Final exam Flashcards
1
Q
Describe organizational ethics.
A
Involves resource allocation, business development, access to care, disagreement about treatment decisions.
It is applied ethics.
2
Q
Being conscious of similarities/contrasts between different cultural groups + understanding in which ways culture can affect different persons approach to health, illness, healing.
A. Cultural Awareness
B. Cultural Sensitivity
C. Cultural Competence
D. Cultural Safety
A
A. Cultural awareness
3
Q
Being aware + understanding the characteristics, values, perceptions of your own culture and the way this may impact your approach to patient from other cultures
A. Cultural Awareness
B. Cultural Sensitivity
C. Cultural Competence
D. Cultural Safety
A
B. Cultural sensitivity
4
Q
Refers to the attitudes, knowledge, and skills of HCP. Blend knowledge, conviction, and capacities of action.
A. Cultural Awareness
B. Cultural Sensitivity
C. Cultural Competence
D. Cultural Safety
A
C. Cultural competences
5
Q
Understanding the power imbalances that are inherent & the institutional discrimination. Understanding culture as context dependent + power lead/privileges + the way history impacts on the communities.
A. Cultural Awareness
B. Cultural Sensitivity
C. Cultural Competence
D. Cultural Safety
A
D. Cultural safety
6
Q
In which step is cultural humility achieved?
A. Cultural Awareness
B. Cultural Sensitivity
C. Cultural Competence
D. Cultural Safety
A
D. Cultural safefy
7
Q
Name the 8 ethical theories relating to normative ethics.
A
- Virtue ethics
- Deontology
- Utilitarianism
- Principlism
- Feminist ethics
- Care ethics
- Narrative Ethics
- Casuistry
8
Q
What are the 4 fields of ethics
A
- Metaethics
- Normative ethics
- Descriptive ethics
- Applied ethics
9
Q
Field of ethics that looks at deep philosophical questions. Defines moral terms; asks questions. Focuses on analysis of meaning + creating justification for actions and inference from moral concepts
A
Metaethics
10
Q
Field of ethics that focuses on formulation and defence of basic principles, values, virtues and ideals governing moral behaviour. “What make someone good or bad?”. Justice as norm.
A
Normative ethics
11
Q
Field of ethics that focuses on factual descriptions and observations. Empirical analysis of what people actually do. Does not try to answer what is good or how best to live. Describes the current reality.
A
Descriptive ethics
12
Q
Field of ethics that focuses on the practical application of ethics to specific contexts. Poses questions such as “in real life and specific contexts, what is the right thing to do”
A
Applied ethics
13
Q
Name some ways to develop ethical fitness
A
- know one’s strength.
- be aware of the professional code of ethics
- understand how the contexts of health care and nursing influence moral distress
- identify strategies that develop ethical fitness
- promote interventions that are in the best interest of patient and families
14
Q
What kind of ethics issue is the following example:
How do we fairly allocate ICU beds if there is resource scarcity during a pandemic?
A
Organizational ethics
15
Q
What kind of ethics issue is the following example:
Business development: is it ethical for hospitals to take money from having fast food restaurants on site?
A
Organizational ethics issues
16
Q
What kind of ethics issue is the following example:
Access to care for the uninsured: a patient without RAMQ requires dialysis. What is the responsibility of the hospital?
A
Organizational ethics issues
17
Q
What kind of ethics issue is the following example:
Disagreement about treatment decisions: Nurses in the ICU have different opinions on withdrawing treatment at the end-of-life. What is the hospital’s policy?
A
Organizational ethics issues
18
Q
What branch of ethics is the following definition for:
The organization’s efforts to define its own core values and mission, identify areas in which important values come into conflict, seek the best possible resolution of these conflicts, and manage its own performance to ensure that it acts in accord with espoused values
A
Organizational ethics
19
Q
What are the 7 values of the nursing profession as outlined by the OIIQ
A
- Integrity
- Respect of the person
- Professional autonomy
- Professional competence
- Excellence in care
- Professional collaboration
- Humanity
20
Q
Which ethical theory focuses on the moral agent?
“What kind of person am I?”
“What kind of person should I be?”
A
Virtue ethics (subset of normative ethics)
21
Q
Name some critiques of virtue ethics.
A
No clear guide as to how to act.
Focuses on agent’s own character
Not culturally relative.
