Medical Ethics Flashcards
What are a set of moral standards and code for behavior?
medical ethics
What is what people perceive to be right or good?
morality
What guides individual interactions with others and society?
code for behavior
What are the principles of biomedical ethics?
- autonomy
- beneficence
- nonmaleficence
- justice
What is used to inform, guide, and shade behaviors/decisions?
principles of biomedical ethics
Describe autonomy?
- patients make their own decisions
- must be voluntary and informed
- must be competent
- treat with dignity and respect
What are the responsibilities associated with autonomy?
- patient confidentiality
- honest communication
- informed consent/refusal of treatment
What includes providing adequate information that is comprehendible to a competent patient or patient surrogate such as mutual participation, respect, and shared decision making?
informed consent
What is the ultimate goal of informed consent?
patient understanding, not just agreement with the recommended treatment and not just a signature
What should be conversational, not authoritative?
informed consent
What are the components of informed consent?
- diagnosis/recommendation for treatment
- nature of recommended procedure/treatment
- risks and benefits
- alternatives to recommended procedure
- identity, credentials and experience of those performing the procedure
- cost of procedure
What must be signed, dated, and time-stamped?
informed consent
What are the requirements of informed consent?
- understand relevant information
- appreciate medical condition and consequences
- communicate a choice
- discuss own values in relation to provider’s recommendation
- provider’s judgment
What is the ability to understand the nature and consequences of the procedure or treatment that the patient is being asked to undergo?
competency
What is the practice of overriding or ignoring preferences of patients in order to benefit them or enhance their welfare?
paternalism
What “trumps” autonomy due to it being the best interest of the patient?
Beneficence
What is the promotion of the well-being of others and is the guiding purpose in healthcare (here to help others get better)?
beneficence
What are the moral rules of beneficence?
- protect and defend the rights of others
- prevent harm from occurring to others
- remove conditions that will cause harm to others
- help persons with disabilities
What is non deliberately causing harm to others, “do no harm”?
nonmaleficence
What are the moral rules associated with nonmaleficence?
- do not kill
- do not cause pain or suffering
- do not incapacitate
- do not cause offense
- do not deprive others of the goods of life
What is taking sufficient and appropriate care to avoid causing harm to a patient given what the circumstances would demand of a reasonable and prudent health professional?
due care
What is the absence of due care, intentionally causing harm, or unintentionally, but carelessly imposing risk of harm?
negligence
What is the rule of double effect?
distinction between intended effects and merely foreseen effects
-single act: 1 good effect and 1 bad effect
What are the conditions that must be met for the rule of double effect?
- nature of the act must be good
- the agent’s intention must be only the good effect
- the distinction between means and effects (bad effect must not be a means to the good effect)
- proportionality between the good and bad effect (good must outweigh the bad)
What is associated with the fair and equitable distribution of benefits and burdens and treating others equally?
justice
What are the four components to ethical decision making?
- agent
- choices
- consequences
- context
In ethical decision making, who is the one that will be making the decision and is based on our character (personal characteristics, beliefs, values)?
agent
In ethical decision making, what is associated with the morals that will help direct the decision, right vs wrong, and telling the truth vs deliberately hurting people?
choices
In ethical decision making, what is the result/outcome of the decision, good or bad?
consequences
In ethical decision making, what is the setting that influences the decisions made?
context
What are the 3 broad types of ethical theories?
- consequential theories
- non-consequentialist theories
- agent-centered theories
What theory is concerned with ethical consequences of a particular action?
consequential theory
What theory focuses on the person making ethical decisions about particular actions?
non-consequentialist theories
What theory is concerned with overall ethical status of agents (individuals) and less concerned with morality of particular actions?
agent-centered theories
The virtue theory is associated with?
agent-centered theories
What focuses on the moral character of the agent and teach/develop certain skills and will make good decisions?
virtue theory
What is a stable character trait developed by practice over time?
virtues
What helps one to act well?
virtue
What is immoral behavior?
vice
What are the different virtues in the virtue theory?
- integrity
- respect
- courage
- humility
- empathy
- justice
What allows a person to be true to self when values are challenged?
integrity
What is the tendency to regard another as having some worth and consequently, the desire to treat them with civility?
respect
What are the 2 levels of respect?
- respect because they are fellow human beings (inherent and fundamental)
- respect due to status or position in a hierarchy (over and beyond the general respect we owe others)
What describes making difficult choices despite negative consequences and includes standing up for yourself and/or for the good of your patients?
courage
What describes recognizing one’s limitations and that there is always something to learn whether is it from patients or other healthcare team members?
humility
What describes understanding another person’s point of view, is driven by compassion, and occurs when we listen and communicate effectively to patients and healthcare team members and develops a trusting relationship with patients?
empathy
What describes the quality of being just, impartial, fair, and practicing non-discriminately?
justice
What are the four topics of ethical decision making?
- medical indications
- patient preferences
- quality of life
- contextual features
What is associated with the diagnostic and therapeutic intervention being used to evaluate and treat the medical problem and includes beneficence and nonmaleficence?
medical indications
What is associated with expressed choices of the patient about their treatment and you gave to provide respect for autonomy?
patient preferences
What is included in the ethical decision making topic quality of life?
- beneficence, nonmaleficence and respect for autonomy
- features of the patient’s life prior to and following treatment
What is included in the ethical decision making topic “context”?
- principles of justice and fairness
- conflict of interest
- identifies familial, social, institutional, financial, and legal settings where the case takes place
What are everyday ethical issues?
- trust
- patient-provider relationship
- patient confidentiality
- sexual relationships
- difficult patients
What is the foundation of the PA-patient relationship?
trust
What involves applying one’s knowledge to assist the patient in healing?
trust
What includes assured reliance on the character, ability, strength or truth of someone or something, includes empathy and respect, and listening to what patients are telling you?
trust
What are ways you can gain patient’s trust?
- addressing pts by name/title
- eye contact
- pleasant tone of voice
- smile
- humor
- listen attentively
- avoid showing frustration
- respect
- keep agreements with the patient
- provide competent health care
How can you apply trust in medicine?
- obtain detailed medical history
- pt more comfortable/cooperative with physical exam
- compliance = better outcomes
If patients are confident their privacy is protected, they are more likely to what?
discuss their problems
What is strictly prohibited with patients?
sexual relationships
Usually, the problem with “difficult patients” is what?
the patient-provider relationship
“difficult patients” are exacerbated by what?
- chronic medical issues
- social factors
What is key with developing a trusting relationship?
truth
