Final Review Flashcards
1
Q
Four elements of negligence
A
duty of care, breach of duty, injury/actual damages, causation
2
Q
Autonomy
A
right to make ones own decisions
3
Q
Paternalism
A
making decisions for others
4
Q
Compassion
A
sympathy for another’s suffering
5
Q
Fairness
A
ability to make judgements free from discrimination
6
Q
Active euthanasia
A
intentional commission of an act that results in death (lethal dose of meds)
7
Q
Involuntary euthanasia
A
Decision to terminate life of an incurable person made by someone else
8
Q
Oregon, Washington, and Vermont…
A
legalized physician-assisted death
9
Q
Defining death
A
irreversible cessation of all brain functions including the brain stem
10
Q
Physician-assisted suicide
A
Is an action in which a physician voluntarily aids a patient in bringing about his/her death
11
Q
Withholding of tx
A
Is a decision not to initiate tx or medical intervention for the pt
12
Q
Withdraw of tx
A
Is a decision to discontinue tx or medical care
13
Q
Malpractice
A
negligence of a professional person
14
Q
Intentional Torts
A
Assault and battery, false imprisonment, defamation of character, invasion of privacy, infliction of mental distress
15
Q
Fraud billing scam
A
A pharmacist dispensed the generic equivalent of a drug and billed for the higher cost brand name.
16
Q
Fraud self-referrals
A
Dr. L ordered unnecessary highly expensive lab tests for his patients. Dr. L referred his pts to a private lab, in which he owned 30%
17
Q
Senate: select committee on ethics
A
Authorized to receive and investigate
18
Q
Emergency medical tx and Active Labor Act of 1986
A
Is a federal law that requires anyone coming to an emergency department to be stabilized and treated, regardless of their insurance status or ability to pay, but since its enactment in 1986 has remained an unfunded mandate.
19
Q
Ethics in Pt Referral Act of 1989
A
A fed law, Stark law, prohibits referrals by a physician to a clinical lab in which the physician has a financial investment
20
Q
Independent contractor
A
Responsible for their own negligent acts
21
Q
Caregivers Rights
A
Nurse in operating room refuses to participate in an elective abortion
22
Q
Ethical theories
A
Attempt to introduce order into the way people think about life and action
23
Q
Consequential ethics
A
Rightness and wrongness of an action is based on the consequences or effects of the action
24
Q
Non-maleficence
A
-avoid causing harm
-not concerned with improving others
-well-being but with avoiding the infliction of harm
25
Intrinsic value
Something that has value in and of itself
26
Instrumental value
Something that helps to give value to something else
27
Partial reasoning
Involves bias for or against a person based on ones relationship with that person
28
2 million people die in the US every year...
80% in hospitals/LTC, 70% of those decide to forego life-sustaining treatment
29
Passive euthanasia
life saving treatment is withdrawn/withheld, allowing person to die a natural death; treatment recognized as futile.
30
US Supreme Court, in two unanimous and separate decisions ruled:
1. laws prohibiting assisted suicide are constitutional
2. laws allowing Dr's to assist in suicide of their terminally ill pts is constitutional
31
Development of law
tradition, culture, customs, beliefs
32
Why laws change...
political climate, social changes, religious beliefs, and values change
33
Public laws
Relationships between individuals and government
34
Private laws
relationships between individuals
35
government organization legislative branch
enact laws, amends or repeals existing legislation, creates new legislation
36
Government organization judicial branch
resolves legal disputes, supreme court, nations highest court; 8 associate justices and 1 chief justices
37
Assault
deliberate threat, coupled with apparent ability to do physical harm to another. Actual contact not necessary
38
Battery
intentional touching of another's person in socially impermissible manner without persons consent
39
Defamation of character
Involves communication to someone other than the person defamed that tends to hold that persons reputation up to scorn and ridicule -> slander
40
Subpoena
A legal order requiring the appearance of a person and or the presentation of document to a court or administrative body
41
Kinds of evidence
direct evidence, demonstrative, documentary, exam of witnesses, expert witnesses
42
Trial procedure
1. closing statement
2. judges charge to the jury
3. jury deliberation
4. damages
5. appeals
43
A principle of law
no one can lawfully do that which tends to be injurious to public
44
XIV Amendment: US Constitution
citizenship rights and equal protection of the laws and was proposed in response to issues related to former slaves following the American Civil War
45
Privacy Act of 1974
Establishes a code of fair info that governs the collection, maintenance, use and dissemination of info about individuals that is maintained in systems of records by federal agencies.