Lacks guidance on how to become virtuous
22
Q
Which ethical theory does this describe:
Non-consequentialist.
Conforming to a moral law or principle.
Actions should be motivated by duty to be right and good.
A
Deontology (normative ethics)
23
Q
What are some critiques of deontologism
A
Outcomes/contexts not considered.
Conflicting duties?
Who makes the rules and who do they apply to?
Dismisses moral value of actions motivated by emotions or good will.
24
Q
What ethical theory does this describe:
What is good? What is right?
Actions are right based on what produces the most good.
Actions are right/wrong based on consequences.
Egalitarian.
Doing nothing is an action.
A
Utilitarianism
25
What are some critiques of utilitarianism?
Only looks at future consequences.
Problem of agent's integrity.
Possible conflicts with justice and rights.
26
Name some examples of utilitarianism in healthcare and nursing.
Scarcity - limited resources and allocations of resources.
Striving for collective good (public health)
Evidence-informed care
Global health & animal rights
27
The following describes which ethical field/theory?
Based on ethical principles such as: autonomy, beneficence, nonmaleficence, and justice
Principlism
28
How can Principlism be applied in Clinical ethics?
Consent
Resource allocation and distribution
Resuscitation orders for all unless specified
29
Which ethical field/theory does this feature in?
Importance of attention to context, especially social context, and to unique properties of individuals
Feminist and care ethics
30
Which ethical field/theory asks questions about power before questions of care and justice?
1. Feminist ethics
2. Care ethics
Feminist ethics
31
Which ethical field/theory does this apply to:
"The art or skill of applying abstract or general principles to particular cases"
Casuistry
ex: NANCY B vs Hotel Dieu "ventilator turned off murder? No. Right to stop treatment... is not suicide/murder"
Sue Rodriguez "whose body is this if I cannot consent to my own death"
32
What are the principles of ethics?
Autonomy
Beneficence
Nonmaleficence
Justice
33
Describe the principle of autonomy.
Moral and legal obligation to promote client autonomy.
Ex. Informed consent, respect
34
Describe beneficence/nonmaleficence and give an example.
Promoting good and avoiding harm.
End-of-life care.
Will our patient benefit from our action or will there be heightened risks.
35
Describe the principle of justice and provide examples.
Equity in resource allocation
Reduction of inequities
Limitations
ex. organ donations, bed management, low resources environments
36
What does IDEA stand for.
Identify the facts
Determine the relevant ethical principles
Explore the options
Act.
37
What are the elements of liability?
1. Fault
2. Damage (harm/prejudice has been done)
3. Causation
38
The capacity of an individual to sustain or restore their integrity in response to moral complexity, confusion, or setbacks
Moral resilience
39
Negative feelings that arise when one decides on a morally correct action in a given situation but is constrained from taking that action. You can't exercise your moral agency
Moral distress
40
Which kind of moral distress occurs in real time as the situation unfolds?
Initial distress
41
Which kind of moral distress arises after the situation has passed and involves lingering feelings about one's failure to act on the initial distress?
Reactive distress or moral residue.
42
What can nurses do to address moral distress?
1. Recognize the symptoms of moral distress. Practice awareness.
2. Reflect on/be curious about the ethical aspects of clinical situations.
3. Reconnect to your original purpose and intentions as a nurse.
4. Commit to your personal well-being
5. Support and restore your moral integrity
6. Listen to your intuition/somatic responses
7. Develop ethical competence
8. Speak up about your ethical concerns and take principled actions
43
Define misconduct
Doing lawful things in an unlawful manner.
ex. failing to keep records as required; failing to renew one's license; improperly delegating a controlled act; practicing while impaired
44
Define malpractice
Professional negligence.
Improper/unethical conduct or unreasonable lack of skill by a holder of a professional position. Denotes negligent or unskillful performances of duties when professional skills are obligatory
45
What is included in "Burden of proof" when seeking to have treatment authorized
1. the person does not have the capacity to consent to proposed treatment.
2. proposed treatment is in the patient's best interest
46
What are the eligible criterion for MAiD
1. RAMQ
2. 18+
3. Able to consent to care
4. Serious incurable illness
5. Advanced state of irreversible decline in capability
6. Constant/unbearable physical/psychological suffering that cannot be relieved.
47
What are some arguments against MAiD?
