Shared Flashcard Set

Details

N330 final
ethics
60
Nursing
Undergraduate 2
04/15/2014

Additional Nursing Flashcards

 


 

Cards

Term
names of the big three ethical theories
Definition
virtue theory, deontological theory, consequentialist theory

ETHICAL THEORY READING
Term
virtue theory
Definition
judgement of agents are most basic

ETHICAL THEORY READING
Term
deontological theory
Definition
judgement of actions are most basic

ETHICAL THEORY READING
Term
consequentialist theory
Definition
judgement of consequences are most basic

ETHICAL THEORY READING
Term
virtue theory: virtues can be applied to ___ (2)
Definition
human begins & objects

ETHICAL THEORY READING
Term
virtue theory: three goals
Definition
-develop and defend conception of the ideal person
-develop and defend list of virtues necessary for being an ideal person
-defend a view of how persons can possess these virtues

ETHICAL THEORY READING
Term
virtue theory: examples from the history of philosophy
Definition
- Aristotle - four cardinal virtues: courage, justice, temperance, and wisdom
- St. Aquinas & St. Augustine - faith, hope, and charity

ETHICAL THEORY READING
Term
deon
Definition
greek word for "duty"

ETHICAL THEORY READING
Term
deontology regards the fundamental ethical task as ____
Definition
Deontology regards the fundamental ethical task as one of doing the right thing (or avoiding the wrong thing)

ETHICAL THEORY READING
Term
deontology commonly guides action with a set of moral principles or rule. Two types:
Definition
RULES OF PARTICULAR CIRCUMSTANCES & ABSOLUTE RULES

-rules may refer to particular circumstances: actions of type T are never (always_ to be performed in circumstance C
-rules may be absolute (prohibiting actions in all circumstances): actions of type T are never to be performed

ETHICAL THEORY READING
Term
essential tasks of deontology (2)
Definition
-formulate and defend a set of moral rules
-develop and defend some method of determining what to do when rules conflict

ETHICAL THEORY READING
Term
general types of deontology (2)
Definition
- Rule deontology: requires agents to perform actions that follow a rule
- Act deontology: do what's right rather than blindly following a rule

ETHICAL THEORY READING
Term
the state of character most important for deontology is _____. why? define. exampes.
Definition
The state of character most important for deontology is conscientiousness
-It makes us to follow rules despite temptations to make an exception
-Conscientiousness is not an intrinsic good – its value is a result
-Examples: Ten Commandments, Kant’s categorical imperative, Stoics – natural law

ETHICAL THEORY READING
Term
what is most important to consequentialism
Definition
judgement of value of consequences of actions are most important

ETHICAL THEORY READING
Term
consequentialism: how should one act?
Definition
one should act to obtain the best result

ETHICAL THEORY READING
Term
3 goals of consequentialism
Definition
-Specify and defend things that are good in themselves
-Provide technique to measure and compare quantities of these intrinsic goods
-Defend policy for those cases where one cannot determine which of a number of alternative actions will maximize the good
ETHICAL THEORY READING

Term
2 types of consequentialism
Definition
-Act consequentialism: perform the action that will most likely maximize good consequences in the particular situation
-Rule consequentialism: follow those rules that will maximize good consequences

ETHICAL THEORY READING
Term
consequentialism: instrumental vs. intrinsic
Definition
-Instrumental things are good only so far as they play a role in bringing about intrinsically good things
-Intrinsically good things are good by itself

ETHICAL THEORY READING
Term
steps of clinical pragmatism framework
Definition
1. assessment
2. moral diagnosis
3. goal setting, decision making, and implementation
4. evaluation of results

APPENDIX 2
Term
ethics vs morality
Definition
ethics = a perspective form which to evaluate and live the moral life. question why certain actions are best
morality = what's right or wrong based on majority's beliefs
(what should i do?)

CHAPTER 1
Term
four basic ethical obligations that pertain to each case after establishment of the clinician-patient relationship
Definition
1. respecting the patient’s privacy and confidentiality
2. communicating honestly about all aspects of the patient’s diagnosis, treatment, and prognosis
3. determining if patient is capable of sharing in decision-making
4. conducting an ethically valid process of informed consent throughout the relationship

CHAPTER 1
Term
eight ethically relevant considerations and virtues for caring for patients
Definition
1. the balance between benefits and harms
2. disclosure, informed consent, and shared decision-making
3. the norms of family life
4. the responsibilities of physicians and nurses in the context of relationships with patients
5. professional integrity
6. societal norms of cost-effectiveness and allocation
7. cultural and religious variations
8. considerations of power

CHAPTER 1
Term
why is it important not to divorce ethical reasoning from clinical reasoning
Definition
theory vs. practice

CHAPTER 1
Term
professional integrity
Definition
integration of beliefs about values and purposes. important in determining whether treatment or care requested by patients or surrogates is ethically appropriate.

