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Endo, Cardio and Neuro > PVB bits > Flashcards

PVB bits Flashcards

1
Q

approaches to child decisions

A

child paternalistic approach

child liberationist approach

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2
Q

what are the types of best interests for children

A

basic interests - physical/emotional wellbeing
developmental interests - promote child development/emotional maturity/education/confidence/socialisation
autonomy interests - respecting and promoting autonomy

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3
Q

when do basic and developmental interests take precedence in children

A

if the autonomous decision will result in death or serious harm

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4
Q

should 18 be a cut off for legal protection from bad decisions?

A
  • development continues after 18
  • values and beliefs change as an adult
    + if we value autonomy, yes
    + practically there must be a legal cut off
    + there if more than just law to protect from bad decisions
    + autonomy should be respected especially as children start to be able to be exposed to risk factors for ill health at their own choice - drinking alcohol, smoking, extreme sports without adult supervision
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5
Q

how should decisions be made for children without autonomy (babies, infants etc)

A

best interests - basic and developmental

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6
Q

approaches to parental autonomy

A

parental rights

best interests

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7
Q

pros and cons of parental rights argument

A

+ parents share values/beliefs with children

  • dont have a right to impose beliefs on others
  • parents have duty to ensure child reaches autonomous adulthood
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8
Q

parental autonomy best interests argument

A

+ parents know child more than anyone else, family welfare is relevant to child

  • parents may be too emotionally involved, lack of objective weighing up
  • personal values/beliefs may mean they consider effective treatment as unacceptable
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9
Q

risks and benefits of tissue donation as a child

A

risks - physical harm to child donor, transplant fails for recipient and causes grief and guilt
benefits - altruisim, saving a life, if sibling dies without transplant, guilt and grief

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10
Q

professional guidance for children participation in research

A

minimal risk of harm
not possible to do in adults
condition specific to children
parental consent

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11
Q

age of consent for children

A

16+

court approval for major decisions with parental disagreement over 16

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12
Q

what are the requirements for Gillick competency

A

ask child if you can tell parents - if they say no, respect it
assess child maturity - understanding etc
likely to suffer harm without treatment given

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13
Q

what is utalitarianism

A

consequence based approach - whatever decision brings greatest happiness is right (benefit is measured by overall happiness from consequences)

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14
Q

pros and cons of utalitarianism decisions

A

+ democratixc, each persons happiness has value
+ intuitively 10 lives better than 1

  • certain actions always wrong
  • not all consequences can be forgiven
  • may justify heinous acts for greater good
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15
Q

rights based approach to decisions

A

moral obligation placed on people to uphold rights of others

negative rights - may not harm us, may not steal from us may not kill us etc
positive rights - autonomy, education, healthcare (things that must be provided)

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16
Q

pros and cons of rights based approach decisions

A

+ protects all individuals, incl marginalised and lacking power
- no power shifting possible

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17
Q

what is the concept of justice

A

reciprocal relationship between individuals + society - all humans valued equally

if human life valued equally - justice means ensuring equal capability to flourish - access to healthcare

requires that societal structures value people equally

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18
Q

is justice equity?

A

no, instead removing barriers and engaging with priorities instead of helping those with barriers overcome them

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19
Q

how does listening and enagaging with those affected by conditions help (co-production)

A

informs understanding of health inequalities
identifies meaningful needs
informs sustainable and effective interventions

20
Q

what is the concept of equity

A

recognising that people have different needs to achieve the same outcomes

21
Q

what is the mental capacity act

A

decisions made on behalf of a person lacking mental capacity must be in individuals best interests

22
Q

what is best interests

A

physical and emotional interests (values, aspirations, likes/dislikes)
autonomy interests

23
Q

interaction of best interests and mental disability

A

previous best interests should be considered

24
Q

health vs wellbeing

A

medical interests dont always = best interests
bad health decision may be in someones best interests/medical interest may not align with best interests (therefore their wellbeing)

25
Q

importance of free will

A

being free to make ones own choices helps us flourish as humans

26
Q

what do autonomous choices require

A

ability to understand information
ability to form values
ability to make decisions based on values and understanding

27
Q

how does one enable autonomy to patients

A 
provide adequate information
clearly explain
give time to consider options
don't pressure patient
non-judgmental approach
provide reasonable choices
28
Q

positive impacts of autonomy on care

A 
helps drs give better advice
enable better decision making
improve mutual understanding
improve trust
improve adherence
29
Q

how can doctors go against their moral instincts in treatment?

A

by talking to the patient and understand each others perspective

30
Q

what is paternalism

A

overriding/undermining patients autonomy based on healthcare professionals view of patients best interests

31
Q

what falls under paternalism

A

presenting one side of the argument
withholding information
coercion
lying

32
Q

arguments for/against withholding information being lying

A

for - intention is the same then lying = withholding morally. wrong to assume patients dont want to know. esp if you know the patient would be influenced by the information

against - withholding restricts autonomy less. patients may actively collude in withholding. impossible to tell patients everything. less likely to cause mistrust

33
Q

what offenses may be committed if a doctor acts without consent

A

criminal - assault and battery

civil - claim for damages

34
Q

situations where consent is not required

A

emergency - obtaining consent may lead to damage to the patient
implied - llifting top after asking if they can be examined, not good for invasive treatment
waiver - decision given to someone else
best interests - unconscious, dementia etc

35
Q

what is expressed consent

A

oral or written permission

36
Q

what is consent

A

a competent person that understands the nature of the treatment based on information in broad terms without coercion who then gives permission

37
Q

what is competency

A

understand information
retain information
use information to make a decision
communicate the decision

38
Q

arguments for paternalism

A

patients may be depressed if given bad news

patients are laymen so may put undue weight to certain side effects

39
Q

what is duty

A

certain actions are right or wrong in themselves irrespective of consequences
e.g to not kill, not torture etc

but how is it decided?

40
Q

what are the conflicting duties of abortion

A

duty to respect autonomy

duty to not end life

41
Q

what is virtue

A

a character trait a human being needs to flourish/live well

42
Q

foetal rights

A

no legal rights til birth

being pregnant doesnt take your rights away - can engage in harmful behaviours, refuse medical treatment

43
Q

paternal rights over foetuses/pregnant women

A

once born

none during pregnancy - no say in abortions, no legal right to be consulted/informed of one

44
Q

legal grounds for abortion

A

pregnancy under 24wks or
necessary to prevent gradve/permanent injury to mother or
continued preg would be greater risk than termination or
substantial risk of serious physical/mental handicap

45
Q

what is consequentialism

A

actions ethically right/wrong determined by overall consequences of the action

46
Q

problems with consequentialism

A

certain actions always wrong
consequences aren’t always clear
could justify heinous actions for greater good
doesnt take rights into account

Endo, Cardio and Neuro (22 decks)

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