Famous Cases Flashcards
What did the Nuremberg code establish, in terms of research? (3)
- Voluntary consent
- Benefits have to outweigh the risks
- Ability of subject to terminate participation
What are the three Belmont principles?
- Respect for pt autonomy
- Beneficence
- Justice (equitable distribution of harm / benefits)
What is the relation between group size and the groupthink concept?
Bigger groups = more groupthink
What was the Tarasoff v Regents case?
Former girlfriend killed by Podder, who was not held appropriately held after stating homicidal intention
What were the two things that came out of the Tarasoff and Regents case?
- Duty to warn
- Duty to protect
What did we learn from the Dax Cowart case?
-Pt should maintain ability to make a decision that you deem is incorrect
What did we learn from Larry McAfee case?
Resources make a huge difference
What did we learn from the Janet Adkins/Dr. Kevorkian case?
Don’t be a renegade
What did we learn from Elizabeth Bouvia?
(cerebral palsy wishes to die)
- Every human should maintain the right to die
- Public opinion is substantial
What was learned from the Karen Quinlan case?
(Vegetative state pt, with parents wanting to withdraw life support)
- Standard of care is fluid
- State recommended hospitals enact ethics committees
What are the three standards of legal evidence?
- Preponderance of evidence
- Clear and convincing evidence
- Most rigorous standard (beyond a reasonable doubt)
What did the US supreme court rule in the Nancy Cruzan case? (3)
(Vegetative state pt with state saying it had an interest in preserving life)
- Made the standard that patients have the right to refuse life sustaining measures
- Finding it was acceptable to require “clear and convincing evidence” of a patient’s wishes for removal of life support
- Huge push for advanced directive
What was learned from the Schiavo case?
(severe hypokalemia 2/2 eating disorder lead to cardiac arrest and severe hypoxic-ischemic encephalopathy. EEGs were flat)
The court is not the best place to mediate issues in the family
What was the main issue with the Schiavo case?
No societal consensus about whether a feeding tube is in the best interest of a patient in PVS
What was involved in the Karen Quinlan case? (court, impact)
- New Jersey Supreme court
- Motivated hospitals to develop process for addressing ethical issues
What was involved in the Nancy Cruzan case? (court, impact)
- US SC
- Sparked state and federal legislation to facilitate use of advanced directives (danforth self determination act)
What was involved in the Terri Schiavo case? (court, impact)
- Florida SC
- Heightened importance of surrogate decision maker
True or false: Coma = Vegetative state
False–Vegetative state is a potential outcome of a coma, but not the only outcome
What is coma AND vegetative state?
Pts are unresponsive and unarousable
When is vegetative state persistent? Permanent?
-1 month = persistent
Permanent:
- 3 month if anoxia
- 12 month if traumatic brain injury
What is a coma? (eyes open or closed) Vegetative state?
Eyes-closed state = coma
Eyes open = vegetative state
What is a coma?
initial presentation to severe brain injury and is self limited, usually lasting a few weeks. Can progress to brain death or complete recovery
What is a minimally conscious state? What is the prognosis?
- A vegetative state that has yet to become permanent
- Has fluctuating consciousness level, and uncertain prognosis
True or false: a minimally conscious state is still a state of consciousness
True
