Ethics Flashcards
What is beneficence?
Trying to do the right thing for the patient.
What is the most fundamental ethical concept?
An adult with the capacity to understand his or her medical problems can refuse any therapy or test NO MATTER WHAT.
If a mentally intact adult patient is refusing a life-saving therapy with virtually no side effects, and the ethics question answer choices include discussing it further w/ the patient vs. “honoring wishes” what do you choose?
Discussing it further.
Difference between capacity and competence?
- capacity: determined by physicians
- competence: legal term, determined by courts and judges
When is a psych consult warranted?
When the patient’s capacity to understand is not clear (NOT when clearly competent or in a coma/clearly not able to understand).
Do minors (under age 18) have capacity?
No, not unless emancipated.
What is an emancipated minor?
although the patient is < 18 yo, they can make their own decisions - are living independently, self-supporting, married, or in the military
When is partial emancipation present?
In cases of contraception, STDs, HIV, prenatal care, substance abuse counseling
NOT in abortion situations (36 states have parental notification laws)
Can parents refuse lifesaving therapy for a child?
No (not even Jehovah’s witnesses, who can refuse blood transfusions for THEMSELVES but not for a kid).
What are the components of informed consent?
- benefits
- risks
- alternatives
- info in a language the patient can understand
- informed consent must be given for EACH PROCEDURE
How does informed consent work in an emergency?
It is implied in an emergency when there is not enough time to determine capacity or prior wishes. If prior wishes KNOWN, this takes precedence. Consent obtained via telephone is valid (including by the patient’s proxy).
Can pregnant women refuse therapy, even if the life of their fetus is at risk?
Yes, but once the baby comes out she cannot refuse Tx for the baby.
According to confidentiality rules, who does NOT have a right to any of the patient’s medical info?
What is the exception?
- relatives, employers, friends, spouses, other docs (without consent), members of law enforcement (w/o court order or subpoena)
- when other people must be protected (e.g. transmissible diseases like TB, HIV, syphilis, gonorrhea, psych pt planning to harm others); if the doc does not inform people at risk, he/she is liable for harm that befalls the innocent person
What is done in situations where the patient has no capacity and no advance directives (HCP or living will)?
Family and friends attempt to outline what they heard the patient say she wanted. If no clear expression of wishes, weakest basis on which to act is “the best interest of the patient.”
When is an ethics committee used?
- the patient is not an adult with capacity
- there are no clearly stated wishes on the part of the patient
- the caregivers are in disagreement about the nature of the care
