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23 Cards in this Set

  • Front
  • Back
What is an autonomous choice?
A formulation and action based on conceptions of how the person should live his/her life.
Result from autonomous decisions.
What is an Autonomous decision?
A preference that is
- based on individual's values and beliefs
- Free from coercion
- made with deliberation
- reflect morality
- made with adequate information and understanding.
What is the goal of the principle of "Respect for Autonomy"?
Keep the patient as much in control as we can of his health.
What is the DOCTRINE OF DOUBLE EFFECT (what does it say)
That there is a morally relevant difference between the intended effects of an action and the foreseen but unintended effects of the same action
What are the four conditions to justify an action that has collateral effects?
1. The action must not be intrinsically wrong.
2. The actor must only intend the good effect
3. The bad must not be the means to achieve the good
4. Overall the good must outweigh the bad
What is the goal of the consent process?
To allow autonomous choice
What are the elements of a morally valid consent?
Threshold elements:
- capacity
- voluntariness
Information Elements:
- Disclosure
- Recommendations
- Understanding
Consent Elements:
- Authority
- Deliberation
What are the two senses or informed consent?
Sense 1.
As an autonomous authorization
assumes responsibility
transfers authority
Sense 2.
An effective consent
Policy oriented
Focuses on consent seeker not on autonomy of the patient.
What is the relationship btw sense 1 and sense 2?
Sense one ought to be a model for sense 2
ACCESSING CAPACITY insufficient tests
Status test
- pt. fits in a category (ex. age based)

Outcome test
- pt chooses what phys. suggests.

Function test (Global Capacity)
- Ability to make decisions in general
ACCESSING CAPACITY sufficient tests
Function test (local capacity)
Ability to make decisions at hand
Comprehends situation
Understands consequences
Offers recognizable reasons
They are reasons that have valid premises and a conclusion that relates to them
Reasons that even though the physician would not agree with, they are rational and plausible
2 ways that reasoning can fail
invalid premises
valid premises but unrelated conclusion
5 reasons why it is good to tell the truth
promotes trust
Shows respect for pt
reduces providers liability
emphasizes importance of good communication.
reduces risk of harm
Promotes pt's well being
Difference between Canadian and US standards of disclosure of risks
Canadian= what the average person would like to know in the place of the pt
US= what the average person would like to know.
How do we protect the autonomy of those who cannot decide?
Proxy decision maker
- usually family member
- expresses the wishes of the pt
- charged with the duty of acting on the pt's wishes
Substitute judgement
- When the wishes of the pt are not known.
- Decisions based on a best interest standard
Some advanced directives
- wills
Appointing a proxy decision maker
- default proxy = spouse, parent, child, relatives, court
What does ASSENT mean?
to agree voluntarily in the absence of a full comprehension to the action or suggestion of another.
- Privacy: The right to be free from interference
The right to have medical records free from interference (counter ex. robber braking into hospital)

- Confidentiality
The right that a physician has to hold secret information about a patient
What needs to be kept confidential?
- Everything said about a patient
- Everything said by a patient or about a patient
Breaches of confidentiality can be
- Harm to pt
- Harm to others
- Prevention of future harms
- Insurance requests

-SHop talk
- Unguarded comments
DUTY to warn (For)
- Serious danger to another
- Legal duty to would-be victim
- It does not violate the code of ethics
DUTY to Warn(against)
- Pt will stop seeking treatment
- Full disclosure is necessary for treatment
- Increased risk of danger to public because people will stop seeking for help