Lecture 5 - Ethics of Cost Conscious Care

Question 1

What are the 4 core medical ethics that constitute the values system of health care providers

Answer 1

Autonomy
Beneficence
Nonmaleficence
Justice

Question 2

How can you translate each of the 4 core medical ethics that constitute the values system of health care providers into decision making?

Answer 2

Autonomy - patient has right to refuse treatment (informed medical consent, patient in correct state/capacity)

Beneficence - doctor act in best interst of the patient (this requires being up to date on most important treatments etc)

Nonmaleficence - to do no harm (don’t leave tools and shit inside people)

Justice - fair distribution of resources (stewardship goes here)

Question 3

Stewardship

Answer 3

Stewards are persons who are charged with the task of taking good care of that with which they have been entrusted.

The gatekeepers

Question 4

Explain antibiotic stewards ship

Answer 4

• Systematic measurement and coordinated interventions designed to promote the optimal use of antibiotics

Question 5

Give two examples of antibiotic stewardship

Answer 5

Prospective Audit and Feedback (PAF) - review antibiotics and provide recommendations

Preauthorization - approval needed before antibiotics are administered

Question 6

Win-win example for health care

Answer 6

• vaccines
• prenatal screening
• generic medicine

Question 7

Lose-lose example for health care

Answer 7

• IV contrast in elderly patient with renal failure

Question 8

Good for patient =

Answer 8

Beneficence

Question 9

Good for society =

Answer 9

Justice

Question 10

Two types of rationing

Answer 10

1. Individual Rationing/Bedside Rationing (unaffordable treatments may not be offered, HMO budgets, PCP referral required)
2. System Rationing (insurance coverage)

Question 11

Antibiogram

Answer 11

Shows different types bacteria are susceptible to antibiotics