exam 3 Flashcards
competence
patients ability to understand a situation and make a choice based on their understanding
–> patient must communicate choices, patient understands alternatives, patient understands risks
substituted judgement standard
surrogate decision makers–> how would the ward make the decision if they were fully competent
best interest standard
decision made on behalf of incompetent patients
disclosure standards in informed consent
information that a reasonable person would need to make an informed decision
fiduciary relationship
a relationship between 2 people involving a special trust and the need to maintain confidences
patient care partnership
document that tells patients their rights/responsibilities.
genetic test result challenges
there must be sensitivity due to relationship impacts, potential discrimination, and unexpected findings
–> there is a right NOT to know
informed consent in research
with/without risk to patient, they must get informed consent (information must be provided before consent is acquired
placebo effect
physiologic effect of endorphins
–> can lead to loss of trust or inadequate diagnosis
battery
offensive touching without a person’s consent
tort
civil wrong which infringes right and that causes harm
acute care vs chronic care
acute care: treatment for brief but severe episodes of illness
chronic care: chronic disease continue to evolve and are not preventable which requires extra care
achieving a caring response in chronic disease care
focus on quality of life
–> clinical interventions may improve quality of life or not
–> expectations of cure may/may not be realistic
–> long term medical or social services may need the voice of an advocate
–> caregivers may need rest
quality of life at end of life
offer comfort, patience with patient/family and prioritize what the patient deems important in quality of life
abidement
patients need to believe and are relying on the healthcare providers sticking out with them
–> accept without objection
supererogation
going above and beyond
–> more work than duty requires
double effect
may be permissible to harm an individual if there is another effect that is positive
–> double effect one bad the other good
–> however the beneficial action must be intended
palliative care
patient-centered, family-centered care optimizing quality of life (reduce/relieve severity of symptoms not cure)
hospice care
working to maintain the patient as much as pain-free, comfortable, alert, and humane enviornment
–> no curative intent/no treatment
medical futility
therapy that does not improve the patients medical condition
–> consider benefits to quality of life
extraordinary measures
measures to save the person from death, not likely to improve patients conditions
benefit-burden test
extending life but at what cost
–> consider cognitive. psychological, communication effects
(life should be extended as long as it is beneficial, when it becomes harmful than it can be questioned)
advance directives/information/preferences that should be contained
written, legal documents kept with you, physician
–>provide instructions for medical care if you cannot communicate your own wishes (resuscitation, mechanical ventilation, tube feeding, dialysis)
durable power of attorney
surrogate chosen to make treatment decisions (health care proxy)
medically assisted suicide
physician provides means, patient does the act
medical euthanasia
physician commits act medically
