Week 1 - Course Overview

Front 1

Why do Doctors need to have medical ethics and good palliative care?

Back 1

Because they can be sued for medical malpractice, given licensure discipline, and be prosecuted criminally if they don't.

Front 2

What does Deontologic ethics refer to?

Back 2

Ethical principles that are duty based; it's your duty to do something because it is a good act in itself.

Front 3

What does Utilitarian ethics refer to?

Back 3

Ethical principles that say you should do something because the OUTCOME is good.

Front 4

Another name for Utilitarinism is:

Back 4

Consequentialist

Front 5

What is MORALITY?

Back 5

The norms for conduct

Front 6

What are ETHICS?

Back 6

The PRINCIPLES governing conduct

Front 7

What is a Profession?

Back 7

A Skill that is based on systematic theory and practice.

Front 8

What does it mean to say doctors are SANCTIONED by the community?

Back 8

-Education is controlled by the profession
-Licensure is controlled by the state

Front 9

What does a professional CULTURE consist of?

Back 9

-Values
-Norms
-Symbols

Front 10

Where do physicians derive their ethical influences?

Back 10

From Ethical Codes:
-Patient-doctor
-Doctor-Doctor (AMA)
-Professional society

Front 11

What is a Fiduciary Relationship?

Back 11

One in which the fiduciary (doctor) is extremely loyal to the principle (patient) to whom they owe duty.

Front 12

What are the 3 princples that are inherent to the doctor's fiduciary relationship to the patient?

Back 12

-Best interest
-Non-abandonment
-Financial considerations are irrelevent in decision making

Front 13

What are the 2 LEGAL duties that physicians have to their patients?

Back 13

-Fiduciary relationship
-Confidentiality

Front 14

What are the sources of moral guidance for physicians? (5)

Back 14

-Religion
-Philosophy
-Law
-Role-specific obligations
-Personal moral values

Front 15

What does "role specific obligations" refer to?

Back 15

Holding back a story at a party where someone else might be free to tell it.

Front 16

What are 2 sources of RIGHT ANSWERS for ethical questions in medicine?

Back 16

-People who have that role-specific obligation to provide answers
-the LAW

Front 17

What people are obligated to help you find right ethical answers?

Back 17

-Medical society (AMA)
-Peers
-Board examiners

Front 18

What role does the LAW play in medical ethics?

Back 18

It is the minimal standard that is generally agreed on by all

Front 19

What do we most often look to the law to tell us about ethics?

Back 19

What the RIGHTS of patients and doctors are

Front 20

What CAN'T law do?

Back 20

Mandate Care and Compassion

Front 21

What are 3 major eras that we've seen in the history of medical ethics?

Back 21

1. The age of Paternalism
2. The age of Autonomy
3. The CURRENT era

Front 22

What were the prominent physicians in the age of paternalism?

Back 22

Hippocrates and Percival

Front 23

What 3 things did we see come about with the Age of Autonomy?

Back 23

-Abuses of Experimentation
-Evolution of informed consent
-Role of technology

Front 24

What were two specific abuses of experimentation?

Back 24

-Nuremberg - euthanasia research in nazi concentration camps
-Tuskegee - syphilis study in untreated african americans

Front 25

What are the 3 main things we're seeing NOW in the current era of medical ethics?

Back 25

-Rising healthcare costs
-Cost containment
-Divided allegiances and Conflicts of Interest

Front 26

What are 2 broad categories of medical ethics?

Back 26

-Those that are 'settled'
-Those that are still controversial

Front 27

What are some Settled Medical Ethics?

Back 27

-Patient autonomy for those who are decisional
-Truth telling
-Informed consent
-Confidentiality
-Fiduciary duty
-Limitation of treatment at end of life

Front 28

What are some still Controversial Medical Ethics?

Back 28

-Futility
-End of life issues
-Fetal/maternal issues
-PAS

Front 29

What are the 6 main Frameworks for solving Medical Ethical problems?

Back 29

1. Principlism
2. Casuistry
3. Virtue
4. Ethics of Care/Compassion
5. Narrative
6. Communitarianism

Front 30

What is the Principalism framework?

Back 30

Looking to the PRINCIPLES of ethics to answer ethical questions

Front 31

What ARE the 4 main medical ethical principles?

Back 31

1. Beneficence
2. Nonmalificence
3. Autonomy
4. Justice

Front 32

What is Beneficence?

Back 32

Making medical decisions that are the best for the patient, without regard to personal gain or the interests of others.

Front 33

What is Nonmalificence?

Back 33

Do no harm

Front 34

What is Autonomy?

Back 34

Patient self determination

Front 35

What is Justice?

Back 35

Fair distribution of resources

Front 36

What is Veracity?

Back 36

Telling the truth

Front 37

What is Confidentiality?

Back 37

Keeping confidences

Front 38

What is Fidelity?

Back 38

Keeping promises

Front 39

What is involved in the Casuistry framework for ethical problem solving?

Back 39

Looking at Cases and reasoning from them

Front 40

What are the 4 main things you should look at in the Casuist approach?

Back 40

-Medical facts and indications
-Patient preferences
-Proportionality
-Contextual features

Front 41

What needs to be determined in looking at patient preferences?

Back 41

Whether the patient is decisional or nondecisional

Front 42

What needs to be decided if the patient is nondecisional?

Back 42

Whether to simply act in their best interest, or use substituted judgment

Front 43

What does Proportionality refer to?

Back 43

Weighing the Benefits and Burdens with regard to patient's quality of life

Front 44

What is the gist of the Virtue framework of ethical problem solving?

Back 44

"I'm not the kind of physician who does that"

Front 45

What is the basis of the Care and Compassion framework of ethical problem solving?

Back 45

Physicians have an obligation to ameliorate suffering

Front 46

What is the Narrative framework of ethical problem solving?

Back 46

Listening to the story of the patient and using humanities in medicine to further its goals of professionalism, communication, empathy and reflection..

Front 47

What is the Communitarianism framework of ethical problem solving?

Back 47

Looking at the responsibility of the individual to the community, rather than just on patient autonomy.

Front 48

What is a good example of Communitarianism?

Back 48

Quarantine laws

Front 49

What are Ethics Committees?

Back 49

Interdisciplinary groups of medical personnel

Front 50

What is the JCAHO requirement for ethics committees?

Back 50

They are needed as a mechanism for resolution of ethical problems

Front 51

What are 3 functions of ethics committees?

Back 51

-Education
-Policy formation
-Case consultation

Front 52

Who can do ethics consults?

Back 52

-Full ethics committees
-Ethics consultants
-Ethics consultation teams

Front 53

What is required for Medical Research to be ethical?

Back 53

Informed consent

Front 54

What are the objects of medical research called?

Back 54

Subjects (not patients)

Front 55

What is needed for most medically funded research?

Back 55

an IRB