Ethics and Types of Case Studies

Question 1

Are advanced directives and advanced statements legally binding?

Answer 1

advanced directives- are legally binding
Advanced statements- (s-softer)- are not legally binding

Question 2

What is an Advanced Directive

Answer 2

This is a document made when they have capacity. This outlines the preferences patients have in respect to medical treatment when they no longer have the capacity.

• these are legally binding

(examples- refusing CPR, ventilation, antibiotics for an infection that all prolongs dying)

Question 3

What is an Advanced Statement?
(s-softer)

Answer 3

This is a document which outlines a patient’s preferences for when they no longer have capacity. (wishes, beliefs and ethical values)

• These are not legally binding. (’softer’ type decision)

(*examples- wanting only vegan food, halal meals due to religion, to be washed and cared for by only females)

Question 4

What type of study is an Audit?

Answer 4

Systematic Review

Question 5

How is confirmation of a death carried out?

Answer 5

Confirmation of Death:

• no signs of life for 5 minutes
• death in hospital- need X2 qualified doctors, to assess the patient on seperate occasions

Question 6

What clinical signs are assessed when confirming a death?

Answer 6

Examination:

• confirmation of the absence of pupillary light reflex, corneal reflex and of any response to painful stimuli (usually the application of supraorbital pressure).
• confirmation that there is no palpable central pulse and no heart sounds on auscultation for 2 minutes.
• confirmation of chest wall movement and no audible breath sounds for 2 minutes.

Question 7

What are the the DVLA driving rules for patients having a schizophrenic episode?

Answer 7

Schizophrenia: must not drive during acute illness and must notify the DVLA, cannot drive until have been stable and well for >3 months

Question 8

What are the rules around HIV, where a patient to refuses to tell their contact partners?

Answer 8

HIV- you are required to break patient confidentiality if they refuse to notify their contacts. As this is a serious communicable disease if left untreated.

Question 9

What is Selection Bias?

Answer 9

• error in assigning individuals to group which may influence the outcome (e.g study on chlamydia prevalence only analysing student population, not a representation of the general population)

Question 10

What is the Hawthorne Effect?

Answer 10

this describes a group changing its behaviour due to knowing it is being studied

Question 11

What is a Randomised Control Trial?

Answer 11

al- participants are randomly allocated to an intervention or to be the control group. (e.g one patient gets new medication other gets placebo)

Question 12

What is a Cohort Study?

Answer 12

(observational and prospective) group of individuals share a similar characteristic or experience, to measure the future outcome (e.g group of smokers to see how many develop lung cancer in the future)

Question 13

What is a Case Control Study?

Answer 13

Patients with a particular condition data in analysed into the past to see if a past exposure caused it. (e.g patients with mesothelioma, see if they exposed to it in their work)

Question 14

What is a Cross Sectional Study?

Answer 14

• ‘snapshot’ this is at one moment of time information is collected. (e.g survey in a supermarket for one day)

Question 15

What are Retrospective and Prospective Studies?

Answer 15

• Retrospective- looking back in time to analyse outcomes which have occurred.
• Prospective Study- watches for outcomes such as the development of a disease in the future