Sanctity of life;
Nonmaleficence;
Social justice;
Palliative care is sufficient
48
What are some arguments FOR MAiD
Autonomy
Beneficence
Safeguards will protect the vulnerable
Palliative care will not work in all cases
49
Advance Medical Directives (AMD)
Means used to document and communicate a person's preferences regarding life-sustaining treatment in the event that they become incapable of expressing those wishes themselves
50
Advance care planning
Ongoing process whereby patients, in consultation with health care professionals and loved ones, make decisions about their future healthcare
51
Doctrine of double effect
performing an act that brings about a good consequence may be morally right even though the good consequence can only be achieved at the risk of a harmful side effect.
Ex. giving a patient morphine to ease her pain and suffering which causes the side effect of respiratory depression causing her death.
52
Withholding treatment
What does it mean? Is it legal or not?
Failure to start treatment that has the potential to sustain a person's life.
Cause of death: underlying disease
Legal: Yes
53
Withdrawing treatment
Stopping treatment that has the potential to sustain a person's life.
Cause of death: underlying disease
Legal: Yes
54
Palliative care
Holistic care which focuses on relieving physical, social, psychological, spiritual suffering. Neither seeks to prolong life nor hasten it.
55
Continuous palliative sedation
Using medication to reduce consciousness to reduce suffering that can't otherwise be alleviated
56
Medical aid in dying
Doctor gives medication to a person at their request to relieve their suffering by bringing about their death.
Legal since 2015
57
Conscientious objection (CO)
The refusal to perform a legal role or responsibility because of personal values/beliefs
58
What are the essential functions of public health
1. health protection
2. health surveillance
3. population health assessment
4. disease and injury prevention
5. health promotion
6. emergency preparedness and response
59
MADO reportable diagnoses
rabies, gonorrhea, chlamydia, hepatitis b & c, giardia, syphilis, HIV, measles, tuberculosis, lyme disease, amiantosis, carbon monoxide poisoning
60
Criterion for burden of proof
1. person does not have capacity to consent to proposed treatment
2. proposed treatment is in the patient's best interest.
3. expert reports required for both elements (psychiatrists)
61
Parameters for confinement in an institution?
1. patient represents a serious and immediate danger to themselves or others
2. burden of proof by the healthcare establishment
3. 2 psychiatric reports in support of motion for confinement
4. authorization by law or the court
62
What are the types of confinement possible?
1. voluntary confinement
2. Forced confinement (preventive, provisional, authorized)
63
Describe provisional confinement
Person must be a danger to himself/others
Court order is required on the request of physician or interested person.
Obtained if patient refuses to be evaluated on his dangerousness.
Usually concludes in which police assistance is authorized or ordered
64
Describe preventive confinement.
Person must be a danger to himself/other
Danger must be grave and immediate
Court order NOT required (ordered by physician)
Possible to get assistance from peace officer
65
Define authorized confinement
The only type of confinement that isn't preliminary.
Motion requested by health institution
Authorized by court following 2 psychiatric examinations.
Duration is set by the court (max 30 days)
Must be reevaluated at 21 days. Can be extended for additional 90 days
66
What is the expiration period for preventive confinement
72 hours total.
1st PSY must be carried out within 24 hours.
67
For authorized confinement, how long can the confinement be?
30 days.
can be extended for a maximum of 90 additional days.
68
Duty to report ("signalement")
If reasonable grounds to believe that the security or development of a child is or may be considered to be in danger must bring the situation to the attention of the Director of Youth PRotection without delay
69
Define "mature minor"
Common law concept in ONTARIO ONLY.
Person under the age of majority with:
- capacity to make an informed healthcare decision
- independence to make voluntary decision
70
in childhood ethics, what are exceptions to confidentiality?
- client consent/waiver (autonomy)
- court order (administration of justice)
- statutory duty (protection of life)
- public interest (protection from harm)
71
Palliative sedation: the double effect.
What are the 4 conditions.
1. nature of the act is itself good or morally neutral.
2. the intention is for the good effect and not the bad
3. the good effect outweighs the bad effect, the situation merits the risk of the bad effect.
4. the bad effect (ex. death) is not used as a means to achieve the good effect (ex. pain relief)
72
name the 11 conditions for a good death
relief from physical pain/sx; effective communication with HCP; performance of spiritual rituals; relief from emotional distress; autonomy regarding tx; dying in preferred place; life not being prolonged unnecessarily; awareness of the deep significance of what is happening; emotional support; not being a burden; right to terminate one's life
73
what are some challenges to the idea of "a good death"
Can be challenging for family members.
