Ethics Lectures Flashcards

1
Q

what are the three steps of valid consent

A

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

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2
Q

why must valid consent be informed

A

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

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3
Q

how much information do we need to give patients

A

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

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4
Q

what kind of information can we give patients

A

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

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5
Q

what is the bolam test

A

test to decipher whether there has been clinical negligence

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6
Q

what are the problems with the bolam test

A

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

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7
Q

what is paternalism

A

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

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8
Q

what are guidelines for

A

they set a floor or minimal standards

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

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9
Q

what are the basic principles of medical ethics

A

autonomy
justice
beneficence
non-maleficence

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10
Q

what is autonomy

A

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

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11
Q

what is justice

A

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

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12
Q

what is beneficence

A

the intent of doing good for the patient involved.

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13
Q

what is non-maleficence

A

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

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14
Q

why do we have autonomy

A

patients have the right to make their own decision

they can refuse treatment and decide which treatment they would like

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15
Q

what are the limits of autonomy

A

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

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16
Q

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

A

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

17
Q

when should CPR be applied

A

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

18
Q

what are the risk of CPR

A

may cause rib fracture and damage to internal organs

if unsuccessful the patient may die in an undignified manner

19
Q

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

A

the patients request

20
Q

why should CPR be discussed with patients before hand

A

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

21
Q

what is a DNACPR decision

A

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

22
Q

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

A

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

23
Q

what is the HRA article 8

A

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

24
Q

what is the duty of candour

A

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

25
what is capacity
an adult with capacity has the right to make decision about their care even if those decisions appear unwise or irrational
26
when does a person develop capacity at different ages
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
27
when can refusal be overridden in treating young people
by courts on the basis of a best interests judgment when life/death and serious permanent har could result
28
how might someone under 16 prove they have capacity to make a decision
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
29
why is competence asymmetrical
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.
30
what is transitional paternalism
"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