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MT Laws > Bioethics > Flashcards

Bioethics Flashcards

1
Q

ethics focused on moral issues in the field of health care

A

Bioethics

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2
Q

ETHICAL SYSTEMS

A

Deontological ethics
Teleological ethics
Virtue ethics

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3
Q

focused on adherence to independent moral rules or duties

A

Deontological ethics

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4
Q

when you follow your duty, you are behaving morally; when you fail to follow your duty, you are behaving immorally.

A

Deontological ethics

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5
Q

focused on the consequences which any action might have;

A

Teleological ethics

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6
Q

ends justifying the means

A

Teleological ethics

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7
Q

focus on helping people develop good character traits,

such as kindness and generosity, which allow a person to make the correct decisions later in life.

A

Virtue ethics

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8
Q

“___________is defined as practice that reflects the commitment to caring relationships with patients and families and strong ethical values; utilization of specialized knowledge, critical inquiry, and evidence-informed decision making; continuous development of self and others; accountability and responsibility for insightful competent practice; demonstration of a spirit of collaboration and flexibility to optimize service.”

A

Professional practice

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9
Q

“Professional practice is defined as practice that_____ the_____ to____ relationships with patients and families and strong______;

utilization of_____,_______, and______ decision making;

continuous development of_______;

____ and _____for insightful competent practice;

demonstration of a spirit of_____ and _____ to optimize service.”

A

reflects; commitment; caring; ethical values

specialized knowledge; critical inquiry; evidence-informed

self and others

accountability and responsibility

collaboration and flexibility

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10
Q

concerned with the obligations of the doctors and the hospital to the patient along with other health professionals and society.

A

Medical ethics

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11
Q

Ethics in medicine/medical practice

A

Medical ethics

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12
Q

FOUR MAJOR ETHICAL PRINCIPLES

A

Autonomy
Beneficence
Non-maleficence
Justice

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13
Q

The act of respecting the decisions of others

A

AUTONOMY

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14
Q

The basis of informed consent: patient must Understand the procedure and its likelihood of success

A

Autonomy

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15
Q

Free from coercion

A

Autonomy

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16
Q

doing an action that benefits others

A

Beneficence

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17
Q

Intention of doing good for the patient

A

Beneficence

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18
Q

chief objective of health professionals: to help

A

Beneficence

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19
Q

Kung di ka magpakuha dugo mapatay ka

A

No autonomy

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20
Q

Blood extraction for lab test and help in the diagnosis

A

Beneficence
Non- maleficence

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21
Q

avoidance of doing harm to others through commission or omission

A

NON-MALEFICENCE

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22
Q

The ‘do no harm’ principle

A

Non-maleficence

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23
Q

Imbes na vein kuhaan kau artery

A

Non maleficence

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24
Q

Treat all patients equally.

A

JUSTICE

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25
Q

‘Give to each that which is his due’

A

Justice

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26
Q

Gi sigwan kay gi correct ang mali

A

Maleficence

Beneficence

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27
Q

PROBLEMS IN MEDICAL ETHICS

A

IGNORANCE
NEGLIGENCE

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28
Q

•Medical Negligence/Medical Malpracticel

A

NEGLIGENCE

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29
Q

Brachial artery ka nagkuha dugo

A

Wala justice

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30
Q

DNR pero wala kabalo si patient

Most justifiable thing to do?

A

I ingon kay patient

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31
Q

lack of technical or theoretical knowledge in the act of doing work

A

IGNORANCE

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32
Q

examples:
incompetent
no experience
no knowledge of consequence
failure of job execution

A

IGNORANCE

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33
Q

Ignorance examples

A

examples:
incompetent
no experience
no knowledge of consequence
failure of job execution

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34
Q

Dentist mag suture/ diagnose tas nagka problem

A

Ignorance

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35
Q

the failure to observe, for the protection of the interests of another person, that degree of care, precaution, and vigilance which the circumstances justly demand, whereby such other person suffers injury

A

NEGLIGENCE

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36
Q

Negligence

the failure to____, for the protection of the interests of another person, that degree of____,____, and_____ which the circumstances justly demand, whereby such other person suffers injury