Physical burdens, chronic fatigue, social burdens, income loss, lack of access to home pall care services.
Unpaid care-giving women 2.5x > men.
74
What are some ethical issues facing nurses providing end of life care?
Provision of "futile" care (acharnement therapeutique)
Conflict over goals of care.
Poor DNR/LOC discussions
75
Who can act as a surrogate decision maker in Quebec?
Mandatary, tutor or curator
Spouse
Close friend or relative
76
In mental health legislation, what are some ethical dilemna present regarding human rights?
1. deprivation of liberty
2. detention
3. interference with privacy
4. restriction of freedom of movement
5. use of forced medication that may alter the peron's thinking.
77
What are the different levels of coercion.
Persuasion
Interpersonal
Inducements
Threats
Compulsory treatment
78
Who can decide to apply restraints in cases of mental health?
Doctors, PT, OT, nurses
79
Expecting individuals to act in a characteristic manner that conforms, most often, to a negative perception of their social or cultural group.
A. Stereotyping
B. Prejudice
C. Descrimination
D. Stigma
A. Stereotyping
80
A hostile attitude toward others simply because they belong to a group that is considered to have objectionable characteristics.
A. Stereotyping
B. Prejudice
C. Descrimination
D. Stigma
B. Prejudice
81
The negative differential treatment of others because they are members of a certain group or identified as being negatively different (unfair treatment)
A. Stereotyping
B. Prejudice
C. Descrimination
D. Stigma
C. Discrimination
82
The negative, disciminatory, and rejecting attitudes and behaviour toward a characteristic or element exhibited by an individual or group. Results from negative stereotypes and can be self, public or structural
A. Stereotyping
B. Prejudice
C. Descrimination
D. Stigma
D. Stigma
83
How can stigma affect population health inequalities?
1. influences several physical/mental health outcomes
2. disrupts/inhibits access to multiple resources -- structural, interpersonal, psychological -- that could be used to avoid or minimize poor health
3. enables creation of new, evolving mechanisms that ensure reproduction of health inequalities among members of socially disadvantaged populations
84
Name some problems in mental healthcare ethics
1. lack of dignity and caring in medical settings
2. commonly held stereotypes inducing fear, blame and hostility
3. attribution theory -- weakness of morals as cause of illness
4. devaluing of needs of patients with mental illness
5. in-ward stigmatization
85
When seeking a court order for a treatment order, what questions must the Judge assure are answered?
1. Is the treatment required, and if so, is it sufficiently described?
2. Do the benefits outweigh the negative consequences?
3. How long should the authorization be granted for?
86
For treatment orders, what are the 5 questions from the NOVA SCOTIA criteria?
1. Does the person understand the nature of illness for which treatment proposed?
2. Does the person understand the nature/purpose of the proposed treatment (+ other available options)?
3. Does the person understand the benefits and risks of the proposed treatment?
4. Does the person understand the risks and consequences of not undergoing the proposed treatment?
5. Is the person's ability to understand affected by their illness?
87
Once a court order has been authorized, does the patient have to accept this decision?
Patient can appeal through the following avenues:
1. court of appeal
2. tribunal administratif du quebec
88
What is meant by childhood assent in healthcare?
Assent implies
1. Optimizing the child’s understanding of his/her condition and proposed tests and treatments.
2. Seeking the child’s voluntary cooperation to the proposed care
89
Conditions for confidentiality disclosure?
Conditions for Disclosure
1. Clear risk to identifiable person or group of
persons
2. Serious risk of bodily harm or death
3. Imminent danger
Extent of Disclosure
* Limited in proportion to imminent risks
90
With the 3 bioethics cases discussed in class (Karen Anne Quinlan, Nancy Cruzan, Nancy B vs hotel dieu) on withdrawing care, what are the three important points displayed.
1. Became legally/ethically permissible to consent to withdrawal of treatment (doesn't constitute euthanasia.)
2. Artificial hydration/nutrition is considered a medical intervention + can be withdrawn
3. Surrogate decision makers can make decisions on behalf of incompetent patients.
91
What are the ethical considerations to end-of-life care?
