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EH- Med Ethics Final
Review for Med Ethics Final
24
Medical
Professional
05/02/2011

Additional Medical Flashcards

 


 

Cards

Term
Ten Ethical Considerations for Case Discussions
Definition
1. Beneficence
2. Non-maleficence
3. Autonomy
4. Cost-effectiveness
5. Sanctity of Life
6. Family
7. Culture & Religion
8. Provider/Pt Relationship
9. Professional integrity of provider
10. Justice
Term
5 Components of Decision Making Capacity
Definition
1. Can understand and process the prognosis, diagnosis and treatment
2. Can weigh the benefits, burdens and risks associated with treatment
3. Can apply values to making the decision
4. Can communicate their decision
5. [The decision they make is consistent over time]
Term
2 Myths about DMC
Definition
1. DMC is an all or nothing phenomenon
2. Lack of DMC never changes
Term
3 Parts of Informed Consent
Definition
DMC, Disclosure, Voluntariness
Term
Two standard of Disclosure
Definition
Professional Practice standard (provider sets the standard)
Reasonable Person (patient sets the legal standard)
Term
3 Exceptions to Informed Consent Requirement
Definition
1. Emergency Care
2. Therapeutic Exception
3. Waiver of consent
Term
Ethical Requirements for Breaking Confidentiality
Definition
physical harm to an identifiable person, a benefit will result, it is a last resort, generalizable (you would be ok with it if you were the pt)
Term
HIPAA (Health Insurance Portability Accountability Act)
Definition
federal privacy regulations
Term
Two Types of Death
Definition
Brain death
Cardiac death
Term
Brain death
Definition
irreversible cessation of all clinical brain function, including the brain stem
Term
Difference between Minimally Conscious States & Vegetative States
Definition
Minimally Conscious State (MCS)- severely altered state of consciousness but still has some awareness of environment
Vegetative State (VS)- "wakefulness w/o awareness"; no awareness of self or environment but still have some brainstem function

Difference is consciousness!
Term
Key Outcome of Quinlan ruling (LST)
Definition
Surrogates could refuse LST for on behalf of incapacitated (VS) patients even if the patient will die
Term
Advance Directives
Definition
Statement a person makes when they have DMC about how treatment decisions should be made at some point when they no longer have DMC
Term
Substituted Judgement
Definition
Judgement used to make decisions when the pt's wishes are known or can be inferred (based on pt preferences or interests)

Example: conversations about what happened on tv
Term
Best Interest Standard
Definition
Used by surrogate when don't know what patient would want
Term
3 Formal Conditions for Futility
Definition
1. Goal
2. Action aimed at achieving the goal
3. Virtual certainty that action will fail
Term
Withholding vs. Withdrawing treatment
(Moral Distinction)
Definition
NO moral difference b/c all relevant moral factors are the same:
Provider's duty to respect the pt's wishes
Consequences
Intentions
Cause of death
Potential for abuse
Term
Macro Allocation of Resources
Definition
determine the amount of resources to allocate to specific services
Ex: how much to spend on dialysis this year?
Term
Micro Allocation of Resources
Definition
Determine the amount of resources to allocate based on particular persons
Ex: Which person receives the organ?
Term
6 Principles of Rationing Scarce Resources and Examples
Definition
Treating People Equally:
1- A lottery
2- First come/first served

Favoring the worst off:
1- Sickest first
2- Youngest first

Maximizing Benefits:
1- Saving the most lives
2- Using prognosis or life years remaining
Term
What is DNR and when does it apply?
Definition
Do Not Resuscitate- applies only in cardiac arrest settings and only to CPR performance
Term
DNR vs. DNI
Definition
DNR- does not include the life sustaining treatments that might go along with CPR; such as intubation, cardioversion or other treatments

DNI- do not intubate; does not specify anything about CPR and CPR is usually not effective without intubation
Term
Euthanasia vs. PAS vs. Withdrawal of Treatment
Definition
Euthanasia- provider administers agent of death
PAS- patient administers agent of death
Withdrawal of LST- physician assists the person in death but the cause of death is the disease
Term
Un-controlled Donation after Cardiac Death vs Controlled Donation after Cardiac Death
Definition
Uncontrolled DCD- death is sudden (i.e. MVA); organs depleted of blood

Controlled DCD- death is planned (i.e., withdrawal of LST); can plan for donation and retrieval
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