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Bioethics 1-6, 10, 11 > Lecture 6-autonomy > Flashcards

Lecture 6-autonomy Flashcards

1
Q

Informed consent requires disclosure

A

Disclosure involves providing the relevant treatment information to patients

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2
Q

Informed consent requires disclosure

-Acceptable exceptions?

A
  • Emergency
  • Waiver
  • Incompetency
  • Therapeutic privilege (Very limited)
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3
Q

Informed consent requires disclosure

-Exceptions-emergency example?

A

Mass casualty

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4
Q

Informed consent requires disclosure

-Exceptions-Waiver example?

A

Patient tells you what to do in advance

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5
Q

Informed consent requires disclosure

-Exceptions-Incompetency example?

A

Unconscious patient

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6
Q

Informed consent requires disclosure

-Exceptions-Therapeutic privilege?

A
  • Very limited

- If necessary for decision making, must present serious harm

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7
Q

Informed consent requires voluntariness

-What can constrain voluntariness?

A
  • Voluntariness involves the right a patient has to make treatment decisions free from undue influence
  • Internal and external factors constrain voluntariness
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8
Q

Informed consent requires voluntariness

-External factors include?

A
  • Force

- Coercion

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9
Q

Informed consent requires voluntariness

  • External factors include
    - Force?
A

-Physical restraint/sedation

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10
Q

Informed consent requires voluntariness

  • External factors include
    • Coercion?
A
  • Implicit/explicit threat
  • Manipulation
    • deliberate distortion of information to influence patient decision making-violates both the ‘informed’ and ‘consent’ aspects of informed consent
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11
Q

3 ways autonomy can get messed up?

A
  • Autonomy and actions
  • Autonomy and options
  • Autonomy and decision making
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12
Q

Autonomy and actions

  • Cases in which?
  • Example?
A
  • Cases in which we are influenced by physical force or coercion (institutionalization)
  • Example-patient is restrained legally or patients in nursing care facilities
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13
Q

Autonomy and options

  • Autonomy requires?
  • Example?
A
  • Autonomy requires that we have genuine options to decide between (access to care, awareness of alternatives)
  • Example-patient who does not have adequate healthcare to receive a particular treatment
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14
Q

Autonomy and decision making

  • Autonomy requires?
  • Example?
A
  • Autonomy requires that our relevant options be made known to us (disclosure)
  • Example-physician does not tell patient about all potential options intentionally
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15
Q

Truth telling and medicine

-Exposes the?

A

Exposes the pressure point between autonomy and paternalism

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16
Q

Reasonable restrictions on autonomy?

A
  • Harm principle
  • Principle of paternalism
  • Principle of legal moralism
  • Welfare principle
17
Q

Reasonable restrictions on autonomy

-Harm principle?

A

Prevention of harm to others

18
Q

Reasonable restrictions on autonomy

-Principle of paternalism?

A

Prevention of harm the individual themselves

19
Q

Reasonable restrictions on autonomy

-Principle of legal moralism?

A
  • The prevention of law breaking including for the punishment of law breaking
  • Acceptable to restrict someone’s autonomy when they are breaking a law and when they are in jail their autonomy is highly restricted
  • Assumption: the function of law is to enforce morality
20
Q

Reasonable restrictions on autonomy

-Welfare principle

A
  • Benefit to others
  • Small restriction of autonomy of one person provides maximum benefit for others
  • Example of this would be taxation-restrict income to provide services for everybody
  • Assumption-We’d have to give up a negligible amount of autonomy to provide extreme benefit for others
21
Q

Truth telling and medicine

-When might we want to protect the patient from the truth?

A

When a patient is extremely emotional

22
Q

When might a patient want us to protect them from the truth?

A

Patient says not to tell them the results of a test before they have had a chance to talk to their family

23
Q

Protective deception does not equal?

A
  • preference for ignorance
  • rather, protective deception involves considering whether the disclosure itself would cause suffering (either physical or emotional)
24
Q

Protective deception does not equal preference for ignorance

-In severe enough cases?

A

In severe enough cases, such suffering may require the exercise of “therapeutic privilege”

25
Q

Therapeutic privilege

A

An uncommon situation whereby a physician may be excused from revealing information to a patient when disclosing the information to the patient would pose a serious psychological threat, so serious a threat as to be medically contraindicated

26
Q

What circumstances evoke “therapeutic privilege”?

A

?

27
Q

Informed consent requires what 3 things?

A

Informed consent requires disclosure, voluntariness, and capacity

Bioethics 1-6, 10, 11 (8 decks)

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