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138 Cards in this Set
- Front
- Back
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Reasons why most people do anything
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greed, curiosity and anger
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Conditions for learning
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meaningful content, observation, discussion, practice and feedback
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Examples of common rationalizations
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if it’s necessary, it’s legal, I was just doing it for you, and everyone’s doing it
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Examples of logical fallacies
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equivocation, popular appeal, begging the question
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Functions of critical thinking
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evaluate arguments of others, evaluate one’s own argument, and resolve conflicts
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Critical thinking can be seen as
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a discipline, a skill and an art
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The common elements of critical thinking
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analysis of information, evaluation and creativity
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The three components of an argument
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claim, evidence and general rule
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Four components of a well-reasoned argument
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completeness, consistency, coherence and clarity
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The three components of the thought process
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experience, interpretation and analysis
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Critical Thinking is synonymous with
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reflective thinking
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Examples of pillars of character
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trustworthiness, fairness, caring, respect, responsibility and citizenship.
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Three modes of character integration
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uncritical, self-serving and fair-minded.
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World views that humans are bad
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psychological egoists, hobbesians and religious thinkers.
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World views that humans are good
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altruistists, lockians, and religious thinkers.
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Examples of virtue
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kindness, sharing, generosity and trustworthiness.
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Examples of vices
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greed, envy, hate and revenge.
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Distinguishing characteristics of a professional
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trust, specialized knowledge, and self-regulation.
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Elements of professionalism
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altruism, accountability, excellence and duty.
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Ways values interact
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compete, conflict and compliment.
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Lawrence Kohlberg’s concept of moral reasoning
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preconvention, conventional and post conventional.
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Criticisms of Kohberg's concept of moral reasoning
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1) he studied only boys 2) other ways to solve problem (false choices)
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Gilligan’s concept of moral reasoning
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self-centered, self-sacrificing and mature care.
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Inductive reasoning
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bottom-up reasoning.
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Deductive reasoning
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top-down reasoning.
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Interferences to ethical reasoning and ethical behavior
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self-deception, self-indulgence, self-protection and self-righteousness.
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What is the name of the person who cleans the GPNA building
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?
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Three harmful practices pertaining to ethics
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coercion, manipulation and deception.
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A question for Epistemology
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What is the difference between knowledge and belief?
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A question for Metaphysics
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Are there any absolutes or is everything really relative?
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A question for Ethics
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What theories of conduct are valid and why?
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Two enemies of ethics
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relativism and dogmatism.
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Ethos
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Character
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Pathos
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Emotional response
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Logos
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convincing manner
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Greek idea of interaction
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Ethos, Pathos and Logos
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Dr. McManus definition of ethics
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pertaining to who you are, what you do and why you do something.
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Aristotle’s approach
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Golden Mean.
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Forms of non-consequential Ethics
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Divine Command Theory, Kantian Ethics and Prima Facie Ethics.
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Forms of consequential ethics
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Egoism, Utilitarianism and Altruism.
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Socrates basic approach
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Asking, “What is it?”
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Two traditional subdivisions of moral philosophy
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normative ethics and meta ethics.
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A primary purpose of moral philosophy
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Provide guidance in resolving real life moral dilemmas.
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Seeing morality as a private choice
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Ethical Subjectivism
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A cultural relativist accepts
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majority opinion.
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Double think
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Belief in opposing views.
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Most American adults base their moral decisions on
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Cultural norms and laws.
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Post conventional moral reasoning typically bases reasoning on
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universal moral principles.
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A common phrase among utilitarian is
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The ends justify the means.
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Utilitarian’s give moral consideration to
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animals as well as humans.
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For Aristotle, the natural function of the victorious person is
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to reason well.
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The doctrine of the mean suggests
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between the extremes.
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John Stuart Mills suggests the goal of life is the seek
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Happiness.
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Jeremy Bentham suggests the goal of life is to seek
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Pleasure.
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Deontology denotes what?
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Duty
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Three versions of deontological theory
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Divine command, Kantian and Prima-Facie
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For deontologists, autonomous moral agents
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Use their reason to discern moral principles.
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A Kantian maxim
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Never merely treat a person as a means, but always as an end in itself.