46
Agency for HC Research and Quality
US government agency that functions as part of the Department of Health and Human Services to support research to help improve the quality of healthcare
47
Org ethics codes
Provides guidelines for behavior that help carry out on org. mission, vision, and values
--help to build trust, increase awareness of ethical issues, guides decision making, encourage staff to seek advice and report misconduct when appropriate.
48
Respondeat Superior
A legal doctrine holding employers liable for wrongful acts of their employees
49
Prohibiting termination
Disability, age, race, creed, color, religion, sex, national origin, pregnancy, feeling of safety complaints with OSHA
50
Statutory Consent
An emergency in most states eliminates the need for consent
51
Sherman Antitrust Act
Was the first federal act that outlawed monopolistic business practices
52
Quill vs Vacco
The supreme court found that neither the assistant suicide ban nor the law permitting pts to refuse medical tx treats anyone differently from anyone else/draws any distinctions between persons
53
Pt self-determination Act of 1990
-pts has right to formulate advance directives
-HC providers receiving federal funds under Medicare need to comply with regulations
54
Burden of Proof
Plantiff is required to show that defendant violated legal duty
55
AMA Code of Ethics
Pts have the moral and legal rights to determine what will be done with their own person
56
Executive branch: US Office of Government Ethics
-OGE exercises leadership in executive branch to prevent conflicts of interest
-Resolves those conflicts of interests
-Fosters high ethical standards for employees
-Strengthens public confidence in government buisness
57
HR: Common Ethical Issues
gifts between employees, conflicting financial interests, remedies for financial conflicts of interest, misuse of position
58
Substituted judgement
form of surrogate decision making where the surrogate attempts to establish what decisions the pt would have made if that pt were competent to do so
59
Healthcare proxy
A doc that allows a person to appoint health care agent to make tx decisions in event they become incompetent and unable to make decisions for themselves
60
Surrogate Decisions Making
An agent who acts on behalf of a pt who lack capacity to participate in a particular decision
61
Durable power of attorney for healthcare
An agent makes health and professional care decisions for the pt in events that pt becomes unable to make their own decisions
62
Preparation of witnesses
The manner of which a witness handles questioning at a deposition or trial is often as important as the facts of the case
63
Breach of duty
Failure to perform an adequate history and physical in the ED, such as, failure to properly diagnose a pt at risk for Ebola and discharging the pt back into the community
64
Injury/actual damage
actual damages must be established
65
Infliction of mental distress
Conduct that is so outrageous that goes beyond bounds tolerated by decent society
66
Kinds of contracts
employment, exclusive, commercial ethics, and non-competitions
67
Discovery
Process of investigating the facts of a case before trial
68
Beneficence
-principle of doing good
-demonstrating kindness
-showing compassion
-helping others
69
US judicial code of conduct
provides guidance for judges on issues
70
Administrative law
public law is issued by administrative agencies to direct enacted laws
71
Virtue ethics
focuses on the inherent character of a person rather than on this specific actions he/she performs
72
conscientiousness
One who has moral integrity and a strict regard for doing what is considered the right thing to do
73
In re Storar
every human of adult years and sound mind has the right to determine what shall be done with his/her own body
74
Discernment
Ability to make a good decision without personal biases
75
Standard of care
Actual performance of an individual in a given situation will be measured against what a reasonably prudent person would or would not have done
76
Ultra Vires Act
Acting beyond its scope for authority
77
AMA Code of Medical Ethics
Pt has the right to receive info from physician and to discuss the benefits, risks, and costs of appropriate treatment alternative
78
Futility of tx
-physician recognizes that effects of tx will be of no benefit to the pt
-morally, the physician has a duty to inform the pt when there is little likelihood of success
-the determination as to futility of medical care of scientific decisions
79
Common law principles
precendent, res judicata, stare decisis
80
Bill of rights
amendments to the US constitution were added to protect rights of citizens; freedom of rights, right to keep and bear arms, freedom of speech
81
Advance Directives
-pts have a right to make decisions about their healthcare
-with their physicians may agree to a proposed tx choose among offered tx, or say no to tx
82
Negligence
