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1st term: CPH/PPD > Ethics and Philosophy > Flashcards

Ethics and Philosophy Flashcards

1
Q

What are the roles of the GMC?

A

Keep up to date registers of qualified doctors
Foster good medical practice
Promote high standards of medical education and training
Enforce doctors Fitness to Practise guidelines and standards

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2
Q

What is the law?

A

The principle and regulations established in a community by some authority, which is applicable to its people. This may be in the form of legislation, customs or policies and are enforced by judicial decision

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3
Q

What is a statute?

A

This is written law that has been passed or expressed in writing

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4
Q

What is common law?

A

this is a concept which is part of English law that is derived from customs and judicial precedent
e.g. one has a duty to read contracts

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5
Q

What is referred to as a ‘criminal law?’

A

Crimes against the government or community at large

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6
Q

What is civil law?

A

disputes between private parties

e.g. slander, property damage

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7
Q

What is the golden triad of thought for moral philosophy?

A

Virtue ethics
Consequentialism
Deontology

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8
Q

What is virtue ethics?

A

action is judged by the moral character of the person carrying out the action
i.e. action should be virtuous

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9
Q

What is consequentialism?

A

An action is right if it promotes the best consequences

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10
Q

What is deontology?

A

An action is right if it is in concordance with a correct moral rule or principle. This school of thought is much more in accordance with a fixed set of rules or principles
e.g. duties, roles, justice

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11
Q

What is the ‘four principles’ model often used to judge ethics?

A

non-maleficence
beneficence
autonomy
justice

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12
Q

What is the ‘Paradigm case process’ in ethics?

A

Medical indications
Patient preferences
Quality of life
Contextual features (e.g. conflict of interest)

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13
Q

What is the ‘Structural Case Analysis Model?’

A

Summarise the case
State the moral dilemmas
State the assumptions being made
Analyse case with ref to ethical principles
Analyse case with ref to consequences
Analyse case with ref to the virtuous healthcare professional
Analyse case with ref to the law
Identify justifiable and non-justifiable ethical solutions
State preferred approach with explanation

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14
Q

What is meant by informed consent?

A

A voluntary, independent decision made by a competent and autonomous individual on the basis that they have been provided with adequate information and deliberation, to accept rather than reject some proposed action

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15
Q

What 3 features feed into ‘valid consent?’

A

Information
Voluntariness (individual should not be pressured into the decision and must be given the opportunity to say no)
Competence

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16
Q

What is legally defined as competence?

A 
Mental Capacity Act 2005 requires:
patient must understand
retain information provided
Weigh up information
Communicate their decision
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17
Q

What is meant by information in the context of ‘valid consent?’

A

GMC says:

patient must understand in broad terms the nature and purpose of treatment and should be aware of any significant risks

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18
Q

What is voluntariness in the context of ‘valid consent?’

A

Free choice
Free of coercion
Free of undue pressure or perceived coercion

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19
Q

Why is consent important?

A 
respect for autonomy
Control of own treatment
Realistic understanding of treatment
Establishes trust between patient and practitioner 
Respect and dignity
Legal and professional requirement
20
Q

What is a useful acronym of gaining informed consent?

A

Procedure
Alternatives
Risks
Questions

21
Q

Adequate info for consent is assessed by 3 models:

A

Professional practice standards (This is a medical judgement e.g. Bolam test)
Reasonable person standard
Subjective standard (this is the particular significance to the patient)

22
Q

What are the attributes of consent?

A

can be task-specific
can fluctuate
an irrational decision is not an incompetent decision

23
Q

What is voluntariness in gaining consent?

A

patients must be able to refuse and know they are allowed to do so
patient must be free from undue pressure (perceived or otherwise)

24
Q

When is consent is not possible/necessary?

A

Patient is not competent
patient poses serious risk to others if untreated or unrestrained
declines all information

25
Q

What are the main problems with consent?

A

not possible when patient declines information
Difficult to present info when it is complex or there is clinical uncertainty
Effect of emotion on informed consent (e.g. fear, paternalistic doctor figure, patient influenced by way info is presented)
time consuming
not required if patient poses a risk to others or themselves

26
Q

What is the human tissue act consent?

A

needed for removal, storage and use for:
transplantation
education or training
public display

27
Q

What is a Notifiable Patient Safety Incident (NPSI)?

A

An incident here a patient has suffered or could have suffered unintended harm that may result in death, severe or moderate harm or prolonged psychological harm

28
Q

What is the appropriate course of action if a NPSI occurs?

A

put matters right where possible
apologise
explain fully and prompt what has happened and the likely consequences

29
Q

What are the patient complaint options?

A

NHS complains procedure

GMC fitness panel

30
Q

What are the outcomes of a GMC fitness panel?

A

conditions placed on doctor’s registration
suspend registration
remove registration

31
Q

What are the 2 legal options for medical malpractice?

A

Criminal action e.g. gross negligence, manslaughter

Civil action e.g, patient can sue for damages (Tort of negligence statute)

32
Q

What is the Bolam test?

A

Test used to assess whether a doctor was acting in accordance with a practice accepted as proper

33
Q

What attributes are assessed in the Tort of negligence?

A

Doctor:
breach of duty of care (both patient-doctor relationship and proper accepted practice)
breach caused harm (causation required)
Lack of expertise
Legal responsibility for prescribing for e.g.
good notes vital

34
Q

Why is confidentiality important?

A

public trust in patients
individual right to privacy
legal requirement

35
Q

When is breaking confidentiality permissible?

A

it is required by law
patient consents
justifiable to public interest (e.g. protecting society/individuals from harm)

36
Q

What are the requirements when breaking confidentiality?

A

disclose as little info as possible
use anonymised/coded info where possible/practical
observe all legal requirements
notify patient in advance if time allows and doing so will not out others at risk

37
Q

How does the GMC duty of confidentiality change through life?

A

It continues after death

Note that legally the duty dies with the patient

38
Q

Which areas of confidentiality are referred to in statutory provisions?

A 
(tricky areas)
disease that affect driving
genetic disease
STIs
domestic/child abuse
immigration issues
39
Q

What is ‘reflective practice?’

A

learning though experience toward failing new insights used to better one’s practice

40
Q

What are the 3 types of reflective practice?

A

knowing in action (that which we do almost in reflex)
reflection in action (thinking on your feet)
reflection on action (conscious activity after an event)

41
Q

What is the purpose of reflective practice?

A

metacognition improves cognitive function

expected criteria of academic examinations and clinical work

42
Q

What is an error?

A

failure of planned actions to achieve their intended outcome

43
Q

What are the types of error?

A

slips and lapses: good plan, poor execution

mistake: bad plan, executed well
violation: deliberate attempt not to follow accepted approaches

44
Q

What are the broad reasons why errors occur?

A

Personal
Interactive/system
The deadly 10

45
Q

What are the deadly 10 causes of errors?

A 
defects in:
communication
triaging/prioritisation
system design error
playing the odds
insufficient skill
sloth/minimum effort
fixation
bravado or timidity
ignorance
teamwork
46
Q

What are active causes or error?

A

actions which are close to the patient

more likely to occur if staff are tired, depressed or overloaded or overconfident

47
Q

What are latent causes of error?

A

Actions which occur in the system of care (upstream of patient)
Systemic deficit make active areas more likely. Poor communication is often involved

1st term: CPH/PPD (4 decks)

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