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For Kant, moral maxims and duties are
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Universally Binding.
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“So act to treat humanity, whether in thane own person or any other person, in every case as an end in itself, not as a means only.”
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Immanuel Kant
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Prima-Facie
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At First Glance.
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Natural reason is the function of natural law for
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It is an imprint on us of the Divine light.
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Under natural law theory, something is morally right if
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It is consistent with reason.
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Examples of frequently occurring ethical issues for the CRNA
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challenged by another professional, conflicts of conscience, confidentiality issues, animal research requiring anesthesia, parental consent and patient’s autonomous refusal.
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Dramatic ethics
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When nurses act, “ethically” towards their patients only for fear of criticism or penalty.
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Moral Distress
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Sensing an inappropriate moral act has occurred.
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Three area of negligence
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unskilled, careless and greed.
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Casuistry
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practical reasoning.
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Autonomy
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Self-determination
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Beneficence
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doing good, doing acts of kindness
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No maleficence
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“First do no harm”.
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Justice
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Fairness
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Bioethics
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Life ethics, or ethics in medicine
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Paternalism
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Parental role toward parents and their families.
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Stages of medical ethics
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Hippocratic, rights, and shared responsibility.
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Health care ethics
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applied ethics.
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Elements of informed consent
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Disclosure of information, comprehension of information, voluntary consent and competence to consent.
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Capacity
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Understanding, communicate, assess risks and benefits and consistency.
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Issues are typically defined in medical ethics care in three ways
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collision between principles, virtues, and failures in the health care profession/patients relationship.
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Character Count Coalition suggests guidelines for ethical behavior in the workplace
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be honest, demonstrate integrity, keep promises, be loyal, pursue excellence, be responsible, be kind and caring, treat all people with respect, be fair and be a good citizen.
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Systematic Moral Analysis
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The goal is to examine acts that are required, permitted, prohibited and encouraged.
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Rest’s Four Component Model
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sensitivity, reasoning(judgment), commitment (motivation), action (character)
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A question appropriate to the topic of “Sensitivity”
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Who are the stakeholders?
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A question appropriate to the topic of “Reasoning”
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Are some rights/duties/values/principles more important?
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A question appropriate to the topic of “Commitment”
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What personal negative consequences might limit you?
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A question appropriate to the topic of “Action”
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What interpersonal skills are necessary to do so?
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Indications For Medical Intervention
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critical emergency, terminal condition, prevent untimely death.
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Research ethics topics
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fraud, misrepresentation, deception, whistle-blowing, research misconduct, rights of humans and other animals, conflict of interest issues.
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IRB
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Institutional Review Board
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Research
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A systematic investigation (including development, testing and evaluation).
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Researchers responsibility
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Study is properly designed, scientifically sound, and yields valid results; participants meet selections and eligibility requirements; study is approved by IRB Band conducted according to the protocol; informed consent is properly obtained; protocol changes and adverse events are reported to the appropriate boards and authorities; the rights and welfare of participants are monitored throughout the trial; and research team are qualified and trained in research methods and human participant protections.
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Vulnerable populations
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Children, individuals with questionable capacity for consent, prisoners, fetuses and pregnant women, the terminally ill, student//employees, and comatose patients.
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Belmont Report Principles
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Respect for persons, beneficence, and justice.
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Right
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Something to which one has a just claim.
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Duty
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This is the action required by one’s occupation or position.
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Responsibility
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This is being answerable for one’s actions or decisions.
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Rationale
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This is the explanation of principles of beliefs or practice. The underlying reason.
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Justification
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This is the reason or set of reasons people give to defend their position on any given situation.
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Lex Talonis
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Retributive Justice
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Theories of distributive justice
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equal share (socialist), need (Medicare), effort ( no work, no food), prior contribution (social security)
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Three phases of medical history
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Hippocratic (paternalism), 1960-1970’s (rights), 1980-present (shared responsibility).
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Georgetown Four ‘Principles’
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Autonomy, Beneficence, Non-Maleficence, Justice
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Pain
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An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms such as damage.