Ethical considerations:
beneficence, non-maleficence, autonomy, professional integrity, quality of life, sanctity of life, procedural justice
92
What are the ethical issues to end-of-life-care?
Futility of care
Medical paternalism
Quality of life? (also a consideration)
Conflict of goals
Poor DNR/LOC discussion
93
In end-of-life-care, surrogates must make decisions based on: ...
1. patient’s prior expressed wishes,
2. if these are unknown, based on the best interest standard (care is beneficial, advisable under the circumstances, burdens should not outweigh benefits).
94
Bill 52
C7
MAiD
95
Ethical question surrounding MAiD
Macro --
Meso --
Micro --
Macro: MAiD overall. who should get MAiD? Should minors get MAiD
Meso: MAiD patients in general. How do we ensure equitable access to care&
Micro: THIS specific patient. THIS specific nurse
96
Define the different types of coercion:
Formal, Informal and Perceived
Formal: regulated at an institutional level policy and procedures; clearly stated
Informal: people in position of power asserting control and manipulation. (Ex. Staff and family members)
Perceived: from a patient’s perspective.
97
What is bioethics?
Health ethics
Can be organizational, clinical, research, public health
98
Organizational ethics is part of which field of ethics?
Applied ethics
99
What does TVIC stand for?
Trauma- & Violence-Informed Care
100
What is Trauma-informed care (TIC)?
Safety for service users by understanding the effects of trauma, and its close links to health and behaviour
It is not about eliciting or treating people’s trauma
101
What are the 4 principles of TVIC?
1. Build awareness and understanding
2. Emphasize safety and trust
3. Offer authentic choices through connection and collaboration
4. Find and build on people's strengths
102
The pursuit of beneficence involving overriding a person's wishes or actions in order to promote their own welfare.
Paternalism
103
What are the five principles to judge public health interventions in global health ethics?
1. effectiveness
2. proportionality
3. necessity
4. least infringement
5. public justification
104
What are the 7 basic requirements for
ethical research? What additional requirement can be made when research is ocurring in developing countries?
1. value
2. validity
3. fair subject selection
4. favourable risk to benefit ratio
5. independent review
6. informed consent
7. respect for enrolled participants.
For developing countries: how the research addresses inequality and who will ultimately benefit from the work. Is this research necessary? Who benefits from it?
105
What is HIV criminalization?
Applying criminal laws to people living with HIV based solely on their HIV status. Such as unintentional HIV transmission / perceived or potential HIV exposure / non-disclosure of known HIV-positive status.
106
In Canada, can an HIV-positive person be charged for not disclosing their status? What legal body states this?
Yes. No law imposes the duty to disclose but it was established by the Supreme Court.
107
According to the Supreme Court of Canada's ruling v. Mabior in 2012; what can negate the legal duty to disclose HIV status?
Viral load at the time of sexual relations was low/undetectable
AND
Condom protection was used.
108
In Quebec, what is the definition of "realistic possibility of HIV transmission" entail?
If VL < 200 + treatment + Viral load testing 4-6 months = no realistic possibility.
Case by case basis for things like oral sex.
109
How does HIV criminalization impede prevention efforts?
People do not get tested; live in denial; you cannot get prosecuted if you don't know your status.
110
The organized efforts of society to keep people healthy and prevent injury, illness, and premature death. It is a combination of programs, services, and policies that protect and promote the health of all Canadians.
Public health
111
What are the main functions of public health? (6)
1. Health protection
2. Health surveillance
3. Population health assessment
4. Disease and injury prevention
5. Health promotion
6. Emergency preparedness and response
112
Explain the following function of public health:
Health protection
Taking action to ensure water, air, food are safe. Regulatory framework to control infectious diseases. Protection from environmental threats; expert advice to food and drug safety regulators
113
Explain the following function of public health:
Health surveillance
Ongoing, systematic use of routinely collected health date for purpose of tracking/forecasting health events or health determinants
114
Explain the following function of public health:
Population health assessment
Understanding health communities/specific populations/factors that underlie good health or pose potential risk. To produce better policies and services
115
Explain the following function of public health:
Disease and injury prevention
Investigating, contact tracing, preventive measures to reduce risk of infectious disease emergence/outbreaks. Activities to promote safe, health lifestyle to reduce preventable illness/injuries
116
Explain the following function of public health:
Health promotion
Preventing disease, encourage safe behaviours, improving health through public policy, community-based interventions, active public participation, advocacy or action on environmental/socio-economic determinants of health
117
Explain the following function of public health:
emergency preparedness and response
Planning for both natural/man-made disasters to minimize serious illness, overall deaths, social disruption
118
What is social justice?
