Term
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Definition
| obligation to respect patients as individuals and honor their preferences |
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Term
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Definition
| special ethical duty to act in the patient's best interest, however autonomy comes first |
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Term
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Definition
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Term
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Definition
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Term
| informed consent requirements |
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Definition
| discussion of pertinent info, patients voluntary agreement to the plan of care, freedom from coercion |
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Term
| excepsions to informed consent |
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Definition
| pt lacks capacity or legally incompetent; implied in emergency; therapeutic privilege (if info would harm the patient); waiver (pt waives right to consent) |
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Term
| when is parental consent not needed with minors? |
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Definition
| emergency situations, when prescribing contraceptives, tx of STDs, medical care during pregnancy or management of drug addiction |
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Term
| requirements for capacity |
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Definition
| patient makes and communicates a choice; pt is informed; decision remains stable; decision is consistent with patients values and goals; decision is not a result of delusions or hallucinations |
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Term
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Definition
| incapacitated patients prior oral statements is used |
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Term
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Definition
| describes treatment the patient wishes to receive or not if they become incapacitated and can't communicate about treatment decisions |
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Term
| durable power of attorney |
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Definition
| patient designates a surrogate to make medical decisions in the event they lose decision making capacity |
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Term
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Definition
| spouse > adult children > parents > siblings |
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Term
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Definition
| if an incompetent patient has not prepared an advance directive, this person must determine what the patient would have done |
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Term
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Definition
| respects patient privacy and autonomy |
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Term
| exceptions to confidentiality |
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Definition
| potential to harm others is serious; likelihood of harm to self is great; no alternative means exist to warn or to protect those at risk; |
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Term
| what steps can physicians take to prevent harm |
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Definition
| reporatble diseases, the Tarasof decision, child/elder abuse, impaired automobile drivers, SI/HI pt |
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Term
| what is the tarasoff decision? |
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Definition
| law requiring physicians to directly inform and protect potential victim from harm; may involve breach of confidentiality |
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Term
| what is the appropriate response if... pt is noncompliant |
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Definition
| attent to identify reasons for noncompliance and willingness to change |
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Term
| what is the appropriate response if... pt desires unnecessary procedure |
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Definition
| attenpt to understand why pt wants it and address undying concernce |
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Term
| what is the appropriate response if... pt has difficulty taking meds |
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Definition
| provide written instructions, attempt to simplify treatment regimens |
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Term
| what is the appropriate response if... family members ask for information about patient's prognosis |
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Definition
| avoid discussing issues with relatives without the permission of pt |
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Term
| what is the appropriate response if... child wishes to know more about illness |
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Definition
| ask what parents have told them; parents decide with info can be relayed |
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Term
| what is the appropriate response if... 17 y/o girl is pregnant and requests abortion |
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Definition
| many states require parental notification |
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Term
| what is the appropriate response if... 15 y/o pregnant nd wants to keep child but parents want to put up for adoption |
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Definition
| pt retains right to make decisions regarding her child |
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Term
| what is the appropriate response if... terminally ill pt requests physician assistance in ending life |
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Definition
| may prescribe medically appropriate analgesics that coincidentally shorten the patients life |
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Term
| what is the appropriate response if... pt is suicidal |
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Definition
| assess seriousness of the threat, if serious suggest pt remain in hospital voluntarily |
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Term
| what is the appropriate response if... pt states they find you attractive |
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Definition
| ask direct, closed-ended questions and use a chaperone if necessary |
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Term
| what is the appropriate response if... middle0aged married woman who had a mastectomy feels ugly when she undresses |
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Definition
| find out why the pt feels this way; don't offer falsely reassuring statements |
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Term
| what is the appropriate response if... pt is angry about the amount of time he spent in the waiting room |
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Definition
| acknowledge the pt's anger but do not take the anger personally; apologize for any inconvenience but don't explain the delay |
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Term
| what is the appropriate response if... pt is upset with the way he was treated by another doctor |
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Definition
| suggest that the patient speak directly to that physician regarding his concerns; tell pt you will speak to them if they are a member of the office staff |
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Term
| what is the appropriate response if... drug company offers a referral fee for every pt a physician enrolls in a study |
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Definition
| never acceptable to receive compensation; pt must be told about the existence of a referral fee |
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Term
| what is the appropriate response if... physician orders an invasive test for the wrong pt |
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Definition
| inform a patient that a mistake has been made |
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Term
| what is the appropriate response if... pt requires a treatment not covered by insurance |
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Definition
| never limit or deny care because of expense in time or money; discuss all tx options even if not covered |
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