A

observe

care, precaution, vigilance

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37
Q

failed to take an action that a reasonable person would do

A

Negligence

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38
Q

did something that a reasonable person would not do

A

Negligence

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39
Q

Doctor na kabalo sa mga bulihaton pero naiwan ang gloves sa loob ng patient

A

Negligence

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40
Q

Failed to double check

A

Negligence

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41
Q

Medical malpractice is under

A

Negligence

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42
Q

‘a particular form of negligence which consists in the failure of a physician or surgeon to apply to his practice of medicine that degree of care and skill which is ordinarily employed by the profession generally, under similar conditions, and in like surrounding circumstances’

A

Medical malpractice

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43
Q

ELEMENTS OF NEGLIGENCE

A

a duty was owed

the duty was not met: breach

Injury or harm was done

failure to meet the duty owed resulted to the injury: proximate cause

44
Q

may be implied from the physician’s affirmative action to diagnose and/or treat a patient, or in his participation in such diagnosis and/or treatment

A

DUTY

45
Q

created when the patient engages the services of the doctor and the doctor agrees to provide care to the patient

A

Duty

46
Q

There must be a professional relationship between the patient and the physician

A

DUTY

47
Q

Nagtalk si sir niel kay doc chessa abt sa iya sakit yas bigla nagsulpot si doc isma

A

Naa nau duty

Why? Cuz maki engage si doc isma

48
Q

Doctors’ arguments: they were just passing by the ER for lunch

These doctors ordered and x-ray, gave medication and recommended care to the patient is already and implied physician-patient relationship.

Hindi kailangan na siya talag ang attending physician.

A

Neglect of Duty

49
Q

breach of the standard of care/improper performance expected of other similarly trained medical professionals acting under the same circumstances

A

BREACH

50
Q

BORROMEO V. FAMILY CARE HOSPITAL

Borromeo’s wife was sent to the hospital for acute appendicitis

Post-op, patient had low blood pressure and was unresponsive to blood transfusion and IV infusion

Patient became restless and pale and then died (hemorrhage due to disseminated intravascular coagulation is the COD)

A

Issue: Is there negligence?
SC verdict: NO MEDICAL MALPRACTICE (the death was due to a medical disorder)
no proof that the doctor fell short of the expected standard required under the circumstances

51
Q

Direcy result of doctors breach

A

Injury

52
Q

testimony of an expert witness
Doctrine of res ipsa loquitur

A

Injury

53
Q

Doctrine of

(‘the thing speaks for itself”):

A

res ipsa loquitur

54
Q

Doctrine of res ipsa loquitur (‘the thing speaks for itself”): if availed, the need for expert witnesses is dispensed with

Obvious na may injury.

It REQUIRES a testimony form expert witness.

A

Injury

55
Q

special knowledge experience and practical training that qualify him/her to explain highly technical medical matters to the Court.

A

EXPERT WITNESS TESTIMONY

56
Q

Ramos v. CA: the expert witness, who is a pulmonologist, not qualified to testify on the field of anesthesiology

A

EXPERT WITNESS TESTIMONY

Dapat anesthesiologist

57
Q

Cereno v. CA: The Court excluded the testimony of an expert witness whose specialty was anesthesiology, and concluded that an anesthesiologist cannot be considered an expert in the field of surgery or even in surgical practices and diagnosis.

A

Expert witness testimony

Dapat surgeon

58
Q

allows the mere existence of an injury to justify a presumption of negligence on the part of the person who controls the instrument causing the injury

A

RES IPSA LOQUITUR

59
Q

RES IPSA LOQUITUR elements

A
  1. The accident is of a kind which ordinarily does not occur in the absence of someone’s negligence;
  2. It is caused by an instrumentality within the exclusive control of the defendant or defendants;
  3. The possibility of contributing conduct would make the plaintiff responsible is eliminated.
60
Q

CANTRE V. GO
Injury in left arm of a woman after giving birth

Wound was caused by constant taking of blood pressure: forgot to deflate the BP cuff after use

Wound is not an ordinary occurrence after childbirth Sphygmomanometer is under the supervision of the physician
Wound was outside the control of the mother

A

Res ipsa loquitor

61
Q

Gloves naiwan and nah cause injury

A

Res ipsa loquitur

62
Q

BATIQUIN V. CA
A piece of a rubber glove was left on the patient’s uterus after giving birth