Fair distribution of society’s benefits and responsibilities, and focuses on eliminating the root causes of inequities
119
What is health equity?
Fair distribution of resources for health
The absence of systematic disparities in health between groups with different levels of wealth, power, or prestige
120
What are the 4 public health ethics framework according to Upshur?
1. Harm principle
2. Least restrictive or coercive means
3. Reciprocity principle
4. Transparency principle
121
Explain the following public health ethics framework in accordance to Upshur:
Harm principle
Justifiable to prevent harm to others, but not to prevent harm to oneself
122
Explain the following public health ethics framework in accordance to Upshur:
Least restrictive or coercive means
The full force of state authority should be reserved for exceptional circumstances. Forceful methods are only employed when less coercive methods have failed
123
Explain the following public health ethics framework in accordance to Upshur:
Reciprocity principle
Once public health action is warranted, the individual/community must be assisted in discharging their duties and be compensated for burdens imposed on them
124
Explain the following public health ethics framework in accordance to Upshur:
Transparency principle
All stakeholders should be involved in decision-making, with the quote input, free of political interference or coercion
125
What are key difference between medical ethics and public health ethics?
Medical ethics: focuses on individuals. Pt seeks HCP, curative, clinical settings, pt may reject advice, should be in interest of pt.
Public health ethics: focuses on populations, HCP seeks out patient, preventative, community settings, hard to opt-out, may not be in best interest of some individuals
126
What are 5 questions that can be asked when implementing public health policies according to Markmann?
1. What are the expected health benefits of the intervention for the population?
2. What are the potential burdens/harms of the intervention?
3. How does the intervention affect the autonomy of the individuals in the target population?
4. Impact on equity: How are the benefits and burdens distributed?
5. Efficiency: What are the costs and opportunity costs of the intervention?
127
What are the 4 pillars of emergency preparedness/disaster planning?
1. Prevention and mitigation
2. Preparedness
3. Response
4. Recovery
128
Within the 4 pillars of emergency management, which pillar does the definition below describe.
“Refers to actions taken to identify and reduce the impacts and risks of hazards before an emergency or disaster occurs”.
Prevention and mitigation
129
Within the 4 pillars of emergency management, which pillar does the definition below describe.
“Increases the ability to respond quickly and effectively to emergencies and to recover more quickly from long-term effects. Involved actions taken prior to an event to ensure the capability/capacity to respond”
Preparedness
130
Within the 4 pillars of emergency management, which pillar does the definition below describe.
“Refers to actions taken during or immediately after an emergency or disaster for the purpose of managing the consequences”
Response
131
Within the 4 pillars of emergency management, which pillar does the definition below describe.
“Refers to actions taken after an emergency or disaster to re-establish or rebuilt conditions and services”
Recovery
132
What are the four perspective on public health ethics?
1. Professional ethics
2. Applied ethics
3. Advocacy ethics
4. Critical public health ethics
133
What is professional ethics? (In PH)
A perspective in public health ethics.
The ethics OF public health.
Relates to the mission of public health to protect and promote health and focuses on the virtues or professional character.
134
In terms of the perspective on public health ethics, what is applied ethics?
Ethics IN public health.
Seeks to develop general principles that can be applied to practical situations to guide ethical practice.
135
What is advocacy ethics? (In PH)
One of the 4 perspectives on public health ethics.
Ethics FOR public health.
Involves taking a stand for the goals, interventions, and reforms that are most likely to achieve the moral aims of public health.
136
What is critical public health ethics?
One of the 4 perspectives on public health ethics.
Historically informed practically oriented, and considers social values and trends in analyzing/understanding both the public health situation at hand and the mor problems it raises.
137
What is harm reduction?
a philosophy and set of programs and services focusing on preventing the harms of substance use, not reducing substance use per se.
138
the standard of evidence or burden of proof required for public health action may be at variance with that of traditional conceptions of scientific reasoning.
the decisions made by PH officials are based on a different logic than scientific reasoning.
tutiorism
139
Jordan's principle
Responsibility of the federal/provincial government to pay for natives who live on native land. Whoever is contacted first, pays.
