Ethics Study Guide Flashcards
(113 cards)
1
Q
What is autonomy
A
To have self governance or to function independently
2
Q
What is autonomy in healthcare?
A
The right of the patient or research subject to have self-determination.
3
Q
What should patients be told about their condition under autonomy?
A
The truth
4
Q
What should patients be informed about under autonomy?
A
The risks and benefits of treatments.
5
Q
Are patients allowed to refuse treatment even if the best information indicates that treatment would be most beneficial?
A
Yes
6
Q
Autonomy DOES NOT negate _______________
A
Responsibility
7
Q
What is autonomous professional practice granted through?
A
Licensure laws
8
Q
A patient’s right to autonomy should not be permitted at the price of what?
A
The physical therapist’s parallel right of autonomy
9
Q
What is the exception to patient autonomy?
A
Therapeutic exception is the one exception. This occurs when the physician feels it is too harmful for the patient to know the full risk.
10
Q
What is Beneficence?
A
Care that is in the best interest of the patient
11
Q
What is Beneficence the manifestation of?
A
The provider’s fiduciary duty owed to his/her patients.
12
Q
Bringing about a positive good=
A
Beneficence
13
Q
What is nonmaleficence?
A
Doing/intending no harm
14
Q
Can actions harm the patient by commission or omission?
A
Yes
15
Q
What is justice?
A
Equity or fair treatment
16
Q
What is the goal of justice?
A
MAximize fairness to all patients and potential patients.
17
Q
Distributive justice
A
How equitably health care services are distributed at the societal level.
18
Q
What are distributive justice issues? (4)
A
- Universal health care coverage
- Prevention and tax of AIDS
- Rationing healthcare interventions at end of life
- Heroic measures with premature births
19
Q
What is comparative justice?
A
How health care is delivered at the individual level
20
Q
What are 3 issues of comparative justice?
A
- Reimbursements and denial of care involving individual patients
- Disparate treatment of patients on the basis of age, disability, gender, race and ethnicity or religion.
- Tuskegee syphilis study (1932-1972) was a breach of professional ethics.
21
Q
What type of justice is federal law based on?
A
Individual justice
22
Q
What is Veracity?
A
An element of respect for persons
23
Q
What is an acceptable form of deception?
A
Therapeutic privilege
24
Q
What is therapeutic privilege?
A
The practitioner determines the patient would be unable to handle the information given to them
25
What is a dual relationship?
When a professional has more than one role with a patient
26
Fidelity=?
Loyalty
27
Veatch defines fidelity as what?
The patient-caregiver relationship- a special relationship between the patient and caregiver
28
When do problems arise with Fidelity?
When keeping a commitment is not always the best way to produce the best consequences for the patient.
29
According to fiduciary duties where do patient interests lie?
Above all others.
30
The individual of the realm of the RIPS model involves what?
The good of the patient/client
31
According to the realm of the RIPS model the organizational/institutional level relates to what?
Good of the organization, focuses on structures and systems, that facilitate organizational or institutional goal.
32
According to the realm of the RIPS model "societal" is concerned with what?
Common good
33
The individual process: Moral sensitivity
Recognizing, interpreting and framing the ethical situation
34
The individual process: Moral judgement
Right versus wrong actions. Generating options, selecting and applying principles.
35
The individual process: Moral motivation
Priority on ethical values over other values. Professionalism is a primary motivator for ethical behavior.
36
The individual process: Moral courage
Implementing the chosen ethical action, development of a plan
37
The individual process: Moral potency
Includes the decision making that includes moral ownership, courage and self efficacy.
38
Situation: Issue/problem
Important values present
39
Situation: Dilemma
Two alternative courses of action
40
Situation: distress
The right course of action is known but the clinician cannot perform it.
41
Situation: Temptation
Choice between right and wrong
42
Situation: Silence
Values are challenged but no is speaking about this challenge to values.
