Unit 4 - Masters Concepts

Front 1

What does informed consent legally require

Back 1

1. Discussion of pertinent information
2. Patient's agreement to the plan of care
3. Freedom from coercian

Pts must understand the risks, benefits, and alternatives including no intervention

Front 2

Exceptions to informed consent

Back 2

1. Pt lacks decision making capacity or is legally incompetent
2. Implied consent in an emergency
3. Therapeutic privilege - witholding information when disclosure would harm the patient or undermine informed decision making capacity
4. Waiver - patient waives the right of informed consent

Front 3

Consnt for minors

Back 3

Parental consent must be obtained unless minor is emancipated (married, self supporting, has children or is in the military)

Front 4

You are preparing a clinical trial of different doses of Drug X. Drug X has already been proven to be clinically effective and is approved by the FDA for clinical use. You are only studying whether a higher dose of Drug X will lead to enhanced benefit. Is informed consent required?

Back 4

Yes, always

Front 5

A infectious disease specialist is asked to be a clinician member of a local pharmaceutical company’s IRB. What would be her primary role?

Back 5

Ensure humane tx of participants

Front 6

Discuss the prohibitions of the Genetic Information Nondiscrimination Act.

Back 6

Health insurers cannot use genetic information to determine eligibility or premiums.
Employers or prospective employers cannot use genetic information for hiring, job assignment, promotion or firing decisions.
Health insurers and employers cannot require or request genetic testing.

Front 7

Requirements for appropriate testing:

Back 7

reliable and accurate test;
predictive of presence or absence of disease or condition, i.e. high positive and negative predictive values;
identifying relative and absolute risk of disease;
leading to better outcome for patient.

Front 8

Genetic Screening tests:

Back 8

only if intervention will prevent disease or treatment is more effective when started early in disease. (Personal utility by patient may occur without clinical utility – family planning for example)

Front 9

Assisted Suicide

Back 9

Pt swallows or administers to themselves the lethal dose of drug

Front 10

Active Voluntary Euthanasia

Back 10

Physician a lethal dose of medication; both supplies the lethal agent and is the final human agent in events leading to the pts death

Front 11

Passive Euthanasia

Back 11

Witholding or discontinuing tx to all pt to die

Front 12

A 23 yo man was caught up in a mob and crushed 3 weeks ago. He currently is nonresponsive to oral commands but sleeps and wakes (having his eyes open and blinking) and occasionally grunts. What is his LOC status

Back 12

Vegetative State

Front 13

Vegetative Functions

Back 13

Breathing, circulation; wake/sleep cycles

Front 14

Minimally Conscious State

Back 14

some awareness, potentially responsive

Front 15

Persistent Vegetative State

Back 15

unresponsive but wakeful, at least 1 month duration

Front 16

coma

Back 16

unresponsive, not wakeful

Front 17

brain dead

Back 17

neither cortical nor brainstem function

Front 18

vegetative state

Back 18

unresponsive but wakeful

Front 19

Determination of death

Back 19

Cessation of breathing and circulation

Front 20

A 47 yo woman suffered hypoxia during a swimming accident. She is nonresponsive, requires artificial ventilation. She has spinal reflexes and maintains a heart beat without artificial means.

Back 20

Brain dead

Front 21

Durable power of attorney

Back 21

Pt designated surrogate to make medical decisions in the event that he/she loses decision making capacity. Pt may also specify decision sin clinical situations. Surrogate retains power unless revoked by patient. More flexible than a living will.