Commission or omission of an act that a reasonably prudent person would or would not do under given circumstances
83
Meta-ethics
the study of the origin and meaning of ethical concepts
84
Benchmark darling case
the court in this case enunciated a "corporate negligence doctrine" under which hospitals have a duty, for example, to provide adequately trained medical and nursing staff
85
Causation
Must be a reasonable, close and casual connection between the defendant's negligent conduct and resulting damages suffered
86
Subpoena duces tecum
a written command to bring records, does, or other evidence described in the subpoena to a trial or other investigative proceeding
87
Subpoena an testificandum
orders the appearance of a person at a trial or other investigative proceeding to give testimony
88
In re Spring
Pts mental impairment and his/her medical prognosis with or without tx must be considered prior to seeking judicial approval to withdraw/withhold tx from an incompetent pt
89
Tort law
is a wrong, other than a breach of contract, committed against a person or property for which a court provides a remedy, generally in the form of monetary damages
90
Nonfeasance
failure to act when there is a duty to act -> failure to prescribe antibiotics when indicated and respond to emergency call
91
House of Reps Committee of Ethics
-Designated to "supervising ethics office" for the House of Reps
-Only standing committee of the House of Reps with its membership divided evenly by party
92
The Non-consequential ethical theory
Denies that the consequences of an action are the only criteria for determining the morality of an action
92
Misfeasance
improper performance of an act -> wrong sided surgery, leaving an instrument in a pts body
92
Deontology Ethics
-"duty based ethics"
-Involves ethical analysis according to a moral code of rules, religious/secular. Deon is derived from the greek work meaning 'duty'
92
Malfeasence
execution of an unlawful/improper act -> performing a partial birth abortion when prohibited by law, performing a procedure without having proper credentials
92
Healthcare Quality Improvement Act
A fed law that was enacted to create a national tracking system of physicians with a history of medical malpractice payments or advice. National Practioner Data Bank
93
Applied Ethics
the philosophical search (within western philosophy) for right and wrong within controversial scenarios
94
Normative Ethics
is prescriptive in that it attempts to determine what moral standards should be followed so that humane behavior and conduct -> euthanasia and abortion
95
Descriptive ethics
also known as comparative ethics, is the study of what people believe to be right and wrong and why they believe it
96
Sources of public policy
legislation: admin rules, regulations, decisions, judicial decisions, professional code of ethics may contain an expression of public policy
97
Fidelity
being true to out commitments and obligations to others
98
Ethical Relativism
actions can be considered right and wrong depending on the accepted norms of the society in which they are practiced -> slavery may be considered an acceptable practice in one society and unacceptable in another
99
Sarbanes - Oxley Act of 2002
The Sox Act mandated strict reforms to improve financial disclosures from corporation and prevent accounting fraud
100
In re Dinnerstein
"no code" orders are valid to prevent the use of artificial resuscitative measures on incompetent terminally ill pts
101
In re Quinlan
-constitutional right to privacy protects pt's right to self-determination
-a state interest does not justify interference with ones right to refuse treatment
102
What form of ethics is globally based vs. individual?
Macro ethics while micro ethics focuses on individual
103
Morality ethics
is a class of rules held by a society to govern conduct
104
Philosophical ethics
Inquiry of ways of life and rules of conduct
105
What are considered virtue ethics
freedom, fairness, fidelity
106
What virtue of ethics is the ability to make a good decision without personal bias?
discernment
107
Fidelity
faithfulness, being true
108
Honesty
confidence that a person will act with the right motives
109
Which ethical theory bases right and wrongness on the intention and not the outcome
non-consequential ethics
110
Utilitarian ethics
greatest good for the greatest number for people, maximizing happiness (form of consequential ethics)
111
Relativism
morality is relative to the norms of the culture
112
A decision made for another person that they believe is in their best interest is an example of _______.
Paternalism
113
Justice
obligation to be fair
114
What is the process of forming conclusions, judgements or inferences?
reasonings
115
2 types of reasonings and defintions
Partial reasoning - bias for or against an individual based on your relationship
Circular reasoning - an individual that has already made up their mind
116
What legislation allows for individuals to ensure that they are informed of their rights to choose medical care?
