Medical ethics, breaking bad news, grief, statistical principles Flashcards
List the nine major considerations in medical ethics
- Beneficence
- Autonomy
- Altruism
- Non-maleficence
- Justice
- Futility
- Paternalism
- Consent issues
- Resource allocation/cost
Define beneficence. What character trait is associated with this?
The aim of doing the most good to benefit others. Teh associated character trait is benevolence.
Define autonomy
Self governance - having one’s own choices, free will
Define altruism
Selfless concern for the welfare of others
Define non-malificence
Do no harm
How does justice apply to healthcare?
This involves equality of “worth” - equal rights to healthcare.
What is paternalism?
Intentional over-riding of a person’s decision making, based on your own judgements and values, with a goal to avoid harm for the person whose will is over-ridden (ie for their own good)
What ethical conflict arises from paternalism?
A conflict between beneficence and autonomy.
What three major ethical issues need to be considered with regard to consent?
- Patient understanding
- The patient’s right to refuse
- Training, innovative surgery, the learning curve of a surgeon.
What does the SPIKES protocol stand for?
- Setting up/preparation
- Perception: Assessing the patient’s knowledge and understanding.
- Invitation: find out how much the patient want’s to know
- Knowledge: disclosing the news and its implications
- Emotions: observe, identify emotions, identify the reasons for those emotions, show empathy
- Strategy and summary: discuss options, make plans, offer additional resources
- Make a plan for follow up.
What are the five stages of grief:
- Denial
- Anger
- Bargaining
- Depression
- Resigned acceptance
Define sensitivity in the context of statistical reporting of results.
The proportion of people with the disease who test positive
Define specificity in the context of statistical reporting of results.
The proportion of people without the disease who test negative.
Define “positive predictive value”. When does the positive predictive value increase?
The chance that people have the disease if they test positive. It increases when the prevalence within a population is high.
Define “negative predictive value”. When does the negative predictive value increase?
The chance that people don’t have the disease if they test negative. This increases when the prevalence in a population is low.