CHAPTER 2
Term
basic tenets of the nursing code of ethics (5)
Definition
patient advocacy. treat patient, not disease.
-participates in improving healthcare as a whole
-participates in advancement of nursing profession as a whole
-collaborates with other professionals
-be a good rep for nurses.

CHAPTER 2
Term
how law and ethics are similar yet different.
Definition
both concerned with identifying norms of conduct. BUT Law seeks to educate and to regulate by setting a minimal standard of conduct and establishing disincentives for ignoring that standard. Ethics supports many basic conduct required by law, but extends beyond the law to prescribe desirable conduct and articulate ideals and virtues we should aim for

CHAPTER 4
Term
privacy vs confidentiality
Definition
privacy - the ability to control information others have about us
confidentiality - process where a person's right to privacy is recognized and honored. a form of promise that is based on a trust relationship

CHAPTER 7
Term
negative vs positive right of privacy
Definition
Negative right - the right to be left alone.

Positive right - right to control access to and distribution of information on self

CHAPTER 7
Term
clinicians' duty to warn
Definition
-duty to warn third parties who are at risk of injury by the patient
-exercise professional judgment on course of action to protect potential victims

CHAPTER 7
Term
Tarasoff v. Regents of the University of California
Definition
protecting private health information is a primary duty of the mental health professional, except when patient shares to therapist a threat concerning an identifiable third party

CHAPTER 8
Term
types of flawed disclosures and why they are flawed
Definition
5.
- “Just the facts” - just give facts. no emotion
- “There’s always hope” - making them too hopeful
- You can’t tell a patient everything - clinician's duty to tell what is meaningful, important, useful to the patient
- Omission - form of lying: remaining silent when speech would be ethically appropriate
- Evasion - change subject

CHAPTER 8
Term
when it is ethically appropriate and inappropriate to disclose or not to disclose information to a patient
Definition
let patient, by his or her questions, responses, and actions, guide the decision about how much information is helpful. consider the importance of the information to each patient's specific clinical situation, personal needs, future implications of the information, and so forth

CHAPTER 8
Term
communication elements necessary for an "ideal clinician-patient relationship" (6)
Definition
1. Choice
2. Competence
3. Compassion
4. Continuity
5. Lack of Conflict of Interest
6. Communication—a two-way street

CHAPTER 8
Term
capacity vs competence
Definition
competence - legal term
capacity - ability to make a decision

CHAPTER 9
Term
concepts of determining capacity
Definition
outcome, category, functional

CHAPTER 9
Term
determining capacity - outcome
Definition
person judged capable based on outcome of decision
If decision reflects values that reject conventional wisdom, capacity may be questioned.
This standard should be rejected.

CHAPTER 9
Term
determining capacity - category
Definition
person judged capable based on category/ status. Example: considered incapable if mentally ill/retarded, aged, minor, critically ill
This standard should be rejected.

CHAPTER 9
Term
determining capacity - functional
Definition
recognized functional ability as decision-maker
Functionally able:
1. Understanding relevant information
2. Communicating with caregivers about decision
3. Reasoning about relative alternatives, consequences against a background of personal values and beliefs

CHAPTER 9
Term
types of surrogate decision making standards for incapacitated patients
Definition
best interest, substituted judgment, other/professional

CHAPTER 9
Term
surrogate decision making standards for incapacitated patients - best interest standard
Definition
what would be in the person’s best interests if that person’s values are not ascertainable or person never was capacitated

CHAPTER 9
Term
surrogate decision making standards for incapacitated patients - substituted judgement standard
Definition
what the person him or herself would have wanted based on their values and preferences

CHAPTER 9
Term
surrogate decision making standards for incapacitated patients - other standards/professional standard
Definition
the physician decides. May subject patients to decision that conflict with their own values.