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First to isolate patients for treatment and observation
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Florence Nightingale
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The disease is the
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medical story (biomedical perspective)
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The illness is the
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personal story (patient’s perspective)
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‘AND’ Designation
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Allen Natural Death
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Moral distress
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Extreme discomfort in a patient’s outcome. Something done, or not done, that you felt was not right.
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Futility
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Incapable of producing any result, failing utterly of the desired and through intrinsic defect.
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Physiologic futility
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an utter improbability that the physiologic response can be affected by any intervention.
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Quantative futility (Probabilistic futility)
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Designates an effort to provide a benefit to a patient, which reason and experience suggests is likely to fail, and whose rare exceptions cannot be systematically produced.
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Elizabeth Kubler Ross’s stages of dying
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Denial, Anger, Bargaining, Depression and acceptance.
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Advanced Directive
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A legal document through which people make their request for services.
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SB-1260
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Directive to Physicians, Medical Power of attorney, out of hospital DNR, and Declaration of Mental Health.
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Euthanasia
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Good or happy death.
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Right to die organization
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Hemlock Society
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The seven components of the Four Filter (Topic) Model
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Indication for medical intervention, patient preference, quality of life, contextual features, principles, virtues,and professional-patient relationships.
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Dex’s major reason for wanting to die
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pain
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An example of ‘Facts’
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Diagnosis//Treatment
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An example of ‘Patient Preferences’
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consent PA//Surrogate preference//Informed
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An example of ‘Quality of Life’
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Patient’s criteria//Changes in QOL//Expectations
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An example of ‘Principles’
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Autonomy, Beneficence, Non-Maleficence, and Justice
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An example of ‘Virtues’
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Trust, Integrity and Advocacy.
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An example of ‘Professional-Patient relationship’
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Competence, Honesty, and Confidentiality.
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Components of culturally competent care
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Awareness and acceptance of cultural differences, self-awareness, understanding the dynamics of differences, basic knowledge of the patient’s culture and adaptation of skills.
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Baby Doe
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Down’s syndrome baby with trachea- esophageal fistula (1982)
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Five ethical issues in pediatrics
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acting against parental consent, acting without parental consent, the adolescent patient, research with children and caring for the dying child.
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A ‘consequential’ type question
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To what degree is your choice of alternatives based on your own or your organization’s best interests?
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A ‘non-consequential’ type question
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Is the intent of this action free from vested interest or ulterior motives?
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An OPO (Organ Procurement Organization)
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Life Gift
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DCD
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Donation after Cardiac Death
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Risk Factors for Addictive Behavior for the Anesthesia Provider
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Ease of drug availability, prior experimentation with mood altering drugs, job-related stress, respect not equivalent to responsibility, intimate knowledge of the power of drugs, life and death decision making, long working hours, altered sleep patterns associated with call.
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Risk Factors for the Nurse Anesthesia Student
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stress, high expectations of performance, perception of poor performance, financial issues, decreasing time for self//family, lack of coping skills, depression from being overwhelmed by the associated demands.
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Behaviors associated with Chemical Dependency(CD)
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isolates and withdraws, tardiness or absenteeism, unwilling or inability to communicate feelings, mood changes, frequent illness or physical complaint, dishonesty, difficult around others, disappears and disappoints, works long hours, visits at unusual hours and around departmental drug supply.
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Enabling Behaviors of Colleagues
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accepting the CFD’s responsibilities and duties, repressing own feelings, feeling superior about CD colleague, believing they can fix CD behavior, moralizing//judging//blaming, denying condition, protecting the CD from consequences, believing the CD can control use, reasoning with, confronting with generalities, expressing vague demands, failure to follow through on ultimatums.
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Anesthesia Awareness (Unintended Intraoperative Awareness)
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Occurs under general anesthesia when a patient becomes cognizant of some or all events during surgery or a procedure, and has direct recall of those events.
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Abandonment issues for the CRNA
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typically involving walking away from the OR, or making difficult choices in the hospital between patient demands.
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Elements of informed consent in research
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Purpose of the study; foreseeable risks/discomforts to the individuals; potential benefits to the individual or others; confidentiality protection for the individual; compensation plan; contact information for questions regarding the study, participants’ rights and in case of injury; and the conditions to refuse or withdraw without penalty.
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