Ethics Flashcards

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1
Q

What are teh core ethical principles?

A
  • Patient autonomy
  • Beneficence
  • Nonmaleficence
  • Justice
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2
Q

What is Patient autonomy?

A

Obligation to respect pts as individuals & to honor their preferences in medical care

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3
Q

What is Beneficence?

A

Physicians have a special ethical (fiduciary) duty to act in the pt’s best interest. If the pt can make an informed decision ultimately the pt has the right to decide

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4
Q

What may beneficence conflict w/?

A

Pt autonomy

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5
Q

What is Nonmaleficence?

A

“Do no harm”

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6
Q

What is Justice?

A

To tx persons fairly

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7
Q

What does informed consent legally require?

A
  • Discussion of pertinent info
  • Pt’s voluntary agreement to the plan of care
  • Freedom from coercion
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8
Q

What are the exceptions to informed consent?

A
  • Pt lacks decision-making capcity or is legally incompetent
  • Implied consent in an emergency
  • Therapeutic privilege
  • Waiver
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9
Q

What is Therapeutic privilege?

A

With holding info when disclosure would severely harm the pt or undermine info decision-making capacity

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10
Q

What is Waiver?

A

Pt waives the right of informed consent

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11
Q

What must pts have an intelligent understanding of?

A
  • Risks
  • Benefits
  • Alternavtives
  • No intervention
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12
Q

When can a written consent be revoked by the pt?

A

Any time, even orally

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13
Q

Who is considered a minor?

A

Any pt <18yo

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14
Q

When does parental consent need to be obtained?

A

Any minor unless the pt is emancipated

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15
Q

When is parental consent NOT required?

A
  • Emergency situations
  • Prescribing contraceptives
  • Treating STDs
  • Medical care of pregancy
  • Treatment of drug addiction
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16
Q

What is Decision-making capacity?

A

Physician must determine whether the pt is psychologically & legally capable of making at particular health care decision

17
Q

What are the components of decision-making capacity?

A
  • Pt makes & communicates a choice
  • Pt is informed
  • Decision remains stable over time
  • Decision is consisten w/ pt’s values & goals, not clouded by a mood disorder
  • Decision is not a result of delusions or hallucinations
18
Q

What are advanced directives?

A

Instructions given by a pt in anticipation of the need for a medical decisions

State specific

19
Q

What is an Oral advanced directive?

A

Incapacitated pt’s prior oral statements commonly used as guide

20
Q

Where do problems arise from in oral advanced directives?

A

Variance in interpretation

21
Q

What makes an oral advanced directive more valid?

A
  • Pt informed
  • Directive was specific
  • Pt made a choice
  • Decision was repeated over time to multiple people
22
Q

What is a Living will (written advance directive)?

A

Describes tx the pt wishes to receive or not receive if he/she loses decision-making capacity

23
Q

What do pts direct physicians to do w/ Living wills?

A

W/hold or w/draw life-sustaining tx if he/she dev a terminal dz or enters a persistent vegetative state

24
Q

What is a medical power of attorney?

A

Pt designates an agent to make medical decisions in the event that he/she loses decision-making capacity & specify decisions in clinical situations

25
Q

When can a medical power of attorney be revoked?

A

Anytime pt wishes (regardless of competence)

26
Q

A medical power of attorney is more flexible than a ____ ____.

A
27
Q

What is a Surrogate decision-maker?

A

If an incompetent pt has not prepared an advanced directive, individuals who know the pt must determine what the pt would have done if he/she were competent

28
Q

What are the priorty of surrogates?

A
  • Spouse
  • Adult children
  • Parents
  • Adult siblings
  • Other relatives
29
Q

____ respects pt privary & autonomy.

A

Confidentiality

30
Q

What are the general principles for exceptions to confidentiality?

A
  • Potential harm to others is serious
  • Likelihood of harm to self is great
  • No alternative means exists to warn or to protect those at risk
  • Physicians cna take steps to prevent harm
31
Q

What are some examples of exceptions to confientiality?

A
  • Reportable dz (STD, TB, hepatitis, food poisoning)
  • The Tarasoff decision
  • Children &/or elder abuse
  • Impaired automobile drivers
  • Suicidal/homicidal pts
32
Q

What is the Tarasoff decision?

A

California Supreme Court decision requiring physicians to directly inform & protect victim from harm