Patient became feverish, pale, and breathing fast plus with an infection in the abdominal cavity

After another surgery, the ovaries were infected and had to be removed

A

Res ipsa loquitur

63
Q

• Objects left in the patient’s body at the time of surgery
• Sponge left in abdomen (Armstrong v. Wallace)
• Broken needle left in the abdomen during cholecystectomy (Hohenthal v.
Smith)
• Rubber drain left in the breast (Evan v. Munro)

A

RES IPSA LOQUITUR IN AMERICAN
JURISPRUDENCE

64
Q

Injury to a healthy part of the body
• Fracture of the maxilla and knocked-out tooth during tonsillectomy (Brown v. Shortilledge)

• Child’s uvula removed during tonsillectomy (Thomsen v. Burgeson)

A

RES IPSA LOQUITUR IN AMERICAN
JURISPRUDENCE

65
Q

• Infection from unsterilized instruments

• Gonorrhea (Helland v. Brindestine)

• Fatal abscess following dental extraction (Barham v. Biding)

A

RES IPSA LOOUITUR IN AMERICAN
JURISPRUDENCE

66
Q

Removal of the wrong part of the body when another part was intended: removal of the wrong tooth (Griffin v. Norman)

A

RES IPSA LOOUITUR IN AMERICAN
JURISPRUDENCE

67
Q

(TAHBSO).

A

Total
Abdominal
Hysterectomy and
Bilateral
Salpingo-
Oophorectomy

68
Q

‘the cause which produces the injury and without which the result would not have occurred’

A

PROXIMATE CAUSE

69
Q

The breach committed by the physician is the direct cause of your injury.

A

Proximate cause

70
Q

Issue: Whether the proximate cause of the deaths was the overturning of the bus or the fire that burned the bus

A

The proximate cause is the overturning

Dili man mangadto ang mga rescuers carrying a light torch kung wala nag overturn ang bus in the first place.

71
Q

the operating surgeon is the person in complete charge of the surgery room and all personnel connected with the
oneration

A

CAPTAIN OF THE SHIP DOCTRINE

72
Q

Kung kinsa ang captain of the ship, masali gid sila if may kaso

A

CAPTAIN OF THE SHIP DOCTRINE

73
Q

PROFESSIONAL SERVICES INC. V. AGANA
patient was rushed to the hospital wherein a doctor diagnosed her to be suffering from cancer of the sigmoid and the cancer has spread to the ovary
Surgeon performed anterior resection and hysterectomy
decided to close the incision despite the fact that the attending nurses informed him that there were missing gauzes
Patient complained of pain in the anal region and 2 pieces of
gauze were extracted from her vagina
The surgeon was held liable

A

Captain of the ship doctrine

Maski wala sala si surgeon, kay kasali gyapon siya kay siya naga lead

74
Q

An act of voluntary agreement between two parties

A

CONSENT

75
Q

CONSENT (2)

A

IMPLIED CONSENT
EXPRESSED CONSENT

76
Q

Written or oral

A

Expressed consent

77
Q

‘Every human being of adult years and sound mind has a right to determine what shall be done with his own body; and a surgeon who performs an operation without the patient’s consent commits an assault, for which he is liable in damages.

A

THE DOCTRINE OF INFORMED CONSENT

78
Q

This is true, except in cases of medical emergency, where the patient is unconscious, and where it is necessarv to operate before consent can be obtained!

(Schloendorff vs. Society of New York Hospitals)

A

THE DOCTRINE OF INFORMED CONSENT

79
Q

“the patient’s right of self-decision can only be effectively exercised if the patient possesses adequate information to enable him in making an intelligent choice” (Li v. Spouses Soliman)

A

THE DOCTRINE OF INFORMED CONSENT

80
Q

“the scope of disclosure is premised on the fact that patients ordinarilv are persons unlearned in the medical sciences”
(Li v. Spouses Soliman)

A

THE DOCTRINE OF INFORMED CONSENT

81
Q

Always inform the procedure to the patients

A

THE DOCTRINE OF INFORMED CONSENT

82
Q

COMPONENTS OF INFORMED CONSENT

A

Disclosure
Capacity
Voluntariness

83
Q

refers to the communication of relevant information by the
clinician and its comprehension by the patient.