43
The defining issues test (DIT).The higher the scores the higher the what?
Determines at what level moral judgements are made.
| Moral judgment ability.
44
What is the average DIT score of grad students? PTs in NJ?
Grad students- 60
| PTs in NJ- 40
45
Do gender differences occur in DIT scores?
Only account for .5% variance
46
What is a predictor of ethical decision making skills?
Eduction is a much more powerful predictor than age.
47
What is moral sensitivity?
The awareness of how our actions affect other people
48
Can someone without moral sensitivity act morally? Why or why not?
No, because it doesn't occur to them what they are doing may affect another person.
49
In moral judgement what is the person aware of?
Possible lines of action and how people would be affected by each line of action.
50
How does moral motivation account for evil people?
Some competing value (i.e wealth) compromises ones moral values which replace concern for doing what is right.
51
What is moral character?
| Moral character requires what 5 things?
Knowledge of what is wrong and willingness to take action to correct it.
1. Perseverance
2. Toughness
3. Strength of conviction
4. Courage
5. Ego strength
52
When does moral failure occur?
- When there is a deficiency in any component
- All 4 components (moral sensitivity, moral judgement, moral motivation, moral character) are necessary to take moral action.
53
What are the 4 determinants of Moral behavior?
1. Moral sensitivity
2. Moral judgement
3. Moral motivation
4. Moral character
54
Moral decision making is the interaction between what?
1. Moral sensitivity
2. Moral judgement
3. Moral motivation
4. Moral character
55
What are the 3 steps of moral potency?
1. Recognizing that there is a problem
2. Determining course of action
3. Taking action
56
What is the purpose of the PT code of ethics? (5)
1. Define ethical principles
2. Provide standards of behavior and performance
3. Provide guidance for PTs facing challenges
4. Educate PTs, students, other HCPs, regulators and the public.
5. Establish APTA standards for unethical conduct.
57
Is the code of ethics exhaustive?
No, seek additional help.
58
What is the code of ethics built on? (5)
5 roles
1. PCM
2. Consultation
3. Education
4. Research
5. Administration
59
When is the right of refusal for a patient inviolate?
Right to refuse treatment is inviolate after all reasonable options and consequences of refusal of treatment have been explained
60
Is the right to refuse absolute?
No, courts have decided for compulsory treatment in situations when the life of a third party is at risk if treatment is not provided.
61
What is a factor of prolonging the dying process in the U.S?
Fear of malpractice.
62
In Europe what is the physicians duty in terms of end of life care?
Their duty is to support the patient when there is a reasonable hence for improvement.
63
What is physician assisted suicide?
Making the means available to a patient who is capable of suicide and acts on their own.
64
What is voluntary euthanasia?
Physician makes the means available at the patient's request and serves as the actual agent of death.
65
In the US is Physician assisted suicide or euthanasia permitted?
No.
66
What is the law in Oregon for Physician assisted suicide?
You can be assisted (receive what you need) but you have to administer yourself.
67
Is active euthanasia legal in the U.S?
No.
68
What is the "double effect of pain medication"?
Medications that relieve pain hasten death.
69
___% of physicians responding to anonymous surveys reported secretly taking active steps to hasten a patients death.
37%
70
What drug has a double effect?
Morphine- slows down the respiration until no longer breathing
71
Do hospices explain the double effect to patients families?
Yes
72
What are some arguments that limit the supremacy of autonomy?
1. Not fair to demand that others take specific actions to end one's life.
2. Toward end of life not so cognitively there
3. Can't put someone in a position to do it for you.
73
What are 7 safeguards for Assisted death?
1. Incurable condition
2. All reasonable comfort oriented measures must have been tried.
3. patient must express clear and repeated request to die.
4. Patient must be competent to make decisions
5. Physician assisted death must be carried out in the context of meaningful physician-patient relationship.
6. Consultation from another physician to confirm patients request is rational and voluntary.
7. Clear documentation that the previous steps occurred and there is a system for reporting, reviewing and studying such deaths.
