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13
Q

Voluntourism Ethical Issues (Select All) 3

A

Evaluating new situations, questions, and decisions on the ground
attitude toward beliefs and values
resource limitations

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14
Q

Voluntourism Ethical Issues (Select All) 5

A

Human Research

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15
Q

Approaches for Who Receives Care

A

First come, first served
Most effective distribution of resources to do the most good for the greatest number of people considering medical and social factors
Directing the resources to those in greatest need
Maximize likelihood of survival to hospital discharge
Maximize number of life-years saved
Maximize individuals’ chances to live through each of life’s stages

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16
Q

Instrumental Value

A

A person’s ability to carry out a specific function that is essential to prevent social disintegration or a great number of deaths during a time of crisis
not a valid basis for ethical decision making

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17
Q

Who informs Public Policy

A

the pursuit of justice

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18
Q

Four Impulses of political philosophy

A

welfare
liberty
virtue
revolution

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19
Q

Welfare

A

focused on achieving the most “good” for the most amount of people (utilitarianism)

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20
Q

Liberty

A

Protection and promotion of individual liberties
even if it does not maximize pleasure and minimize pain
Goal of public policy is to maintain and expand individual liberty

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21
Q

Virtue

A

interested in understanding and achieving society’s inherent purpose or “telos/end” (ontology)

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22
Q

Martsolf and Thomas

A

talks about teaching nurses how to overcome implicit biases, and perpetuated racist ideals that lead to racism in society and health care

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23
Q

Organ Case Study 1

A

whether the disease is preventable or not, disruptive justice mandates that organs be distributed based on need

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24
Q

Organ Case Study 2

A

CORE was rounding preemptively was that ethical before organ donation was discussed with that family and patient was not deceased

25
Q

Dead Donor Rule

A

donors must be declared dead (cardio or brain) before their organs are taken, vital organs should only be transplanted from dead patients

26
Q

Barriers to successful transplants

A

limited organs
organ rejection
growing demand

27
Q

Brain Based Criteria of Brain Death

A

Etiology of the injury to the brain must beknown
Any reversible condition should be ruled out
Hemodynamically normal and stable
Does not react to painful stimuli
Reflex testing
Apnea Test: disconnect from the ventilator. An increase o paCo2 after 10 mins is positive for brain death

28
Q

Cardiac Death Criteria
Conditions

A

patient is expected to die but not brain dead, decision to terminate life support is separate from decision to donate

29
Q

Cardiac Criteria for Death
Procedure

A

ventilation is stopped
palliative care is administered
patient RR and HR must stop within 1 hour to be eligible for donation
HR must stop for 5 minutes before declaration of death
then organ preservation begins

30
Q

Why are Disaster Different?

A

Available resources are overwhelmed
Large numbers of casualties
Infrastructure is diminished
Physical and psychological concerns
-Lack of resources
-Panic
-Diminished decision-
making ability
Affects folks from all walks of life: Homeless to wealthy
the wealthy have the advantage of more resources

31
Q

Standards Of care

A

privacy
duty to treat
EMS
hospital transfers
advocacy
utilitarianism/greater good

32
Q

IOM Report Framework

A

determines disaster standards of care based on:
fairness
duty to care
duty to steward resources
transparency
consistency
proportionality
Accountability

33
Q

Fairness

A

Actions must be viewed as fair by all parties even those disadvantaged by the circumstances
Allocation of resources must be done prior to an event

34
Q

Duty to Care

A

primary duty to patient despite risks and scare resources (do not abandon)
Institutions have duty to provide resources and triage systems

35
Q

Duty to Steward Resources

A

Utilize resources to save as many people as possible critical to establish decision making processes beforehand

36
Q

Transparency

A

establish trust through disclosure
must engage all aspects of the community like disabled, elderly and minorities

37
Q

Consistency

A

all groups must be treated the same
eliminate all unfair practices
only flexible with careful deliberation

38
Q

Proportionality

A

policy will include burdensome aspects proportional to scale of disaster like social distancing in pandemic

39
Q

Accountability

A

policy must be adjusted with data
health care providers must raise objections.
all are responsible for outcome

40
Q

Physical Effects of Restraint Use

A

High blood pressure
increased adrenal steroids
Chronic stress syndromes
Ulcers
Depression of immune system
Impairment of memory Irreversible nerve cell damage
functional decline
skin breakdown

41
Q

Psychological Effects of Restraint Use

A

anger
Loss of independence
Abandonment, Psychological distress
Fear of fire and inability to escape.
Helplessness Degradation
Loss of dignity

42
Q

Ethical Implication or restraint free environment and elderly fall prevention

A

dilemma between restriction of freedom and lack of safety

43
Q

Adherence

A

patient-centered, clinician-patient collaboration
non-judgmental
more about “partnership”
increased quality of life
increases autonomy

44
Q

Compliance

A

clinician-oriented
one way relationship with a provider
focuses on obedience

45
Q

Vulnerable Populations

A

those who are relatively incapable of protecting themselves due to social, economic, political and environmental barriers
determined by group ID or individually

46
Q

Sources of Vulnerability

A

stages of human development
poverty
race
physical and cognitive limitations
lack of social support
certain neighborhoods and environments

47
Q

Determining Vulnerability by Group ID Advantages

A

easier to identify group’s vulnerability
easier to mandate special protections
allows for more culturally and linguistically appropriate consent processes

48
Q

Determining Vulnerability by Group ID Weaknesses

A

overlooks individual variation
belong to multiple groups
status of group may change
stigmatizing

49
Q

Medical Model of Disability

A

focuses on impairment
disabled persons must adapt to fit in
Ex. He can’t climb stairs

50
Q

Social Integration Model of Disability

A

focuses on interaction of person and environment
disability is created by external/ oppressive societal factors
Ex. no lifts provided for those who cannot climb stairs

51
Q

Charity Model of Disability

A

disabled persons deserving of pity
focus on cure more than inclusion

52
Q

Identity Model of Disability

A

disability is positive identity

53
Q

ADA

A

civil rights law with the purpose to prevent discrimination in all areas of public life

54
Q

Medical Errors

A

Failure of action to be completed as intended use of wrong plan to achieve aim

55
Q

Adverse Events

A

injury that results from medical care
not a part of disease process

56
Q

Patient’s/family member’s expectations with Medical Errors

A

full disclosure
repentance
medical or financial compensation
prevention plan
forgiveness

57
Q

Blame-free reporting for medical/nursing errors

A

with errors and near misses follow institutional guidelines to report to appropriate authority
ensure responsible disclosure to patients

58
Q

Second Victim Phenomenon

A

providers involved in unanticipated adverse event in the case of a medical error become victimized due to their associated trauma

59
Q

Factors that increase risk of Medical Errors

A

understaffed units
underqualified nurses
long shift hours
inadequate time available for proper nursing care
failure to follow requirements for continuing education
personal life interfering with professional life
too stressed to think clearly
take on too large of an assignment
show up to work impaired r/t alcohol or drug use

NUr1085 (3 decks)

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