Term
| Q: Why should clinicians avoid divorcing clinical and ethical reasoning, as presented in the textbook Introduction to Clinical Ethics? |
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Definition
-Fallacy of Expertise, thinking Clinical = Ethical Knowledge
-Can forget about ethics and focus on legal stuff. |
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Term
| Q: Describe one of the virtues that clinicians should possess (your choice), as presented in the textbook Introduction to Clinical Ethics. |
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Definition
-Humility: to recognize one’s own fallibility & limits to clinical knowledge
-Courage:
-Caring: |
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Term
| Q: What is one crucial difference between the two definitions of death as discussed in the textbook Introduction to Clinical Ethics? |
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Definition
Body: cessation of heart and lungs
Brain: cessation of brain functions (would then lead to body death) |
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Term
| Q: What are the four steps to the clinical pragmatism framework? |
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Definition
Assessment
Moral Diagnosis
Goal Setting/Decision Making/Implementation
Evaluation |
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Term
| Q: Discuss one key difference between a living will and a durable power of attorney for health care (Chapter 12). |
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Definition
Living Will: applies when patient = unconscious/terminally ill & no hope for recovery. Patient has no capacity to decide what he would want. Living will shows what he wants.
Durable Power of Attorney: a surrogate decision maker decides for incapacitated patient as to what the patient would have decided to do if he could decide. |
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Term
| Know the names and key points of each of the big three ethical theories |
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Definition
Virtue / Deontology / Consequentialist Theories
Virtue Theory: Judgment of Agents
-develop/defend a 1.list of virtues and an 2. Image of ideal person
-Virtues: courage, justice, temperance, wisdom, faith, hope, charity
Deontological Theory: Judgment of Actions
Formula/Defend 1. Moral Rules, and a 2. MoralConflict resolving method
Consequentialist Theory: Judgement of Consequences
-Act as to promote the best consequences
-Specify/defend a 1. List of things that are good, 2. Techniques to measure/compare good consequences, and. 3. Determine what are maximized goods |
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Term
| Know what distinguishes ethics and morality |
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Definition
Morality: shared beliefs about what’s right and wrong
What ought I to do in this and similar situations?
Ethics: philosophic perspectives to evaluate morals and the meaning behind them.
Why should I do x? What reasons justify doing it? |
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Term
| Know the four basic ethical obligations that pertain to each case after establishment of the clinician-patient relationship: |
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Definition
1. Respecting patients privacy & confidentiality
2. Honest communication of diagnosis, treatment, prognosis
3. Decision-making capacity
4. Valid informed consent |
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Term
| Know the eight ethically relevant considerations and virtues for caring for patients |
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Definition
1. Benefit/Harm balancing
2. Shared decision-making, informed consent, disclosure of info
3. Family life norms
4. Rapport/relationships with patients
5. Professional Integrity
6. Cost-effectiveness/allocation of societal norms
7. Cultural and religious variations
8. Considerations of Power |
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Term
| Know what professional integrity is |
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Definition
1. Patient’s freedom to refuse treatment
2. Clinician’s refusal to inappropriate treatment
3. Consent by patient |
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Term
| Know the basic tenets of the nursing code of ethics |
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Definition
1. Practice with compassion & respect
2. Advocate for rights, health, safety of patients
3. Seeks to improve environment
4. Contributes to advancement
5. Collaborate with public & other ___ to promote health needs
6. Maintain professional integrity by articulating values
7. Accountability for practices and delegate tasks. |
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Term
| Know how law and ethics are similar yet different |
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Definition
Ethics & Law: identify norms of conduct
Law:
-to educate/regulate a minimal standard of conduct
-establishing disincentives when not followed
Ethics:
-extends beyond law to prescribe desirable conduct and ideals to aspire to
what is legally permitted may not be ethically justifiable |
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Term
| Know the difference between privacy and confidentiality |
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Definition
Privacy: ability to control information others have about oneself
Confidentiality: right to privacy being honored, information = moral property, foundation for trust. |
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Term
| Know the difference between a positive and negative right |
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Definition
1. Negative Right
-Right to noninterference/righttobeleftalone
-Self-determination
2. Positive Right
-To control access to and distribution of one’s information |
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Term
| Know the types of flawed disclosures and why they are flawed |
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Definition
Just the facts
There’s always hope
You can’t tell a patient everything
