Ethics Flashcards
True or False
Competent pts have the right to refuse knowledge of their own medical information and diagnoses
True
- ensure pt is well informed before they make their decision and find out from the pt who their surrogate decision maker should be
What does capacity mean?
pt can communicate rationally and demonstrate comprehension of proposed tx, alternatives, and consequences of their decision
MMSE is NOT used to judge capacity
True or False
If pt is intellectually disabled or has cognitive impairment, it means the pt has lack of decision making capacity
False
True or False
Physician should respect refusal of tx from a pt who is SUICIDAL
False
True or False
Physician should respect refusal of tx from a pt who is DEPRESSED but NOT SUICIDAL
True
Criteria of Emancipated Minor
Living independently
Married
In military
Self-supporting
Criteria of Partially Emancipated Minor
Contraception
STDs/ HIV
Substance use
Prenatal care
True or False
Parents CANNOT refuse lifesaving therapy for minors
True
True or False
Jehovah’s witness may refuse therapy for himself AND his child
False
- they CAN’T refuse tx for their children but can refuse tx for themselves
True or False
Consent obtained via telephone is considered valid
True
True or False
Pregnant women can refuse therapy even if the life of the fetus is at risk
True
True or False
If pt has transmissible disease (eg. HIV, TB, syphilis, gonorrhea), physician can violate the pt’s confidentiality to protect innocent third parties
True
Physicians are NOT universally req’d to disclose HIV status of pts to involved third parties BUT need to report all NEW cases of HIV to local department of health
True or False
Oral advance directive CAN be honored if pt is dx w/ terminal or irreversible condition AND pt’s wishes were declared to the attending physician + 2 other witnesses
True
No witnesses = not valid oral directive
True or False
Ethics committee can be used if family members are in disagreement about care of pt
True
True or False
Physician needs consent to stop tx for brain dead pt
False
True or False
Family can refuse organ donation even if pt has organ donation card
True
- ONLY organ donation network can ask for consent for the organs NOT the physician
True or False
Tx of family members and friends is unethical and only acceptable in emergency situations where no other doctor available
True
True or False
Sexual contact b/w psychiatrist and pt (current or former) is acceptable no matter how much time has elapsed since ending physician-pt relationship
False
NEVER acceptable!
True or False
Sexual contact b/w a physician (who is NOT psychiatrist) and pt (current or former) is acceptable if there is written letter outlining termination of physician-pt relationship
True
Medicare vs Medicaid
Medicare - for elderly (≥ 65 yoa)
Medicaid - don’t have money
- -> disabled
- -> children of low income adults (50% of all medicaid pts but LOWEST expenditure compared to all other grps)
- -> low income adults
- -> elderly
Hospice
requires survival prognosis of ≤ 6 months
focus is on quality of life NOT cure/prolongation of life
sx control offerred
interdisciplinary team
services provided at home, hospital, or assisted living facility
pts can leave hospice at any time to pursue curative tx and return later
True or False
The following are CIs to hospice care:
- full code status
- co-morbid medical conditions
- inability to provide informed consent
False
Palliative Care
focus is on quality of life
can occur even if pt receiving life prolonging tx (vs. hospice where no tx allowed)
pts have better outcomes in mental health, satisfaction and quality of life