74
What is the "slippery slope" argument against the right to die?
The right to die by advanced directive may be exercised on behalf of an incompetent patient.
75
What did the 1996 U.S court of appeals rule in terms of physician assisted death?
They ruled that patients have the right to physician assisted death
76
What did the Supreme Court rule in 1997 in terms of physician assisted death?
They ruled that the patient does not have "the right" to die.
77
What best describes autonomy?
Self determination
78
What best describes non-maleficence?
Do no harm
79
What best describes beneficence?
Care in the best interest of the patient
80
What is justice?
Fairness
81
What is veracity?
Truthfulness
82
Which principle is informed consent related to?
Autonomy
83
What is the exception to the duty to disclose?
Therapeutic exception/privilege
84
At what level does distributive justice occur?
Societal
85
Why is there such a difference in disclosure of terminal diagnosis between 1961 and 1979
We have treatment options
86
A code of ethics must be what (2)?
Static and dynamic
87
What was unethical in 1935? (3)
1. Develop a PT diagnosis
2. Advertise PT services
3. Dictate the PT intervention to be given
88
Which document governs the ethical conduct of the APTA?
Standards of conduct
89
How many principles are there in the code of ethics?
46
90
What is the primary purpose of the code of ethics? (3)
1. Provide guidance to PTs
2. Educate PTs, students, regulators, the public
3. For the basis of PTs public accountability
91
What is not a role of the PT?
Regulator
92
How do we develop cultural competence?
3 step process:
1. Develop knowledge of your own and other's culture.
2. Willingness to treat others as they wish to be treated.
3. Empathize with/respect individuals with different societal views.
93
What is prejudice?
A positive or negative preconception
94
The US is best at doing something... is part of the concept of?
Ethnocentrism
95
Why do women get paid less than men for doing the same occupation and qualifications?
Sexism
96
What ethical principle is primary in supporting respect for persons?
Autonomy
97
What was Glazer and Rest's work on?
Developing the RIPS model
98
What was Dove's work on?
Ethics and societal expectations
99
Informed consent preserves what 2 things?
1. Autonomy
| 2. Nonmaleficence
100
How does consent work with Emergency care?
It's implied.
101
What are 2 exceptions to duty to disclose?
1. Therapeutic exception
| 2. Waiver- Pt. Does not want to know all of the information... documented.
102
Who developed the RIPS model?
Dolly Swisher
103
Inappropriate sexual behavior is a violation of what ethical principle?
Autonomy
104
What is a power gradient?
A real or perceived advantage one person has over another.
105
Whistleblowing Vs. mandatory reporting
Whistleblowing is telling someone about something wrong like abuse and hoping it gets addressed but not formally reporting it.
106
What are the signs of bullying in the work place?
Repeated mistreatment of one or more employees with a mix of humiliation, intimidation and sabotage of performance.
107
Food and drink vs. Artificial nutrition and hydration?
Food and drink= human care
Artificial nutrition and hydration= clinical treatment (addressing a medical condition)
108
According to research does artificial hydration ease the discomfort of terminal illness?
No, in fact it may heighten discomfort and exacerbate underlying symptoms.
109
Lifecycle ethics: When is it ethical to withhold or withdraw a treatment?
If an intervention is determined to be of more harm than benefit.
110
Lifecycle ethics: Who has the true authority with end of life care?
the patient or legal surrogate
111
U.S vs. Netherlands vs. Germany on "models of dying"
U.S= only withholding and withdrawal of treatment
Netherlands= permits voluntary active euthanasia
Germany= rejects euthanasia but permits non physician assisted suicide
112
What 2 ethical principles but be upheld when prolonging the death process?
1. Beneficence
| 2. Nonmaleficence
113
What is futility?
Continuing treatment when there is no hope of recovery
