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Law and Bioethics > Midterm > Flashcards

Midterm Flashcards

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1
Q

What are the three distinctions in types of law?

A

Criminal
Civil
Regulatory/Administrative

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2
Q

What are the three levels of the federal court system?

A

Supreme Court
Court of Appeals
District Court

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3
Q

Describe Roe v Wade and why it is so important

A

Roe: Woman seeking abortion (Illegal in Texas)
Hallford: Physician
Does: Married couple suing in case woman got pregnant
Wade: Dallas County Attorney

Determined that Texas laws prohibiting procurement of abortion were unconstitutional. Cited 14th Amendment and the woman’s right to privacy, which is broad enough to include this decision.

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4
Q

What is the most known phrase in the Hippocratic Oath?

A

Above all, do no harm

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5
Q

What are popular approaches to Medical Ethics?

A 
Deontology
Teleology/Consequentialism
Virtue Ethics
Justice
Common Good
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6
Q

What is Deontology Ethics?

A

Deontology states that everyone has rights and liberties. For example, the right to life, liberty, and the pursuit of happiness. With our right to life, we also have the right to receive information before we make decisions.

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7
Q

What is Teleology/Consequentialism Ethics?

A

Utilitarianism - The ends justify the means

The most ethical choice is the one that has the best outcome for all, even if the path to get there is undesirable.

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8
Q

What is Virtue Ethics?

A

Looking at the “body of work” of an individual and making a decision based on what kind of person they are and how that decision will impact me and my community.

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9
Q

What is Justice Ethics?

A

A decision must be impartial to a person or group. For example, when deciding who lives and dies you pull straws.

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10
Q

What is The Common Good Ethics?

A

Making a decision for what is best for everyone. Socialism and Communism are both political ideations of the common good. Other examples include quarantine of sick people during outbreaks.

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11
Q

What is the principle of double effect?

A

Commonly accepted and taught among catholic facilities:

The intended good effect outweighs the foreseeable unintended consequences.

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12
Q

When does the physician-patient relationship begin?

A

When the physician accepts, agrees to accept, or undertakes to render care to the patient. Of course, in real life the points at which those events have actually taken place are often not clear-cut at all.

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13
Q

What are two major pieces of legislation that have improved hospital access for patients?

A

EMTALA

Hill-Burton Act

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14
Q

What are basic requirements of EMTALA?

A

For patients coming to ED
Patient must receive appropriate med screening
Patient must have emergency medical condition
Hospital must stabilize
Hospital cannot transfer unstable patient unless they cannot provide proper care

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15
Q

What is required for patients with limited english proficiency?

A

Must provide “reasonable” accommodation
Not limited to language (i.e. deaf, ADA)
Required to participate in CMS

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16
Q

Can a physician terminate their relationship with a patient? How? What must happen?

A

Yes
Must provide written documentation
Must allow time for patient to find new provider
Must make copy of patients record available to them.

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17
Q

What are the two models for informed consent?

A

Paternalism: MD knows best
Autonomy: I can make the decision
TJC recommends a combination of the two

18
Q

What information do you have to provide for informed consent?

A 
The planned procedure
Who will perform it
Risks
Benefits
Alternatives
19
Q

Capacity to consent

A

Consent can get tricky when dealing with patients in extreme pain, mental health issues, drug abuse, etc.

20
Q

Surrogacy in VA

A

Prohibited to broker surrogacy, but cut out to advise both sides in process.
Surrogate has decision making power for herself and child during pregnancy (i.e. can abort)
Surrogate cannot receive compensation
If no contract, gestational mother will remain the mother without court changes.

21
Q

What are eugenics?

A

Effort by society to improve the human race.

22
Q

What is CRISPR?

A

Attempt at eugenics by the modification of genes. Often used to prevent disease and other undesired traits.

23
Q

How do you define mental illness?

A

Different people have different definitions. There is no agreed upon definition.

24
Q

What are the models for defining mental illness?

A

Biological
Psychodynamic
Cognitive-Behavioral

25
Q

What is the Biologic Model of mental illness?

A

All nature, no nurture

Our genes and physical structures determine everything that we are.

26
Q

What is the Psychodynamic Model of mental illness?

A

All mental problems are the products of issues that have not been resolved (most of which we are unaware).
Freud is a big proponent of this model

27
Q

What is the Cognitive-Behavioral Model of mental illness?

A

Combination of nature and nurture. Our physical body, genes, environment, and experience all play a role in our mental health.

28
Q

Which mental health model is favored by the law?

A

Biologic: It is the most concrete of the models.

29
Q

What are the two scopes for substituted judgement, and how would you describe them?

A

Best interest: What would be the best for the patient? For example, should a Jehovah’s Witness receive a transfusion when they are incapable of consent?
Substituted judgement: What decision would the patient make if they were capable of making the decision?

30
Q

When should a patient be permitted to refuse mental health treatment?

A

Autonomy ought to let a patient be as crazy as he likes.

31
Q

What is an advance directive?

A

A written statement of a patient’s wishes for receiving medical treatment should they be unable to communicate at the time of care.

32
Q

What are the three forms of involuntary assessment and treatment?

A

Detention by Police
Emergency Custody Order (ECO)
Temporary Detention Order (TDO)

33
Q

What is Virginia’s requirements for involuntary commitment such as ECO or TDO?

A

Person has mental illness and there is a substantial likelihood that they will:
Harm themselves or others in near future
Suffer serious harm due to lack of capacity to make appropriate decisions

34
Q

Detention by Police

A

Probable cause
Immediate evaluation
No longer than 8 hours

35
Q

ECO

A

Magistrate believes probable cause
Executed by police
Must be executed within 4 hours of issuance
No more than 8 hrs. (4 hr extension possible)

36
Q

TDO

A 
Magistrate issuance
Hearing
Can appeal
Procedure same as ECO
No more than 72 hrs
37
Q

What is public health?

A

The health and safety of a populations rather than individual patients.

38
Q

What are the two types of death?

A

Somatic Death

Brain Death

39
Q

Define somatic death

A

Absence of cardiac and respiratory functions.

Attempts of resuscitation would not be effective

40
Q

Define brain death

A

Irreversible cessation of entire brain functions including brain stem.

41
Q

Who can pronounce brain death?

A

Physician + neurologist, neurosurgeon, or critical care specialist.

42
Q

What are the three types of euthanasia? Describe each.

A

Passive: Withhold treatment and give pain meds
Non-agressive: Withdraw life support
Active: Use lethal substance

Law and Bioethics (1 decks)

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