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SoBehav Year 2 > Medical Ethics- Elliott > Flashcards

Medical Ethics- Elliott Flashcards

1
Q

What are the medical profession’s values?

A
  1. DO NO HARM
  2. Respect the patient
  3. Benefit the patient
  4. Use scarce resources wisely
  5. Be honest

may conflict with patient autonomy and values

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2
Q

Shared decision making

A

Negotiated & Balanced!

Describes the decision-making process and ideal outcome of informed patient choice.

  • physician provides unbiased and compete information + opinion of best way to proceed
  • two way exchange of information/opinions concerning risks, benefits, values.

**patient centered care

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3
Q

Non-malificance

A

First, do no harm

The duty to do no harm to patients

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4
Q

Autonomy

A

the “right” of adult patients of sound mind to participate in decisions regarding their medical care

-the duty to protect and foster a patient’s free, un-coerced choices

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5
Q

Beneficiance

A

The duty to promote good and act in the best interest of the patient and the health of society

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6
Q

Locus of power in decision

A
  • docs have power (even students)

- docs have information

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7
Q

Justice

A

The equitable distribution of the life-enhancing opportunities afforded by health care

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8
Q

Doc-Patient Relationship

A

Special obligations for the physician to serve the patient’s interest because of

  • specialized knowledge that physicians possess
  • the confidential nature of the relationship
  • the imbalance of power between the patient and provider.
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9
Q

Situations that you can decline to treat……

A
  • scope of practice
  • clinical skills
  • exposure to infection (legal but not ethical)
  • Torure/Execution
  • NEED TO Refer (can’t go untreated)
  • Reproductive health
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10
Q

Conscience clauses

A

Legally permits professionals to not provide certain medical services, based on MD’s personal beliefs

Examples: Birth control, abortion, stem cell tx.

(legally don’t need to refer, but ethically you should)

DO NOT ABANDON YOUR PATIENTS (duh)

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11
Q

Paternalism

A

A term describing professional behavior in which a health care professional makes decisions for a patient without allowing the patient to participate fully in medical decision-making

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12
Q

Proxy or surrogate

A

When a person is non-decisional, another person must make health care decisions for them.

The surrogate makes decisions using either substituted judgements of best interest standards

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13
Q

Guardian or Conservator

A

When a person is deemed incompetent to make decisions for them self, the court may assign another person to be her gardian

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14
Q

Substituted judgement

A

-makes decision based on what that person “would have done”

  • based on patient preferences
  • Written documents
  • Discussion
  • Life story, life-style
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15
Q

Best Interests

A
  • used when patient wishes are unknown or never known
  • based on what is best for patient
  • Sources of guidance = pain and suffering, functionality, prognosis
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16
Q

EMTALA

A

= Emergency Medical Treatment and Active Labor Act

requires hospitals to examine and stabilize a patient who presents to an emergency room for attention to an emergency medical condition- without consideration of insurance coverage or ability to pay

17
Q

Do we need informed consent to treat a child in the ER?

A

Not for emergency situations

18
Q

Three states you can get in trouble for not helping as a doc?

A

MINNESOTA
Vermont
Lousianna

19
Q

What states is PAS legal?

A 
Oregon
Washington
Montana
Vermont
New Mexico
California
20
Q

What is death with dignity?

A

Self-administered medication

Requested more often than used

Autonomy, beneficence

**need to be hospice eligible, clear of mind

21
Q

Why is PAS NOT euthanasia?

A

Because it is self-administered!

22
Q

Why is PAS NOT suicide?

A

Death is eminent

23
Q

Intent

A

The intent for the treatment

determines the ethical outcome when the double effect is in place

24
Q

Double Effect

A

Combination of medical interventions creating positive outcomes while also having the potential to do harm

*ethical interpretation of the outcome is based on the intent of the action

Morphine example: pain relief vs. decreased respiration

25
Q

Prescribing morphine to relieve pain even though it decreases respiration is an example of what?

A

the double effect

26
Q

Futility

A

non-beneficial care

-professionals not obliged to proved care they judge to be non-beneficial

Limits patient autonomy
Patients cannot demand care

27
Q

Disproportionate or extra-ordinary care

A
  • is the intervention proportionate to the benefit?

- large risk/procedure/ cost for small benefit?

28
Q

When can you forego medical interventions?

A

When an intervention is likely to offer little benefit to the patient

29
Q

Where do we go to when family doesn’t agree?

A
  • Courts/Committees (ethics)
  • Courts
  • Landmark Cases
30
Q

Who can ask for an ethics review?

A

ANYONE!

31
Q

Conflicting Interests

A

Two concerns focus the professional’s attention at the same time

Attending to one compromises the other

Both cannot be fulfilled

32
Q

Competing Interests

A

Tension that occurs when two concerns demand the professional attention at the same time

Both concerns can be addressed with-out compromising the other

Both have claim and must happen

33
Q

Professional Guidance on conflicting/competing interests?

A

AVOID conflicts, and when cannot….

DISCLOSE them!

34
Q

Privacy

A

Right guaranteed by constitution allows protection from intrusion by government

Family decision, family planning, abortion

termination of life-sustaining treatment

35
Q

Confidentiality

A

Government involved

The right of the patients to privacy and control over their own medical records and information

Docs must respect patient confidentiality and to prevent public or inappropriate release of patient information

36
Q

Tarasoff

A

Case law

“duty to protect” or “duty to warn”

obligation of professional who hears credible threat of harm to specific individual to warn the intended victim and assure the police can protect them

SoBehav Year 2 (11 decks)

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