Omission
Evasion |
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Term
| Know the communication elements necessary for an “ideal clinician-patient relationship” |
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Definition
Choice
Competence
Compassion
Continuity
Lack of conflict of interest |
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Term
| Know when it is ethically appropriate and inappropriate to disclose or not to disclose |
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Definition
| Patients questions, responses, actions… guide physicians on how much and what info is appropriate. |
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Term
| Know the difference between capacity and competence |
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Definition
Competence: to take care of oneself and manage his property
-incompetence negates a person’s legal rights; a guardian/surrogate makes important decisions
Capacity: ability to make a decision |
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Term
| Know the concepts put forth in the literature to determine capacity and how to properly |
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Definition
1. Abilities of the patient
2. Requirement of the task at hand
3. Possible consequences |
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Term
| Know the types of surrogate decision-making standards for incapacitated patients |
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Definition
1. Substituted judgement (what person would have done)
2. Best Interest |
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Term
| Know what a valid informed consent involves |
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Definition
1. Threshold, 2.Information, 3. Consent elements
Threshold elements (preconditions)
1.Capacity (to understand and decide)
2.Voluntariness (in deciding)
Information elements:
1.Disclosure (of material information)
2.Recommendation (of a plan)
3.Understanding (of disclosure and recommendation)
Consent elements
1.Decision (in favor of a plan)
2.Authorization (of the chosen plan) |
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Term
| Know what role the nurse has in the informed consent process |
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Definition
| Provide a major portion of information about treatment to patients. They spend more time with patients. |
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Term
| Know the difference between informed consent and assent |
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Definition
Informed Consent: patient informed, and participates in decision-making for treatments
Assent: an agreement to treatment not legally consent (a kid…) |
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Term
| Know the “senses” of futility |
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Definition
Physiologically futile: treatment ineffective
Lack of benefit: futile b/c it fails to restore consciousness even though physiological effective. |
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Term
| If the surrogate of an incapacitated patient demands, know when it is appropriate for clinicians to refuse to treat a patient: |
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Definition
1. Patient wanting to withhold beneficial treatment, clinicians should not acquiesce
2. Starting harmful treatment
3. Continuing harmful treatment (court approval if necessary)
4. Withholding/withdrawing futile treatments (refusableish) |
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Term
| If the surrogate of an incapacitated patient demands, know when it is appropriate for clinicians to refuse to treat a patient: |
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Definition
1. Patient wanting to withhold beneficial treatment, clinicians should not acquiesce
2. Starting harmful treatment
3. Continuing harmful treatment (court approval if necessary)
4. Withholding/withdrawing futile treatments (refusableish) |
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Term
| Know the various definitions of death |
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Definition
Body
-No breathing nor heartbeat
Brain
-No brain activity (eventually leads to no breathing/heartbeat) |
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Term
| Know what palliative care involves |
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Definition
Care to relieve pain/symptoms/stress
Not focused on providing a cure/solution to medical condition |
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Term
| Know how clinicians should properly deliver bad news |
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Definition
1. Listen to patient: face-to-face, separately, no interruptions, respectfully)
2. Appropriate language usage (medical jargon/lingo only if understand-ed by patient)
3. Do not patronize patient |
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Term
| Know what distinguishes euthanasia and clinician-assisted suicide |
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Definition
Euthanasia:
1. Physician can do anything to free ill from pain that doesn’t fastens death
2. Can withdraw suffer-some therapy
3. Can alleviate patient’s suffering even if jeopardizing patients’ life
4. Can terminate life if patient wanted to die
Clinician Assisted Suicide:
-Physician providing means to death through lethal medication. |
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Term
| Know the ethical guidelines for deciding to forgo life-sustaining treatments when the patient is incapacitated. |
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Definition
Following guidelines are suggested:
1. Physicians make benefit/burden recommendations to surrogates
2. Prior expected wishes/values/beliefs to do ideal treatment.
3. Best Medical interest if values/wishes/beliefs are unknown.
4. Family members as a source of information needed.
5. Obligatory treatment if benefits must exceed burdens (or proportionate)
6. Obligatory treatment withdrawing if its harmful. |
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