Professional Development

Question 1

What is T0?

Answer 1

experimental and applied research: defining mechanisms and targets

Question 2

What is T1?

Answer 2

translation to humans: proof of concept clinical trials

Question 3

What is T2?

Answer 3

translation to patients: clinical trials

Question 4

What is T3?

Answer 4

translation to practice: long-term clinical training

Question 5

What is T4?

Answer 5

translation to community: effect of treatment on population

Question 6

What criteria should you use to determine your research question?

Answer 6

is it feasible, interesting, novel, ethical and relevant? (FINER)

Question 7

What do patients need to know to be considered informed consent?

Answer 7

DRAC:
Diagnosis and prognosis
Recommended treatment
Alternative treatment
Consequences of no treatment

Question 8

What are exceptions to informed consent?

Answer 8

WELT:
Waiver
Emergencies
Lack of decision making capability
Therapeutic privilege

Question 9

What did the Salgo case decide?

Answer 9

Physician has duty to inform a patient of “any facts which are necessary to form the basis of an intelligent consent by the patient to proposed treatment”

Question 10

How do you respond to competent, informed patients who refuse treatment?

Answer 10

SPIT:
shared decision making
protect patient's best interest
inform patient completely
try to persuade patients

Question 11

Describe the Coward case.

Answer 11

requested to stop treatment for severe burns throughout his body, physicians refused

Question 12

What did the Bouvia case decide?

Answer 12

a person could deny medical treatment as a competent patient (had cerebral palsy and wanted to starve to death, hospital refused)

Question 13

What did the Bartling case decide?

Answer 13

competent patient can deny medical treatment; he was hospitalized and needed a respirator but wanted to be removed and hospital didn’t let him

Question 14

What is consent?

Answer 14

patients with decision making capability have the ability to agree or refuse treatment

Question 15

What is assent?

Answer 15

patients who lack decision making capability cannot consent or refuse treatment but health care professional has a moral obligation to get their acceptance of any treatment

Question 16

What is the difference between advanced directives and living wills?

Answer 16

living wills are written advance directives that become active when a person is terminally ill

Question 17

What is an advanced directive?

Answer 17

what you want done in the case that you do not have decision making capacity

Question 18

What makes an advanced directive most accurate/valid?

Answer 18

SIR:
specific treatments
informed
repeated

Question 19

What are systematic problems with advanced directives?

Answer 19

really difficult to predict what you would want done in a specific situation before you’re going through it
often they are uninformed or too general

Question 20

What is the order for determining a surrogate decision maker?

Answer 20

court appointed guardian
surrogates selected by patients
family members
friend

Question 21

What makes a surrogate a reliable decision maker?

Answer 21

consistent with patient’s values

no conflicts of interest

Question 22

What actions should be taken if no relatives can act as surrogate s for the patient?

Answer 22

advanced directives
substituted judgement: what do you think is best based on patients values
best interest: what would a reasonable person do in this case

Question 23

What did the Quinlan case decide?

Answer 23

courts decided family members can act as guardians (22 yr old woman in persistent vegetative state, physicians refused family request to remove her from ventilator)

Question 24

What did the Cruzan case decide?

Answer 24

Provided the standard for individual states to determine evidence necessary for substituted judgment (33 yr old woman in PVS, family requested feeding tube be removed while physicians refused)

Question 25

What did the Shiavo case decide?

Answer 25

political factions tried to influence outcome of case (patient was on ventilate in vegetative state, husband wanted feeding tube removed while family challenged that)