HCM 415- Section 3

Question 1

Define Beneficence

Answer 1

acting with charity and kindness

Question 2

Define Respect for Persons

Answer 2

implied duties and relationships, including a person’s autonomy

Question 3

Define Nonmaleficence

Answer 3

refraining from actions that aggravate a problem or cause other negative results.

Question 4

Define Justice

Answer 4

fairness; equals are treated equally and unequals unequally

Question 5

Define Virtue Ethics

Answer 5

an internal disposition habitually to seek moral perfection, to live one’s life in accord with moral law, and to attain a balance between noble intention and just action

Question 6

In the presence of infectious diseases, the organizations have a responsibility to protect staff and patients; this premise is supported by which principle?

Answer 6

Non-maleficence (to cause no additional harm)

Question 7

Define Reasonable person standard

Answer 7

the “reasonable person” is a composite of a relevant community’s judgment as to how a typical member if said community should behave in situations that might pose a threat of harm (through action or interaction) to the public. The standard also holds that each person owes a duty to behave as a reasonable person would under the…?

Question 8

Define Veracity

Answer 8

Truth telling. Legal principle that states that a health professional should be honest and give full disclosure to the patient, abstain from misrepresentation or deceit, and report known lapses of the standards of care to the proper agencies (Think Verified!)

Question 9

Define Distributive justice

Answer 9

that virtue, whose object is to distribute rewards and punishments to every one according to his merits or demerits

Question 10

Define Utilitarianism

Answer 10

the theory based off of the idea that action should be directed toward doing the “greatest good for the greatest number of people”; “the end justifies the means”; the results of an action are determined by comparing the good brought about by a particular action compared to the good brought about by alternatives, or the amount of evil avoided.

Question 11

Discuss what John Stuart Mill wrote about utilitarianism.

Answer 11

sought to distinguish pleasures (the good) on qualitative grounds; freedom is requisite to producing happiness.

Question 12

Balancing Utilitarian and Kantian Ethics.

Answer 12

Utilitarianism is based on the idea that people’s ethical decisions should be based on whatever provides the greatest useful goodness for the greatest number of people. Utilitarianism ethical theory believed that the moral benefit of an action is determined by the outcome of the action no matter what the motive behind the action was. Kantian ethics state that people have an unconditional moral duty to do what is right, not because it will profit us, not because if we don’t do it and get caught we will be punished but because it is the right thing to do. Kant went on to say that the only true moral act is done from a pure sense of duty.

Question 13

Define Paternalism

Answer 13

the concept that one person knows what is best for another

Question 14

Discuss why autonomy and paternalism conflict with each other.

Answer 14

The two terms are conflicting because physicians act in what they believe to be the patient’s best interest, however autonomy does not eliminate paternalism, but paternalism should be limited to certain situations

Question 15

Utilitarian Logic

Answer 15

benefits of procedures balanced against the harm

Question 16

Kantian Ethics

Answer 16

all people have value and deserve benefits of health care

Question 17

What two principles are conflicting with the consent to treat?

Answer 17

Paternalism and autonomy

Question 18

What are the 4 elements of Respect for Persons?

Answer 18

Autonomy
Truth Telling
Confidentiality
Fidelity

Question 19

Define Autonomy

Answer 19

allows others to govern themselves (viewed as a freedom right)

Question 20

Define Truth Telling

Answer 20

honesty in all activities

Question 21

Define Confidentiality

Answer 21

protecting information that is confidential, both employee and patient

Question 22

Define Fidelity

Answer 22

promise keeping, doing one’s duty

Question 23

An advance directive is a good example of which ethical principle/ theory?

Answer 23

Autonomy

Question 24

Discuss why the concept Justice is important in resource allocation

Answer 24

Because the concept is expressed in health services delivery by expanding greater resources on individuals who are sicker and thus in need of more services

Question 25

Discuss Confidentiality

Answer 25

Act of respecting privileged information

Question 26

Ethical dilemmas and exceptions of confidentiality

Answer 26

an abused child, certain diseases, gunshot wounds

Question 27

When is “Consent” actually “Consent”?

Answer 27

consent is actually consent when a physician discloses the known and existing dangers associated with a course of treatment to a patient, and the patient has approved the treatment without coercion

Question 28

What elements must be present for consent to take place?

Answer 28

consent must be voluntary, competent, and informed

Question 29

If there is no consent and treatment takes place anyway, what are the liabilities of the physician and the hospital?

Answer 29

physicians and hospitals are liable if no consent is given; the exceptions are emergency rooms where it is presumed that patients want treatment, or when the state allows treatment for a minor of mentally incompetent person when those who speak for them refuse to give consent

Question 30

What is the proper role of using medical students, interns, and residents in treating patients in an academic medical center?

Answer 30

consent must first be given by the patient before they can participate

Question 31

What is a Fiduciary Duty?

