Ethics Flashcards
1
Q
Confidentiality
- what is it
- how
- Exceptions: dangers
- Exceptions: STD
- Exception: abuse
- Exception: alcohol
A
- respecting patient privacy and autonomy
- do not discuss pt info in elevator
- high risk of self harm or harm to others and there is no way to warn or protect the people who are at risk of being harmed
- gonorrhea, chlamydia, HIV –> would tell state and state would call all contacts
- child and elder abuse
- impaired and plan on driving
2
Q
Tarrasoff Law
- what happened
- importance
A
- guy liked girl, thought they were in relationship and started stalking girl; he was psychotic and eventually killed girl
- so if someone is in danger they need to be notified they are in danger
3
Q
Informed Consent
- 3 criteria that must be met
- what does coerced mean
- minors: who consents, exceptions
- emancipated situations
- exception: incapacitated
- exception: emergency
- exception: waive right
- exception: therapeutic privilege
A
- discuss pertinent info, pt has to agree, pt cannot be coerced
- pt needs to know about risks and benefits and all alternatives
- parent or guardian has to sign consent; emancipated, drug or EtOH addiction tx, birth control, STD, pregnancy
- minor married, has children, in military, supports themselves
- dementia, lox IQ, on drugs or EtOH
- two doctors must agree that tx is necessary
- pt tells doctor to make the decision; have another doctor shadow case
- withholding info that would severely harm the patient
4
Q
What is decision making capacity
- pt
- decision
- communication
- consistent w/
- made w/o
A
- correctly informed
- remains stable
- clearly makes their choice
- pts values and goals
- delusions or illusions (not high, drunk, on pain meds, or sedated)
5
Q
Surrogate Decision Making
- when used
- order
A
- cases of incompetent pts
- spouse, adult children, parents, adult siblings, other relatives
6
Q
Definitions
- autonomy
- non-maleficence
- beneficence
A
- legal and moral obligation to respect pt as an individual and honor preferences
- to do no harm
- act in best interest of pt
7
Q
Advanced Directive
- Living will
- Durable power of attorney
- oral directive
A
- pt has directed physician about what to do in case of terminal disease or veg state that has left them unable to communicate their wishes; over rules next of kin
- breaks hierarchy of surrogate and pick someone to make the medical decisions; usually someone with medical background
- they tell doctor to stop, need to have long conversation about what pt means
8
Q
Malpractice
- Dereliction
- Damage
- Direct
- # 1 reason for being sued
A
- physician breaches their duty to pt; physician on call and does not answer page
- pt has suffered from negligence; bc did not answer pager pt had MI
- breach of duty has caused harm; pt has MI and now has CHF
- poor communication
9
Q
Medicare vs Medicaid
- carE
- cAID
A
- elderly
- AID the poor
10
Q
Public Health
- Incidence
- Prevalence
- Live longer but not cured; calculated by
A
- number of new cases of dx in specific unit of time
- total number of cases both old and new at certain point of time
- incidence will be same, and prevalence will go up; incidence * time
11
Q
Disease Prevention
- primary
- secondary
- tertiary
- quarternary
- primordial
A
- dx prevented (HPV vaccination)
- detect dx early (pap)
- reduce disability of dx
- avoiding excessive testing and unnecessary invasive procedures
- making law to prevent
12
Q
Infections
- epidemic
- Endemic
- Pandemic
A
- new cases of dx greatly exceed what is expected; limited to small town
- new cases exclusive to certain place, region, population
- spread of infection across large geographic region
13
Q
Probability
- always equal to
- odds of getting certain restul a certain number of consecutive time
- or
- and
- disjoint
- non disjoint
- addition rule for non mutually exclusive event
- multiplication of nonindependent
A
- 100%
- odds * however many times you do it; getting heads is 50% so flipping coin 6x you would multiple 50% 6 times
- add probabilities
- multiply probabllities
- no overlap
- does have over lap
- P(A)+P(B) - P (A and B)
- multiply probability of first to second event assuming first had already happened
14
Q
Case Fatality
- equation
A
- # fatal cases/ # of people w/ dx
15
Q
Sensitivity and Specificity
- true positive
- False positive
- false neg
- true neg
- sensitivity
- specificity
- screening tools
- sensitive tests are
- specific tests are
- tradeoffs
A
- test positive and have dx
- test positive but do not have dx
- test neg but have disease
- test neg and do not have disease
- test ability to detect affected individuals; true positive / true positives and false neg
- tests ability to detect healthy individuals; true neg / false positives and true negative
- need high sensitivity, so they get as many positives as possible; and false positive will be weeded out with confirmatory test
- very good at detecting dx, so if you’re neg then most likely neg
- very good at detecting normal, so if positive you most likely have dx
- you want to make sure that you capture everyone that has dx but that will mean that you will have some false positives but those can be fixed with confirmatory tests
