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Ethics II > Health Law IV > Flashcards

Health Law IV Flashcards

1
Q

Who is allowed to forego a life sustaining procedure in Iowa?

A

A qualified individual

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2
Q

What is a “qualified individual” in terms of refusing care?

A
  • A person who has executed a declaration

- Has signed a DNR

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3
Q

What are the two qualifications of a DNR order that must be met?

A
  • Attending has declared “terminal condition”

- Confirmed and documented by a second physician

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4
Q

What qualifies as a “life sustaining procedure”? What are the two qualifications that must be met?

A

Any medical procedure, tx, or intervention meeting BOTH of the following:

  • Uses mechanical or artificial means to sustain, restore, or supplant a spontaneous function
  • When applied to a patient in a terminal condition, would serve only to prolong the dying process
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5
Q

Life sustaining procedures does not include nutrition or hydration, except under what three conditions?

A
  • from IV catheter
  • Intubation
  • When deemed necessary for comfort care or to alleviate pain
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6
Q

What is the legal definition of a terminal condition? (2)

A
  • An incurable or irreversible condition that, without the administration of a life-sustaining procedure, will, in the opinion of the attending, result in death within a relatively short period of time
  • State of permanent unconsciousness
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7
Q

What are the two qualifications that must be met to have a terminal condition based on a permanent state of unconsciousness?

A
  • To a reasonable degree of medical certainty (not 100%)

- There can be no recovery

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8
Q

What are the two criteria that must be met to be competent enough to make a declaration?

A
  • Declarant’s condition must be terminal

- Declarant is unable to make own decision

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9
Q

True or false: a competent adult may issue a declarant at any time

A

True–but declaration is only given effect if met conditions

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10
Q

What are the two things that a documented declaration of terminal decision must have?

A
  • Signed by a declarant

- Contain a date of execution

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11
Q

How many people must witness the declaration of terminal illness?

A

2 people

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12
Q

True or false: when signing a declarant, the two witnesses must both be present at the same time

A

True

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13
Q

Who cannot be a witness to a declarant?

A
  • at least 1 witness cannot be related

- Neither witness is health care provider, an employee of a health care provider, or under 18

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14
Q

True or false: a witness to a declarant can be a health care provider, or an employee of a health care provider

A

False

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15
Q

True or false: a witness of a declarant cannot be under 18 yo

A

True

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16
Q

True or false: the two witnesses to a declarant can be related to the patient

A

False–at least 1 witness cannot be related

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17
Q

What is the reasoning behind not allowing a doctor to be a witness of a declaration?

A

Dr may be influenced to have patient sign declarant

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18
Q

True or false: as a physician, you can never sign a declarant as a witness

A

False–as long as you’re not acting in medical provider capacity, you can

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19
Q

Does a living will made in another state have effect in Iowa?

A

Yes, but needs to meet state requirements

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20
Q

What should be done with a declaration?

A

Give to physician

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21
Q

If a person does not have a living will, specific steps must be taken before what can be done? (2)

A
  • Before a person can be removed from life support

- Before life support may be withheld

22
Q

What are the steps that must be taken before you can withhold or withdraw life support in a patient without a living will?

A
  1. Person must suffer terminal condition
  2. Attending must consult with, and obtain written consent
  3. Surrogate must be guided by the wishes of the patient
  4. Perform action with a witness
23
Q

What is the order of people who can give consent for an incapacitated patient? (6)

A
  • Designated attorney
  • Guardian
  • Spouse
  • Adult children
  • Parent
  • Adult sibling
24
Q

What happens when adult children disagree on treatment of a patient?

A

Majority rules

25
Q

Can a patient’s power of attorney defer to a family member

A

Yes

26
Q

What should be done if a patient’s power of attorney is in apparent disagreement with the patient’s wishes?

A

Do what is in the patient’s wishes

27
Q

What is the role of a decision maker at the end of life care?

A

Must be guided by patient’s wishes

28
Q

What must be done if you, as the attending, do not feel comfortable complying with a patient request?

A

Must take all steps to transfer care to another physician

29
Q

What steps should be taken if a patient’s living will seems out of date?

A

Follow it still

30
Q

What is the difference between a durable power of attorney, and a power of attorney?

A

Durable = can make medical decisions

31
Q

An attorney in fact cannot be whom? (2)

A
  • Attending physician

- Employee of attending physician

32
Q

Can a durable power of attorney make financial decision in place of the patient?

A

No–only medical

33
Q

What qualifies as “health care decision”?

A

-Involve care or tx to maintain pts health or mental condition

34
Q

Do “health care decision” include decisions about withdrawing nutrition or hydration via IV or intubation?

A

No

35
Q

Do “health care decision” include decisions about withdrawing oral food?

A

No

36
Q

How many witness must there be to sign a durable power of attorney? Who does not qualify, and what are the criteria that must be met regarding this?

A
  • 2 people (one unrelated)
  • In presence of each other and the patient
  • Cannot be less than 18, or the attending physician/employee
37
Q

True or false: if all the criteria are met, then the attorney in fact takes priority over all others

A

True

38
Q

Can an attorney in fact look at a patient’s medical record?

A

Yes, just as the patient could, but not STD related info unless pt specified

39
Q

True or false: a durable power of attorney can only be withdrawn if there is documentation of it

A

False–just verbal

40
Q

What is meant by the term liable?

A
  • Is responsible for

- Has exposure to

41
Q

What is negligence?

A

Not acting as a reasonably careful physician

42
Q

Who defines a “reasonable person”?

A

Jury

43
Q

What is a “tort”, in legal terms?

A

Wrongful act, for which a civil charge can be maintained

44
Q

What is the difference between a civil and criminal lawsuit?

A
  • Criminal = law was violated

- Civil = damage was done, but no law was violated

45
Q

What is the difference between the goal for a criminal case vs a civil case?

A

Criminal = Effect justice, and dispense punishment for crimes committed

Civil = Make restitution to wronged party

46
Q

Is the 5th amendment applicable in civil cases

A

No

47
Q

What is the burden of proof needed to win a civil case? Criminal?

A

Civil = Preponderance of evidence

Criminal = beyond a reasonable doubt

48
Q

Which has the right to a speedy trial: civil or criminal suits?

A

Criminal

49
Q

What is the statute of limitations on medical cases in Iowa?

A

within 2 years of realizing damage

50
Q

What are the three parties that determine settling vs suit?

A
  • dr
  • insurance
  • attorney
51
Q

How are lawyers paid with criminal vs civil cases?

A 
Civil = contingency
Criminal = hourly

Ethics II (16 decks)

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