Ethics Lectures

Question 1

what are the three steps of valid consent

Answer 1

freely given - truly the will of the patient
given by a person with capacity
informed

Question 2

why must valid consent be informed

Answer 2

respect for autonomy
a person cant make a decision that is right for them without relevant info
consent is specific and intentional - must know what it is you are consenting to

Question 3

how much information do we need to give patients

Answer 3

you must give the patient the information they want or need in a way they can understand (what they ask for and any other info needed for them to make a decision

Question 4

what kind of information can we give patients

Answer 4

clinically appropriate treatments
nature of treatment
outcome
risks - burdens or side effects

Question 5

what is the bolam test

Answer 5

test to decipher whether there has been clinical negligence

Question 6

what are the problems with the bolam test

Answer 6

what medical opinion determines as proper should be subject to scrutiny when it does not involve empirical factual matters

Question 7

what is paternalism

Answer 7

action performed with the intent of promoting another’s good but occurring against the other’s will or without the other’s consent

Question 8

what are guidelines for

Answer 8

they set a floor or minimal standards

you must make judgements based on understanding of an respect for the core values of medical ethics

Question 9

what are the basic principles of medical ethics

Answer 9

autonomy
justice
beneficence
non-maleficence

Question 10

what is autonomy

Answer 10

The right of patients to make decisions about their medical care without their health care provider trying to influence the decision.

Question 11

what is justice

Answer 11

The idea that the burdens and benefits of new or experimental treatments must be distributed equally among all groups in
society.

Question 12

what is beneficence

Answer 12

the intent of doing good for the patient involved.

Question 13

what is non-maleficence

Answer 13

Requires that a procedure does not harm the patient involved or others in society

Question 14

why do we have autonomy

Answer 14

patients have the right to make their own decision

they can refuse treatment and decide which treatment they would like

Question 15

what are the limits of autonomy

Answer 15

the patient doesn’t have the authority to demand treatment that is not clinically appropriate
the doctor must provide appropriate clinically justifiable treatment

Question 16

what is the difference between paternalism and the doctor refusing to do certain treatment

Answer 16

it is unethical to provide treatment that is the doctors clinal judgement is not appropriate ie it could be harmful, ineffective ,wastes resources

Question 17

when should CPR be applied

Answer 17

it should only be attempted if likely to be successful and will be overall beneficial to the patient

Question 18

what are the risk of CPR

Answer 18

may cause rib fracture and damage to internal organs

if unsuccessful the patient may die in an undignified manner

Question 19

if the burdens, risks and benefits are all roughly balanced who has the right to make the decision

Answer 19

the patients request

Question 20

why should CPR be discussed with patients before hand

Answer 20

cpr is not always successful
patients expect that CPR will be attempted
creates transparency about end of life
informs patients - respects autonomy

Question 21

what is a DNACPR decision

Answer 21

how an individual chooses to pass the closing days and moments of her life and how she manages her death - again concerns patient autonomy

Question 22

what must you tell patients if the decision is not to provide CPR

Answer 22

you must tell the patient that this is the case and why it is

Question 23

what is the HRA article 8

Answer 23

Article 8 protects your right to respect for your private life, your family life, your home and your correspondence

Question 24

what is the duty of candour

Answer 24

to be honest with patients or where appropriate family and carers if treatment goes wrong or has the potential to cause harm

Question 25

what is capacity

Answer 25

an adult with capacity has the right to make decision about their care even if those decisions appear unwise or irrational

Question 26

when does a person develop capacity at different ages

Answer 26

develops gradually
age 18 - full legal rights to refuse and consent
age 16-17 - right to consent but not refuse - they cant refuse unless others agree with the refusal (presumed to have capacity to consent)
under 16 - right to consent if you can prove you are competent

Question 27

when can refusal be overridden in treating young people

Answer 27

by courts on the basis of a best interests judgment when life/death and serious permanent har could result

Question 28

how might someone under 16 prove they have capacity to make a decision

Answer 28

they have the intelligence - maturity and independence of the mind
they must fully understand the risks, emotional and psychological impacts on him/her and others around them

Question 29

why is competence asymmetrical

Answer 29

Refusal carries greater risks so you need a higher degree of competence when refusal risks death or serious lasting harm.
have the power to consent to life saving treatment but not necessarily the power to refuse it.

Question 30

what is transitional paternalism

Answer 30

“safety net” - justifies shared power to consent

courts or parents can overrule refusal which is necessary as the person transitions to full capacity or maturity