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50 Cards in this Set

  • Front
  • Back

ethical conduct

standard based on moral principles or practices and matters of social policy involving moral issues

legal conduct

behavior that conforms to written law

What are the 4 "D's" of malpractice

Dereliction


Duty (established patient-doctor relationship)


Damaged- patient injured


Directly- caused by physician negligence

What are compensatory damages?

funds given to reimburse patient for bills/lost salary and for pain/suffering

what are punitive (exemplary) damages?

funds awarded to punish physician/set example. Only in cases of extreme neglegence physician is responsible for payment, malpractice insurance wont cover

What criteria must be met for good samaritan laws to apply?

procedure doctor uses must be standard and accepted by med profession



must be within scope of physicians training



doctor cannot be paid



doctor must remain with patient until another physician takes over patients care



What is an emancipated minor?

under 18, considered competent adults and can make their own medical decisions

What are the 4 criteria that would make a minor eligible to be considered emancipated?

self-supporting or


in military or


married or


having a child that they care for

Who determines if a patient meets the standard for competence if there is doubt/dispute?

a judge

what criteria must be met for involuntary hospitilization?

must be dangerous to self or others or unable to provide self care

can an involuntarily hospitilized patient be forced to undergo treatments or take medication? are there exceptions?

usually no



but if patient is suicidal or psychotic they may be deemed incompetent to make their own medical decisions

what are the 2 requirements for a crime?

evil intent and evil deed

what is mens rea?

evil intent

what is actus reus?

evil act

What are the requirements for informed consent (5)

1. understand health implications of diagnosis


2. understand risk/benifits of procedure


3. understand alternatives to procedure


4. understand likely outcome if they dont have procedure


5. are aware they can withdraw consent at any time.

What is the M'Naghten test?

helps determine if individual understands the nature of their crimes and if they were wrong. is the strictest criteria for legal insanity

what is the durham test

test for legal insanity that evaluates weather a person's behavior is product of mental illness. is most lenient of the tests

Can you compel a 14 year old minor to donate bone marrow to a sick sister?

Yes. But only if the minor is the only possible source, provides no serious long term risk, provides a clear benifit to the sister, and has a reasonable chance of success?

What is an exception to the requirement that parents give consent for treatment for minors?

emergency situations when parents arent there. If they are there and object Physicians can even go around the objections of parents in certain situations, if time allows, attempt to get a court order.



another exception relates to contraceptives, pregnancy testing, STD treatment, treatment for mental illness and care during pregnancy

Generally how should you approach genetic testing for children.

if early intervention improve outcome yes. if early intervention does not improve outcome an it has an adult onset, dont test. if it has a childhood onset it is up to the parents.

What are the criteria for noninitiation of rescuscation

gestation less than 23 weeks


birthweight less than 400g


anencephaly


trisomy 13, 18

When is it appropriate to breach confidentiality

patient is suspected of child/elder abuse


risk of suicide


risk to others/ public safety

What was the outcome of the Tarasoff cases

court ruled that physicians must use clinical judgment to determine ways to protect intended victims when their patients are a potential threat to said victims

What are the reportable diseases? (B A SSSMMART Clam or Chicken)

Hep A,B


Salmonellosis


Shingellosis


Syphillis


Measles


Mumps


AIDS


Rubella


Tuberculosis


Clamydia


Chickenpox

What limitations are placed on a doctor who has or suspects they may have HIV

they shall not engage in behavior that would increase risk of transmission to patients

When can a physician breech confedentiality of an HIV infected patient

when they habitually engage in behaviors that put others at risk for infection. particularly if those individuals are unaware of the patients infection

What is a health care proxy?

DUPA is a legal document which grants a proxy the power to make decisions on their behalf when they are incompetent to do so themselves

what is a living will?

legal document that a competent patient produces that indicates their wishes (medically) should they become incompetent to make medical decisions.

What is the substituted judgement standard?

surrogates have an ethical obligation to guide care "as the patient would have" not as they want

What is the progression of medical surrogates?

Spouse


Adult Children


Parents


Siblings


Other relatives/ friends

When is the best interest standard applied?

when patient's wishes are not known

What are the criteria for brain death

absence of:


response to external stimuli/events


spontaneous respiration


cephalic reflexes


electrical potentials over 2mv from symmetrically placed electrodes 10 cm apart


cerebral blood flow >30m


What is the double effect

giving patient medication that will provide analgesia to terminal patient but also shorten their lives. is an accepted practice

describe utilitarianism

ethical theory based on doing the greatest good for the greatest number of people possible. an example of this is the medicare system and the allocation of organs for donation.

what is a weakness of the utilitarian approach?

hard to quantify all variables


can result in biased allocation of resources


can result in ignoring rights of some to achieve outcome

what is rights based ethics?

places emphisis on individual rights. serves to protect individuals from injury.

what is a weakness of rights based ethics.

can encourage individualistic selfish behavior ie: unions protecting their members but not other people

what is duty based ethics

it is based on absolute moral rules that determine our duty to others. A strength is that there is a mandate for respect and impartiality

what is a weakness of duty based ethics?

hard to determine what the set of rules should be and who determines it

what is justice based ethics?

fair distribution of benefits and burdens. based on the veil of ignorance. this ethic is consistant with the single payer insurance systemn

what is a weakness of justice based ethics?

some say that it is unfair for healthy to subsidize unhealthy

what is virtue based ethics?

based on belief that we have a duty or responsibility to others to be virtuous for their sake and not ulterior motives.

what is a weakness of virtue based ethics

can open one up to being taken advantage of

what is the difference between empathy and sympathy

empathy is understanding without experiencing sympathy is feeling sorry for

what are the steps of the 3-step ethics model

is it legal?


is it balanced?


how does it make me feel?

what are the 4 principles of bioethics?

autonomy


benefecence


nonmalfeasance


justice

what is autonomy?

people have the right to make decisions about their own life

what is the principle of beneficence?

doing good

what is the principle of nonmalfeasance?

primum non nocere (first do no harm)


completes principle of beneficence


do good for patient but also do no (minimal) harm in the process

what is the principle of justice?

equals must be treated equally