CHAPTER 9
Term
what a valid informed consent involves
Definition
Threshold elements (preconditions)
Information elements
Consent elements

CHAPTER 10
Term
threshold elements (preconditions)
Definition
capacity (to understand and decide)
voluntariness (in deciding)

CHAPTER 10
Term
Information elements
Definition
Disclosure (of material information)
Recommendation (of a plan)
Understanding (of disclosure and recommendation)

CHAPTER 10
Term
Consent elements
Definition
Decision (in favor of a plan)
Authorization (of the chosen plan)

CHAPTER 10
Term
role the nurse has in the informed consent process
Definition
provide a major portion of information about treatment to patients, partly because they spend more time than the physician talking to the patient, either in formal educational process or in informal bedside conversation.
Evaluate valid informed consent: adequacy of disclosure; patient's understanding, capacity, voluntariness

CHAPTER 10
Term
informed consent vs assent
Definition
informed consent - given by parent
assent - informed consent of a minor under 14, not legal

CHAPTER 10
Term
“senses” of futility (3)
Definition
- When a treatment simply won’t work (e.g., antibiotics for a viral infection)
- Quantitative futility: the likelihood of success of a treatment is extremely remote (CPR for a severely debilitated, imminently dying patient)
- Qualitative futility: when clinicians judge the quality of life after an intervention or the burdens of treatment to be greater than the benefits

CHAPTER 11
Term
when it is appropriate for clinicians to refuse to treat a patient (3)
Definition
To benefit their patients (when no treatment is in their medical best interest)
To be true to their own moral views or their consciences
To meet the interests of larger numbers of other patients or the interests of the greater society.

CHAPTER 11
Term
various definitions of death
Definition
whole-body definition of death, whole-brain definition of death

CHAPTER 12
Term
whole-body definition of death
Definition
Cessation of breathing and absence of heartbeat, higher-brain or neocortical definition of death

CHAPTER 12
Term
whole-brain definition of death
Definition
brain dead, although may be breathing or beating (heart) w/ or w/o help. coma, absence of reactions, flat EEG

CHAPTER 12
Term
higher-brain or neocortical definition of death
Definition
Persistent vegetative state (PVS) – brain stem survives, but patients have no (or little) neocortical function (no speech, no meaningful interaction)

CHAPTER 12
Term
palliative care
Definition
physicians and other clinicians are not to accept suffering as a necessary evil.

-to achieve the best possible quality of life through relief of suffering, control of symptoms, and restoration of functional capacity while remaining sensitive to personal, cultural, religious values, beliefs, practices
1. respecting patients' goals and choices
2. using an interdisciplinary team to provide patients with comprehensive care
3. providing support to family caregivers

CHAPTER 12
Term
how clinicians should properly deliver bad news (6)
Definition
1. Get off to a good start by optimizing physical context, ensuring that all participants who should be in the meeting are there, making introductions/shaking hands/touching patient—addressing patient first
2. Find out how much patient knows about his medical condition by using open-ended questions
3. Find out how much patient wants to know about his clinical situation
4. Sharing information according to the patient's needs, desires; make a mutually agreed upon plan for the future
5. Responding to the patient's feelings
6. Planning and follow-through

CHAPTER 12
Term
euthanasia vs clinician-assisted suicide
Definition
Euthanasia - "good death." Bringing about the death of a hopelessly ill and suffering person in a relatively quick and painless way for reasons of mercy.
C-A suicide - when a doctor facilitates a patient's death by providing the necessary means and/or information to enable the patient to perform the life-ending act

CHAPTER 12
Term
ethical guidelines for deciding to forgo life-sustaining treatments when the patient is incapacitated
Definition
1. Physicians have a duty to make recommendations to other decision-makers based on benefit/burden assessments
2. Benefits and burdens should be assessed within the framework of the patient’s prior expressed wishes or known values, beliefs, and previous decisions about treatment, and a substituted judgment made if possible; if it is not possible, the best medical interest standard should be followed
3. Family members are usually the best source of information about a patient’s preferences, supplemented by information from other members of the clinical team
4. When the benefits of treatment are proportionate to or exceed the burdens, it is obligatory to give treatment (unless refused by the patient in an AD)
5. It is obligatory for clinicians to withhold and strive to withdraw treatments that clearly will harm or are harming the patient

CHAPTER 13
Term
Baby Doe regulations
Definition
- regulations ensure that handicapped infants received all potentially efficacious lifesaving treatment without consideration of quality of life.
- Regulations appeared to require maximal treatment in all cases except those in which treatment was futile because the infant was irreversibly and imminently dying

CHAPTER 14
Term
standards for making medical decisions when dealing with neonates, infants, and children
Definition
Shared process that involves surrogates (parents) and the clinicians involved in the infant’s care

CHAPTER 14
Supporting users have an ad free experience!