140
What are the 5 phases in MAiD?
1. Pre-Contemplative
2. Contemplative
3. Determination
4. Action
5. Post-death
141
Within the 5 phases in MAiD, describe the following phase:
Pre-Contemplative
Respond to preliminary inquiries about MAiD.
Direct patient to information sources
142
Within the 5 phases in MAiD, describe the following phase:
Contemplative
Connect patients to providers
Discuss MAiD with HCP
Discuss alternatives
143
Within the 5 phases in MAiD, describe the following phase:
Determination
Determine eligibility
Complete required assessments
Patient arrives at a decision
144
Within the 5 phases in MAiD, describe the following phase:
Action
Make final arrangements for procedure
Attend MAiD
145
Within the 5 phases in MAiD, describe the following phase:
Post-death
Provide support for family/loved ones
Report as required by relevant process/legislation
Participate in debrief for HCP
146
In Carnevale article "listening authentically to youthful voices: a conception of the moral agency of children", should we use the best interest model?
No.
Too adult-centered (parents)
147
It is recognized that the cultural and religious freedom of families should be respected. In the case of a minor with life-threatening medical condition which can be corrected with a blood transfusion, can we give a child the blood transfusion if the parents refuse? Why not or why yes?
Yes, with a court order.
Courts commonly overruled the objection to such transfusions by Jehovah's Witnesses families, declaring that the child's right to have his or her life preserved overrides the family's religious freedom
148
What is in the indigenous view on complex end-of-life decision making?
Focus on family and community. Make the decision together.
Cherish sanctity of life. Will most likely continue treatment even if chances of survival are very low.
Difficulty thinking ahead; very day-to-day mentality.
149
What are the ethical problems in pediatric critical care?
1. empirical uncertainty (diagnostic and prognostic imprecision)
2. inescapable tragedy (choosing among bad options)
150
Which key case states that stopping treatment does not entail suicide/murder?
NANCY B vs Hotel Dieu
151
Which key case explicitly recognize right of the dying. Artificial hydration/nutrition is a medical procedure that can be withdrawn.
NANCY Cruzan
152
Which key case introduces the right of surrogate decision makers within rights for the dying.
Karen Ann Quinlan
153
Which key case gives the right to a second opinion, but not to insist upon treatment that doctors regards as ineffective/inappropriate.
Hasan Rasouli
154
Which key case states that one cannot force HCP to provide care if their (patient) behaviour is abusive. (Except VS/dialysis)
Jo vs RVH 2011
verbally abusive. Tried to force doctors to put him on kidney transplant list. Patient is on dialysis. Hospital wanted to transfer him to another hospital but he refused.
155
Which key case states that the Hospital cannot refuse to serve a patient on the basis of their residence? (In the case, access to obstetric services)
Jasmin c Cité de la santé de Laval.
156
Which key case was about unlawful confinement due to an inappropriate psychiatric reports?
J.M. c. Hôpital Jean-Talon
157
Which key case concerned the access to one's medical file (right of access is not absolute; reasonable access)?
McInerney v. MacDonald
158
Which key case concerned the right to refuse treatment even in the presence of a psychiatric disorder?
Hôpital Maisonneuve-Rosemont c.H.(M.)
Presence of a psychiatric order does NOT mean a person lacks legal capacity.
The fact that treatment would be beneficial for a patient does not cancel their right to choose to forego treatment.
159
Who can ask for provisional confinement? (2)
Psychiatrist
Interested person (family, friend, neighbor)
160
While there are 4 main principles in principlism ethics (autonomy, nonmaleficence, beneficence, justice), what are the additional 4 principles that can apply to global health ethics
Humility
Introspection
Social justice
Solidarity
161
The nurse practice falls under civil law?
True or false?
False.
Nurse practice falls under statutory law
162
Which nursing actions could result in malpractice? Select all that apply
A. Forgetting to do your patient's assessment
B. Not renewing your license.
C. Practicing while impaired
D. Improperly delegating controlled acts.
E. Giving medication as prescribed even though the dosage feels wrong.
A and E
163
When attempting to determine whether or not nurse was negligent/failed in his or her obligations, what test can be done? What question is asked/what is looked at?
Objective test -->if you fail indicates negligence.
Did the nurse act with the ordinary competence and diligence of a nurse placed in the same circumstances.
