Lecture 3 Flashcards
What are the secondary goals of informed consent?
limit liability, clarify standards of practice, clarify patient’s responsibility (making a decision consciously)
What is the primary goal of informed consent?
Effective communication that honors patient autonomy
What 4 items does the law established in healthcare for obtaining informed consent address?
- patient’s right to make decisions
- Full disclosure of information (risks and benefits)
- that the patient full understands the situation (is competent)
- Voluntariness (there is no pressure)
What types of things constitute “enough information” for most diagnostic procedures, treatments and prognoses?
- length of treatment
- time of recovery
- possible side effects
- restrictions on ADLs (activities of daily living)
- other (procedural/treatment) options (their risks and benefits)
- anticipated results
- consequences of denying or delaying treatment
When type of exam particularly requires consent?
sensitive exams (eg. genital exams)
What does PARQ mean?
P - procedure
A - alternatives
R - risks
Q - questions from the patient
What is required if a patient refuses a treatment plan?
An informed refusal form - a signed document that goes into the patient’s chart
What is the most well known confidentiality agreement in health care? Why was it created?
HIPAA of 1996 - Health Information Portability and Accountability Act
Originally created to safeguard patient health information in faxes and electronic charting (specifically for “individually identifying health information”)
What is the main idea of confidentiality?
Keeping a patient’s private (and identifying) information private
- Keep confidence, build trust, maintain patient’s dignity.
- -> honor the patient’s expectation that private information shared with the Dr will be kept confidential (professional promise –> duty and fidelity)
Describe “need to know basis”
may only share info to other professionals who will further the welfare of the patient
What is “sensitive information”?
information that may be harmful to the patient if shared with others
(ex. embarrassing)
What are legal exceptions for privacy of information?
Emergency - when keeping/withholding information will harm the patient
Incapacitated patients - healthcare surrogate must be informed
Third party is at serious risk (STI)
Requesting commitment of psychiatrically ill patient
Public at risk (terrorist threat - homeland security)
Describe the lesser know confidentiality act? What is it and what does it do?
HITECH Act (Health Information Technology for Economic and Clinical Health Act) of 2009 Widens the scope and enforcement of privacy protections for health electronic records (HER)
Safety and Efficacy (effectiveness) are an extension of what medical ethical principles?
beneficence and non-malevolence
What are some issues related to safety/risks?
toxicities of medicines, poor quality of medicine (tainted, additives, non-absorbable), compatabilities/incompatibilities with other medicines (drug/drug, drug/herb); accuracy of diagnosis (skill of doctor); correct prescription? (iatrogenic causes of death), appropriateness of prescription/dose for age (children/elderly), psychological/spiritual effects, homeopathy: aggravations, marketing or advice leading to inappropriate treatment
–> how high is the risk for the possible benefit?
