Intro to Medical Ethics Flashcards
Define the term Ethics
- Has multiple definitions
- area of study that deals w/ what is morally right and wrong (i.e. good/bad behavior)
- requires clinician to go beyond legal duties to provide more than minimum standard of care
What are the 4 tenets that should factor into every interaction/action w/ a pt
- autonomy
- beneficence
- non-maleficence
- justice
Describe Respect for Autonomy and give example
- moral right of every individual to choose and follow his/her own plan of actions
- applies to pt’s and clinicians
- example: *pt has right to refuse tests, tx, etc
- clinician may be morally against contraception and has right to not prescribe it (does need to make it available by other avenues though)
Describe Justice and give example
- moral/social theories that attempt to distribute benefits and burdens of a social system in a fair/equitable way among all participants in the system (includes resources, risks, and costs)
- example: 2 pts have liver failure - 1 due to autoimmune dz, other due to chronic alcohol abuse…does either have more right to transplant first?…does 2nd pt deserve a transplant?
- example: 2 pts have back pain - 1 due to chronic dz, other due to newly dz metastatic CA…do you cancel 1st pt’s appt to see 2nd pt instead?
Describe Beneficence and give example
- doing of active goodness, kindness, or charity (includes all actions intended to benefit another)
- Respect for Autonomy may interfere w/ this
Describe Non-maleficence and give example
- obligation not to inflict harm intentionally
- often goes hand in hand w/ beneficence
What does minimally acceptable standard of conduct mean
-identifies acts that are so wrong that clinicians will be held legally liable for committing them
Describe Morality
- beliefs about what is right/wrong behaviors
- rest on values or beliefs that can’t be proven but simply accepted
What are the 6 Ethical Guidelines that should be applied to individual cases and approached w/ discretion and judgement
- showing respect for persons
- avoiding deception
- maintain confidentiality
- keeping promises
- acting in the best interest of the pt
- allocating resources justly
What 7 questions should a clinician ask themselves when addressing an ethical dilemmas
- In plain terms, what is the problem/dilemma
- What are the medical facts/issues
- What are the concerns/values/preferences of the clinician
- What are the concerns/values/preferences of the pt
- What are the ethical issues
- What ethical guidelines are at stake
- What practical considerations need to be addressed
Describe Professionalism
-conduct, aims, or qualities that characterize the goals and values of a profession
What are the 2 Major Realms of Professionalism in Medicine
- interaction w/ pts and families
- interaction w/ other health care members
Describe Civility
- respect for others
- one of foundation for professional behavior
What are the 4 Major Components of Civility
- tolerance
- respect
- proper conduct
- diplomacy
What are the 4 Core Values of Professionalism
- pt centered care
- integrity/accountability
- fair/ethical stewardship of resources
- pursuit of excellence
Describe Pt Centered Care when Interacting w/ Pts and Families
- includes pt in decision making (respect autonomy)
- provide accessibility to pts to ensure timely access and continuity of providers
- act to benefit pt when a conflict of interest exists
- build rapport
- show empathy
- communicate effectively
Describe Pt Centered Care when Interacting w/ Health Care Team Members
- work collaboratively w/ other members of care team to facilitate effective service to pt
- demonstrate respect for other team members in all interactions
Describe Integrity/Accountability when Interacting w/ Health Care Team Members
- report impaired/incompetent colleagues
- participate in evaluations of team
- specify standards/procedures for hand-offs across settings of care to ensure coordination/continuity of care
Describe Integrity/Accountability when Interacting w/ Pts and Families
- maintain pt confidentiality
- maintain appropriate relationships w/ pts
- promptly disclose medical errors and take steps to remedy mistake
- actively manage conflicts of interest/publicly disclose any relationships that may affect clinician recommendations related to dx and tx
Describe Pursuit of Excellence when Interacting w/ Pts and Families
- adhere to nationally recognized evidenced based guidelines; individualizing as needed but conforming w/ guidelines for majority of pts
- engage in life long learning/professional development
- apply system level continuous quality improvement to pt care
Describe Pursuit of Excellence when Interacting w/ Health Care Team Members
- participate in collaborative efforts to improve system level factors contributing to quality of care
- develop/participate in local educational conferences on quality improvement
Describe Fair/Ethical Stewardship of Health Care Resources when Interacting w/ Health Care Team Members
- establish mechanisms for feedback from peers on resource use/appropriateness of care
- work w/ clinical/nonclinical staff to continuously improve efficiency of care delivery process and ensure all members of care team are optimizing their contributions to care delivery/administration
- actively work w/ colleagues to coordinate care/avoid redundant testing and maximize prudent resource use across settings
Describe Fair/Ethical Stewardship of Health Care Resources when Interacting w/ Pt and Families
- do not harm
- do not provide unnecessary/unwarranted care
- commit to deliver emergent care equitably, respecting the different needs/preferences of sub-populations, but w/o regard to INS status or ability to pay
- deliver care in a culturally sensitive manner
What are the 7 challenges to Professionalism
- abuse of power
- arrogance
- greed
- misrepresentation
- impairment
- lack of conscientiousness
- conflict of interest
How can clinicians Prevent Professional Conflicts
- make expectations known
- communicate effectively
- model civil behavior
- maintain appropriate boundaries
How can clinicians respond to Professional Conflicts
- hold people responsible for their transgressions
- use an effective grievance process
