Medical Decison Making Flashcards
Competence
One has the abilities, skills and knowledge necessary to make a particular decison
Substituted judgement
Decision made by surrogate for a non competent patient based on what patient would want if he could decide himself
Proxy directive
Legal document in which competent chooses a person to make medical decisions when they are no longer competent
Instructional Advance Directives
Written statements made while patient is competent stating what medical treatments would be acceptable
Autonomous Principle
Autonomous persons should be able to exercise their right to self- determination
J.S Mill
You should have the right to do what you want as long as.
1) You can understand and reflect on your own actions
2) No hidden dangers
3) Not knowingly dangerous
4 aspects of autonomy
Free action
Effective deliberation
Authenticity
Moral reflection
Effective Deliberation
Person ruling themselves shows good judgement
3 things causing ineffective deliberation
Misinformation
Missing information
Mental issues
Authenticity
Freedom to be who you truly are
Moral reflection
Able to consider all your options
Sherwins Relational Approach
Ripple effect– Individual, family, community, society
Prima Facie Right
Moral right that must be honored unless it comes into conflict with the moral right of another
Ethical Relativism
No universal moral obligations binding on all people– everyone is morally right and nobody is wrong
Hardwig
A1: Choice as determined by oneself as best
A2: Responsible
Macklin
Freedom of religion does not include ways resulting in harm or detah of another
Brody
Transparency: Adequate info has been disclosed when doctors basic thinking is transparent to the patient
5 criteria for informed consent
Disclosure Comprehension Voluntariness Competence Consent
3 standards of competence
Minimal
Outcome based
Process of decision making
4 CCB matters of adjudication
Capacity
Consent
Civil commital
Substitute decision making
Parens Patriae
Court authority on treatment if child is deemed in need of protection
CCB
Capacity and Consent Board
4 things to include in informed consent
Nature of procedure
Risks
Alternatives
Expected benefits
Informed Consent Sense 1
Autonomous Authorization– understanding and lack of coercion
