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Law and Ethics NURS 3560 > Week 7 Organ donation/distributive justice > Flashcards

Week 7 Organ donation/distributive justice Flashcards

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1
Q

What is justice?

A

fairness & equity
- resources
- responsibility
- consequences

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2
Q

What is social justice?

A

how we treat individuals and groups within society with fairness and equity

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3
Q

What are the 3 tenants of social justice in the Canada Health act?

A
  1. comprehensiveness - you get what you need
    universaility
  2. Available to everyone
  3. Accessibility - everyone can do/use it
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4
Q

What is distributive justice?

A
  1. how we equitably distribute benefits and burdens
  2. how we compensate those who have been unfairly burdened or harmed
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5
Q

What is the benefit of a socially just society?

A

reduced health inequalities

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6
Q

What is the foundation of determining fair distribution ?

A

our values guide the process, weigh risks, benefits, burdens and costs

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7
Q

What are the 4 things that make up the allocation or resource?

A

Financial resources
Human resources
Time
Medical resources

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8
Q

what is rationing and what are two examples?

A

a method of allocation
- give to those who benefit the most

  1. give limited meds to immunocompromised people
  2. diagnostic equipt to those who don’t have it in the area first
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9
Q

What is Macro-allocation?

A

to an institution or community
ie) govt to health departments

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10
Q

What is Meso-allocation?

A

within an institution or community
ie) how many nurses will work on a unit at a given time

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11
Q

What is Micro-allocation?

A

to individuals
ie) nurse manager distributes patients so that each has 1-2 when short staffed

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12
Q

what are the 5 options available to determine FAIR distribution of resources?

A
  1. option 1 - to each person an equal share - egalitarian
  2. option 2- to each person according to individual need
  3. option 3- to each person according to effort/social contribution
  4. option 4- to each person according to merit (meritocracy)
  5. option 5- to each person according to free-market exchange
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13
Q

What is the problem with option 1- to each person an equal share?

A

What if someone doesn’t need their share?
ie) everyone gets the same number or bed days. Can you sell the ones you don’t need?

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14
Q

What is the problem with option 2 - to each person according to individual need?

A

Sometimes people have the same degree of need at the same time so how do you choose?
You then go to egalitarian - like look who has been waiting the longest.
Or use a score to determine if someone is an ICU candidate more than another but also determine if that’s a viable option for them

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15
Q

What is the problem with option 3- each person according to effort/societal contribution?

A

Does not account for social determinants of health that have acted as barriers
- disadvantaged people or children, people with disabilities would never have a chance to contribute

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16
Q

What is the problem with option 4 - to each person according to merit (meritocracy)?

A

who decides what “merit” to measure? who decides what “deserves” means?
- what about people who contribute to society like doctors or nurses. should they get before someone else cuz we need them?

17
Q

What is the problem with option 5- to each person according to free-market exchanges?

A

people without money are at a disadvantage- they would never have the opportunity to have care

staff go to private clinics because they pay better and then gov’t services decline

18
Q

In healthcare, which option for distributive justice do we typically use?

A

according to need

  • largest patient # = largest budget
  • most ill = first to be seen at ER
  • sickest patients- get more of nurses time
19
Q

What is the framework for resource allocation?

A
  1. transparent- everyone knows the rules
  2. Relevant - the rules are appropriate to the situation
  3. Reviewable - people can appeal a decision made using the proces
  4. Written- put down in policy so they are enforceable
20
Q

What happens if there is no framework for resource allocation that is clear?

A

Then we just decide in the moment and ship people off to other provinces like during covid.

There is supposed to be public consult + written down

21
Q

Do we have an ICU Triage protocol?

A

we do not

22
Q

What is the ICU Triage protocol?

A
  • process to determine ICU eligibility
  • principle of justice
  • who would most likely benefit from ICU
23
Q

What should a triage protocol include?

A
  1. transparent- clinical criteria
  2. relevant criteria
  3. review process- built in review/appeal of decision
  4. written/documented - in policy and enforceable
24
Q

What is Opt-out consent?

A

You are assumed/deemed/presumed a donor unless you opt out

25
Q

What are the 4 tenants of opt out Organ donation protocol?

A
  1. transparent- public awareness campaigns
  2. Relevant- rules are appropriate for increasing donor organs
  3. Reviewable - peeps can opt out - not compelled to donate
  4. Written - public record - avoid arbitrary exceptions
26
Q

What are the two categories of deceased donation?

A

NDD - neurological brain death
DCD - donation after cardio-circulatory death

27
Q

What two organs are considered living donation?

A

Kidney
Liver

28
Q

who is responsible for routine notification adherence to transplant manitoba?

A

physicians
nurses

29
Q

what is routine notification for organ/tissue donation?

A
  • provincial policy/shared health policy
  • ALL patients who meet specific clinical triggers be referred to transplant manitoba
30
Q

What are the 2 criteria for organ donation notification ?

A
  1. ventilated
  2. must have a plan for end of life discussion
31
Q

in which pathway does the donor receive treatments that benefits the recipient?

A

NDD - neurological brain death

32
Q

What are the steps to donation?

A
  1. consent
  2. organ suitability assessment
  3. allocation
  4. ongoing donor management in ICU
  5. retrieval surgery
33
Q

Can someone do a living donation before MAID?

A

no they cannot

34
Q

Can someone donate if they die by MAID?

A

no, illegal b/c they can’t give consent before death if under anethetic - no chance to change their mind

35
Q

Can someone donate who had initial consent and then loss of capacity d/t their disease?

A

Yes if it’s track 1 patients - before they lose capacity

Law and Ethics NURS 3560 (10 decks)

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