Pt Self-Determination Act of 1990
117
A case may be brought forward when it is determined that there was harm suffered as a result of being born. What wrongful case can be brought?
wrongful life
118
Wrongful conception
negligent sterilization/defective contraceptive device
119
Wrongful birth
improper sterilization resulting in birth
119
T/F: all states have endorsed the uniform anatomical gift act
True
120
T/F: The National Organ Procurement Act allows for sale of organs in the US based on need of individuals
False
120
Eugenic Sterilization
Sterilization that is involuntary in some classifications on ind
121
What is the primary purpose of HIPAA
Secure personal medical information
121
T/F: Elective sterilization is typically voluntary
True: 3 different types - elective, voluntary eugenic
121
Voluntary sterilization
Therapeutic if life or health jeopardized by pregnancy
122
T/F: The Tuskegee Study of Syphilis was completed in an ethical manor
False: African American men were told they was no cure for syphilis and thought they were receiving care but instead involved in untreated investigation
123
What is the term used when an individual is given the authority to act on another's behalf?
Attorney - in - fact - POA
--> establishes authorization
123
T/F: Death with Dignity is present in more than 8 states at the present time
True: NJ, OR, WA, MT, VT, CA, DO, HI, NM, ME, DC
123
The FDA was impacted greatly in which of the following?
When the Cures Act was passed allowing for biomedical research and enhanced medical product development
124
Surrogate decision maker
agent makes decisions based on pts morals and religious beliefs
125
Principal
the other person in this scenario giving the authority to another
126
Guardian
court declares someone incompetent and appoints guardian
127
Who makes up an ethics committee
-multidisciplinary team with persons from within an organization and community
-members that are vetted for their ability to handle conflict
128
T/F: An omission under negligence would be considered administration of a medication to the wrong pt.
False
129
T/F: An example of an intentional tort is assault and battery
True
130
Assault
infringement on mental security of an individual
131
Battery
Intention touching and another's person
132
Which is more severe? manslaughter or murder?
murder - unlawful killing of another
133
Burden of Proof in a criminal case must be proven:
beyond a reasonable doubt
134
Legislatively imposed time constraints that restrict when legal action must be commenced is termed what?
Statute of limitations
135
14th Ammendment
State cannot act to deny any person equal protection of law
136
Civil Rights Act
-rights ensured by the US population
-rights of people in a free society
137
EMTALA
Medicare participating hospitals must provide emergency services
138
Privacy Act of 1974
Safeguards individual privacy from misuse of fed records and to give individual access to their own records
139
Ethics in Pt Referral Act of 1989
Prohibits Dr's who have ownership interest of compensation arrangements with clinical lab from referring to that lab
140
False Claims Act
Includes civil and criminal components with or without intent
141
A person that has a relationship of trust or confidence with another is called what?
Fiduciary
142
What is true of a CEO and what is not?
-True: must follow code of ethics, lead org thru day to day operations, appointed by the governing body of the org
-False: lead administrative staff only
143
What is the lowest level of engagement within the profession
emergency medical responder
144
Employment at will
either employer or employee may terminate
145
Equal Pay Act
EST in 1963, addressed wage discrimination based on gender, equal pay for similar work
146
Y/N: can HC providers refuse to participate in medical care or tx?
yes
147
T/F: consent can be verbal, written or implied
true
148
T/F: a person that is mentally incompetent cannot legally consent to a procedure
true
149
What items would be considered a restraint?
A seatbelt that a pt cannot remove, a bed rail that runs the length of the side of the bed, a chest harness to allow for upright posture in a chair
150
If its reported that further tx is futile what is known?
further tx will not result in improvement - hospice or palliative care
151
Therapy tx billed that was not covered by a therapist, billing items not provided. Would this be considered fraud?
yes
152
Governing body of medicaid?
CMS - Centers for Medicare and Medicaid Services
153
If a company engaged in an activity that was outside of their scope, what term would best be used to describe this?
Ultra vires - means beyond the power
154
Indemnification
means to compensate someone for harm or loss
155
Assumption of risk
Accepting risk that is known