A

Disclosure

84
Q

refers to the patient’s ability to understand the information
and to appreciate those consequences of his or her decision that might reasonably be foreseen.

A

Capacity

85
Q

refers to the patient’s right to come to a decision freely, without force, coercion, or manipulation.

A

Voluntariness

86
Q

WHAT SHOULD BE EXPLAINED TO PATIENTS?

A

Nature of the procedure

Risk/s of the procedure

Alternative/s to the procedure

Expected benefits of the procedure

Potential consequences of not doing anything

87
Q

IN CASE THE PATIENT IS INCAPABLE OF GIVING CONSENT…

A

Spouse

Son or daughter of legal age

Either parent

Brother or sister of legal age

Guardian

88
Q

INSTANCES WHEN CONSENT MAY NOT BE NECESSARY

A

In cases of emergency

When the law made it compulsory for everyone to submit to the procedure

89
Q

• “If the patient is unconscious or incapable of giving consent and there is no one who can give consent in his behalf, the physician can perform any medical procedure…without consent.” (Pratt V. Davis)

• “There was valid consent because there had been no time to discuss in full the various risks in such an acute emergency.” (Crouch v. Most)

A

No consent needed

90
Q

Note: If the patient is in full possession of his mental faculties or someone who could act in his behalf is present,_____ must be obtained in spite of the existence of an emergency.

A

consent

91
Q

• People v. Abad Lopez: a father was found guilty of a crime after not presenting his twin children to vaccination

A

When the law made it compulsory for everyone to submit to the procedure

92
Q

Intentionally not disclosing information to a patient or surrogate is legal in situations of emergency or when patients waive their right to be informed

A

INTENTIONAL NONDISCLOSURE

93
Q

if physicians believe “divulging the information would potentially harm a depressed, emotionally drained, or unstable patient”

use of placebos when used properly during experimental research

if the research is relatively risk-free to the participants and when the nature of the research is behavioral or psychological and disclosure might seriously skew the outcomes of the research

A

INTENTIONAL NONDISCLOSURE

94
Q

Autonomy vs. beneficence

A

HOME AGAINST MEDICAL ADVICE (HAMA)

95
Q

A prudent and reasonable physician will not leave the patient at the mercy of a layman’s decision (provide medication plans and follow-up visits)

A

HOME AGAINST MEDICAL ADVICE (HAMA)

96
Q

‘There is no expectation from doctors that they track down each patient who apparently missed their appointments or force them to comply with their directives. After all, a person is still the master of his own body.’

A

HAMA

97
Q

only allowed in cases if ang patient is prisoner.

Detained or convicted prisoner; with a very contagious disease; mentally-ill

A

PATIENT DETENTION

98
Q

….if the patient cannot pay the hospital or physicians bill, the law provides a remedy for them to pursue, that is, by filing the necessary suit in court for the recovery of such fee or bill’

A

PATIENT DETENTION

99
Q

„.if the patient is prevented from leaving the hospital for
his inability to pay the bill, any person who can act on his behalf can apply in court for the issuance of the writ of habeas corpus’ (MDH vs. Chua)

A

Patient detention

100
Q

Prohibits patient detention on the grounds of non-payment of hospital bills

Requires execution of a promissory note covering the unpaid obligation

HOWEVER.patients in private rooms are NOT covered by this act

A

RA 9439

101
Q

The patient has the right to privacy and protection from unwarranted publicity.

Disclosure of confidential information

A

PATIENT CONFIDENTIALITY

102
Q

Patient condition is in controversy in a court litigation
When public health or safety demands
With patient consent
Patient’s condition is discussed in a scientific forum

A

PATIENT CONFIDENTIALITY

103
Q

Result of the evaluation of the nature and extent of the disease, administration of treatment and
procedures

Itemized bill of the hospital and medical services

Continuing health care requirements following discharge

Medical record

A

RIGHT TO INFORMATION

104
Q

Express complaints and grievances without fear of discrimination

A

RIGHT TO EXPRESS GRIEVANCES

105
Q

Right to refuse medical treatment or procedures which may be contrary to religious beliefs

A

RIGHT TO RELIGIOUS BELIEF

106
Q

No discrimination
Good quality of service

A

RIGHT TO QUALITY CARE AND HUMANE TREATMENT

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