Ethics

Question 1

Principles of Bioethics (4)

Answer 1

Autonomy
Justice
Beneficence
Non-maleficence

Question 2

Identify what Principle of Bioethics:

This is compromised when members of an indigenous tribe with no formal education should they agree to participate study.

Answer 2

Autonomy

Question 3

Instances when a patient autonomy is taken into consideration

Answer 3

All patients should be evaluated as to their capacity to make autonomous decisions, regardless of the condition.
Eg. psychiatric patients, Severely Intoxicated , Pediatric

Question 4

Ethical principle rooted in society’s respect for the individuals ability to make rational, uninfluenced decisions.

Answer 4

Autonomy

It includes the right of the patient to agree to a medical procedure and the right to refuse treatment.

Question 5

The capacity of a patient to make an informed , rational, and uninfluenced decision regarding his medical treatment.

Answer 5

Autonomy

Question 6

A 70yo woman, of sound mind , was diagnosed with stage 4 endometrial cancer. Feeling fulfilled with her life already. She decided not to undergo any treatment and opted for palliative care. The Physician respected her decision and complied. What ethical principle was applied?

Answer 6

Autonomy

Question 7

The culture and sensitivity result of a 60year old man with CAP-MR revealed that the organism is highly sensitive to Ampicillin- Sulbactam, however, the patient experienced anaphylactic reaction with this drug decades ago. The physician opted to use other antibiotics.
What ethical principle is applied?

Answer 7

Non-maleficence

Question 8

This means performance or doing of an act.

Answer 8

Feasance

Question 9

Performance of an act that is solely unfair and unlawful.

Answer 9

Malefeasance

Question 10

Wrong performance of a lawful act, negligently or contrary to the accepted standards.

Answer 10

Misfeasance

Question 11

Omission of an act that should have been done

Answer 11

Nonfeasance

Question 12

Ethical principle involved in a doctor spending more time and attention to a patient as warranted by the condition but not necessarily ask for an additional fee.

Answer 12

Equity

Question 13

US Public Health Service Syphilis Study at Tuskegee (1932-72). (5)

Answer 13

1. Study was unjustically unjustified, and the results were disproportionately meager compared with known risk to human subjects involved.
2. Participants informed consent was not collected
3. Researchers told the men they are treated for “bad blood” ( Syphilis, anemia, fatigue)
4. Penicillin was not offered as treatment in the study
5. The men received free medical exams , free meals, and burial insurance

Question 14

This focuses on the obligations of the physician-investigator

Answer 14

Declaration of Helsinki

Question 15

This focuses on the human rights of the human subject

Answer 15

Numberg Code

Question 16

The creation of Belmont report is prompted by the inhumane study of this disease.

Answer 16

Syphilis

Question 17

Fundamental principles included in 1979 announcement of the Belmont Report

Answer 17

1. Respect for Persons
2. Beneficence
3. Justice

Question 18

Set of research ethics principles for human experimentation because of the experimentation at the end of WWII

Answer 18

Nuremberg Code (1947)

Question 19

Preventing inconsistencies in making decisions under Medical Bioethics (3)

Answer 19

1. Defer to extend help by deferring to the existing laws of land
2. Do the publicity test: ask the question “would I decide this way if the decision is publicly known in social media”.
3. Do not decide in haste . Discuss with colleagues.

Question 20

Not a positive step for criticism to foster a healthy criticism scenario.

Answer 20

Superiority of Senior consultants during discussions.

The aim of health criticism is to better the healthcare system.

Question 21

Methods used in Bioethics.

Answer 21

1. Analysis
2. Findings
3. Reasoning

Question 22

If the patient has no advanced directives, what can the family do?

Answer 22

Consult the hospital’s ethics review board

Question 23

Principle of double effect is regarded as a combination of which bioethical principles.

Answer 23

Beneficence & Non-maleficence

Question 24

Ethical requisites for informed consent? (3)

Answer 24

1. Patient has the capacity to make decisions
2. Decision is voluntary and free from duress or coercion
3. Patient is adequately informed of all relevant information

**Does not require that the patient is capable of paying medical dues after treatment **

Question 25

Transferance and Countertransference in ethics in doctor-patient relationships.

Answer 25

**Transference ** Unconscious displacement of earlier relationship experiences and expectations onto the physician. **Countertransference** Corresponding unconscious emotional reaction of the physician to the patient.

Question 26

Questions to justifiably balance benefit and harm.

Answer 26

1. What is expected actual benefit or harm for the patient and the evidence that supports the benefit and harm? 2. How often will harm occur and can it be preventable? 3. Are there any other treatable options available and what are the harm expected if condition is not treated?

Question 27

Required contents of an informed consent document for medical research.

Answer 27

1. Use first person, especially in the certificate of consent 2. Statement of agreement at the conclusion of the document 3. Signed by the adult patient, attending physician , and two adult witnesses.

Question 28

Purpose of informed consent before surgery?

Answer 28

1. Protects the patient’s status as a human being 2. Prevents coercion and deception 3. Asserts patients autonomy ** does not assure the physician will be paid of their services**

Question 29

Small tribe of indigenous people still living in a very traditional way with limited contact to the modern world.

Answer 29

1. Vulnerable population 2. They may lack understanding as to what is being done with them during the study.

Question 30

Vulnerable populations for research

Answer 30

Include but are not limited to: - Children, Minors , Pregnant women, Fetuses, Human in vitro fertilization, prisoners, employees, military personnels and students in hierarchical organizations, terminally ill, comatose, physically and intellectually ill, comatose, physically and intellectually challenged, institutionalized, elderly, visual or hearing impaired, ethnic minorities, refugees, international research, economically and educationally disabled and healthy volunteers.

Question 31

Obligations of a physician in the currently accepted standard of medical practice.

Answer 31

1. Fully inform the patient of their condition and risk of treatment 2. Continue to provide medical care once consent is secured and relationship started 3. Refer the patient to a specialist if necessary