PPD Flashcards
Give 3 considerations in the Ethics of resource allocation
1) Cost-benefit analyses, using QALYs
2) Opportunity cost
3) Public/media perception
Describe the libertarian (JSM), egalitarian and utilitarian (maximising) principles in resource allocation
Libertarian - weight
Egalitarian - equal opportunity, equal access
Utilitarian - maximum utility, greatest pleasure and least harm
Define sustainability. Give 3 types of sustainability issues in the NHS
Defn: meeting the needs of the present without compromising the needs of the future
1) Economic - ageing population
2) Environmental - antibiotic resistance, pollution
3) Clinical waste - over…intervention/prescription/investigation
Human Rights Act - issues related to:
a) Art. 2 (right to life)
b) Art. 3 (to refuse dehumanising treatments)
c) Art. 8 (respect for family life)
d) Art. 12 (found a family)
a) Abortion, euthanasia
b) Withdrawal, patient choice
c) Confidentiality
d) IVF
DOLS:
a) Only valid in what 2 settings
b) Assessment involves capacity and what else?
c) For patients of what age
d) For what treatment
a) Hosp. Care home
b) Best interests, consulting family
c) over 18
d) anything that will involve them being deprived of liberties and staying under close supervision in a care setting (for people without capacity)
Common law:
a) Vs statutory law
b) Confidentiality breaches allowed in what 3 instances?
a) Common - precedent; statutory - legislated
b) Patient consents, public interest, required by law
Give 5 ways in which HCPs or PHE may effect health behaviours/patient choice (scale)
Educate/inform, enable, advise, incentivise/ disincentivise, restrict choice
Expected utility = ?
Likelihood x Value
Define sick role in terms of:
a) Rights
b) Obligations
Rights:
The sick person is exempt from normal social roles
The sick person is not responsible for their condition
Obligations:
The sick person should try to get well
The sick person should seek technically competent help and cooperate with the medical professional
Give 4 cognitive biases/heuristics
Availability, representativeness, anchoring/adjustment, affect heuristic
Human error models:
a) Person approach = ?
b) Systems approach = ?
c) Active failures
d) Latent conditions
e) High reliability organisations
a) Treat errors as moral issues (just world hypothesis)
b) Errors are unavoidable. We cannot change human condition; we can change working conditions.
c) Unsafe acts
d) Resident pathogens predisposing to failure
e) Adopt systems approach and prepare for failures
GMC duties of a doctor:
a) Make the…?
b) Act how?
c) 3 pillars
a) Care of your patient your first concern
b) Honestly, openly, with integrity
c) Knowledge, skills, performance
Jim Reason’s Swiss Cheese Model
a) How it works
b) Example - Wayne Jowett and rule of 2s
a) Holes in defences align - allow failure
b) intrathecal vincristine - 2 doctors, 2 days, 2 places, 2 pharmacy deliveries - all failed
Bucket model of error
a) What are the 3 buckets?
b) 3 examples for each
c) Preparedness - 3 points
a) Self, context, task
b) poor knowledge/skills/experience/energy levels; distracted, stressful situation, poor organisation on ward; many steps, difficult task
c) Accept that errors are unavoidable, have contingency plans, care of patient > professional courtesy
Neglect - 3 types
Medical, personal, nutritional (Mid Staffs)