Answer 31

• Ethical and legal concept.
• Relationship exists when trust and confidence on one side results in a superior position and influence on the other.
• The superiority in a fiduciary relationship raises duties of loyalty and influence.

Question 32

A relationship in which trusts and confidence on one side results in a superior position and influence on the other is which type of relationship?

Answer 32

Fiduciary

Question 33

How to balance Mission and Margin?

Answer 33

Health care must make money. Balancing the yin of quality with the yang of profit needed to survive. Mission needs to consider quality, community, and have a foundation in resources. Need to live beyond the doors of the facility.

Question 34

Discuss the role of HIPAA in accessibility to medical records.

Answer 34

The federal Health Insurance Portability and Accountability Act places substantial restrictions on how health information is obtained, managed, stored, transferred, and used. Health services organizations have a duty to ensure the confidential and appropriate use of patient information

Question 35

Discuss the personnel who should have access to medical records.

Answer 35

The only personnel who should have access to patient‘s medical records are those individual involved in treatment or care of the individual. (i.e. physician and nurses treating the patient.) The patient also has a right to view their medical records.

Question 36

Discuss whether or not healthcare organizations should admit their mistakes

Answer 36

Patients have a right to know if any harm or potential harm inflicted on them by healthcare organizations.

Question 37

When is Consent, Informed Consent?

Answer 37

Informed consent means that there must be full disclosure regarding condition, treatment, alternatives, consequences of treatment and non-treatment.

Question 38

Discuss the rights of the patient to refuse treatment.

Answer 38

Competent patients have the right to refuse treatment.

Question 39

Discuss the rights of a parent to refuse treatment for a minor child.

Answer 39

Parents have the right to refuse treatment for the minor child. In June 1986 the Supreme Court agreed that DHHS did not have the right to force hospitals to treat infants over parental objections.

Question 40

What is the role of the organization in determining that patients have consented in a way that meets ethical criteria?

Answer 40

The organization must ensure that consent is voluntary, the individual is competent, and they are informed.

Question 41

Discuss why advance directives are important.

Answer 41

AMD inform the providers of their wishes regarding treatment.

Question 42

Discuss why patient autonomy may be violated is there is no advance directive.

Answer 42

If the provider is not aware of what the patient’s wishes are they can very easily violate them.

Question 43

What are Living Wills?

Answer 43

allows individuals unable to communicate with caregivers to express their wishes about treatment. Without legislation or case law the living has no legal support.

Question 44

What is a DNR and what must be the healthcare organization’s response
to the presence of the DNR?

Answer 44

• The do-not-resuscitate order is a type of AMD that is used at the point of service delivery.
• DNR policy should identify the chemical and mechanical technologies included and the specific instances in which they will be applied
• patients with DNR may required surgery and anesthesia management for palliative care, pain relief/distress, or to improve patient quality of life
• Non-hospital DNRs recognized in 27 states in 1996
• Problems with DNRs- inadequate hydration and nutrition, staff confused about type of care DNR represented, different perception from Docs of orders equitable writing for differ patients with the same diagnosis other concerns–may encourage systematic rationing of HC to older adults, right to die may become duty to die (slippery slope)

Question 45

Discuss Euthanasia

Answer 45

Euthanasia “good death” is care that makes death less painful.

Question 46

Define Ordinary Care

Answer 46

all medicines, treatments, and operations which offer reasonable hope of benefit and which can be obtained and used without excessive expense, pain, or other inconvenience.

Question 47

Define Extraordinary Care.

Answer 47

all medicines, treatments, and operations which cannot be obtained or used without excessive expense, pain, or inconvenience, or which, if used, would not offer a reasonable hope of benefit

Question 48

Discuss the concept of Nonmaleficence in the presence of infectious disease

Answer 48

Nonmaleficence: “do no harm”except where some degree of harm is necessary to prevent a greater degree of harm. The organization has a duty to protect patients, staff, and the community in the presence of infectious disease.

Question 49

What is the healthcare organization’s duty to patients, staff, and the community in the presence of infectious disease?

Answer 49

The organization has a duty to protect patients, staff, and the community in the presence of infectious disease.

Question 50

Importance of staff competency

Answer 50

look up

Question 51

How to assure competency?

Answer 51

Education, Background checks, etc..

Question 52

Discuss the role of ethics committees

Answer 52

Ethics committees play two roles of general importance: to assist in developing or reconsidering the organizational philosophy[hy (to move the organization towards a more desired culture) and the derivative vision and mission statements. The experience and range of its interdisciplinary membership are likely to produce better reasoned and more thorough results. Education is the second role. It adds a level of sophistication to the organization and improves the quality of clinical and administrative decision making.

Question 53

Discuss the role of Institutional Review Boards

Answer 53

The IRB is responsible for providing guidance and oversight for the human participant protection program (experimenting, clinical lab, etc.) and for helping to maintain compliance with applicable laws, regulations, and policies.