Medical ethics, breaking bad news, grief, statistical principles Flashcards

1
Q

List the nine major considerations in medical ethics

A
  1. Beneficence
  2. Autonomy
  3. Altruism
  4. Non-maleficence
  5. Justice
  6. Futility
  7. Paternalism
  8. Consent issues
  9. Resource allocation/cost
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2
Q

Define beneficence. What character trait is associated with this?

A

The aim of doing the most good to benefit others. Teh associated character trait is benevolence.

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3
Q

Define autonomy

A

Self governance - having one’s own choices, free will

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4
Q

Define altruism

A

Selfless concern for the welfare of others

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5
Q

Define non-malificence

A

Do no harm

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6
Q

How does justice apply to healthcare?

A

This involves equality of “worth” - equal rights to healthcare.

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7
Q

What is paternalism?

A

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)

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8
Q

What ethical conflict arises from paternalism?

A

A conflict between beneficence and autonomy.

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9
Q

What three major ethical issues need to be considered with regard to consent?

A
  1. Patient understanding
  2. The patient’s right to refuse
  3. Training, innovative surgery, the learning curve of a surgeon.
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10
Q

What does the SPIKES protocol stand for?

A
  1. Setting up/preparation
  2. Perception: Assessing the patient’s knowledge and understanding.
  3. Invitation: find out how much the patient want’s to know
  4. Knowledge: disclosing the news and its implications
  5. Emotions: observe, identify emotions, identify the reasons for those emotions, show empathy
  6. Strategy and summary: discuss options, make plans, offer additional resources
  7. Make a plan for follow up.
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11
Q

What are the five stages of grief:

A
  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Resigned acceptance
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12
Q

Define sensitivity in the context of statistical reporting of results.

A

The proportion of people with the disease who test positive

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13
Q

Define specificity in the context of statistical reporting of results.

A

The proportion of people without the disease who test negative.

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14
Q

Define “positive predictive value”. When does the positive predictive value increase?

A

The chance that people have the disease if they test positive. It increases when the prevalence within a population is high.

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15
Q

Define “negative predictive value”. When does the negative predictive value increase?

A

The chance that people don’t have the disease if they test negative. This increases when the prevalence in a population is low.

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16
Q

List the five levels of scientific study quality/evidence.

A
  1. systematic reviews, RTCs
  2. Cohort studies
  3. Case-controlled studies
  4. Case series
  5. Expert opinion
17
Q

What does BAANJo stand for, in the context of medical ethics?

A
Benificence
Autonomy
Altruism 
Non-maleficence
Justice