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Principles of HC - 350 > Final Review > Flashcards

Final Review Flashcards

1
Q

Four elements of negligence

A

duty of care, breach of duty, injury/actual damages, causation

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2
Q

Autonomy

A

right to make ones own decisions

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3
Q

Paternalism

A

making decisions for others

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4
Q

Compassion

A

sympathy for another’s suffering

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5
Q

Fairness

A

ability to make judgements free from discrimination

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6
Q

Active euthanasia

A

intentional commission of an act that results in death (lethal dose of meds)

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7
Q

Involuntary euthanasia

A

Decision to terminate life of an incurable person made by someone else

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8
Q

Oregon, Washington, and Vermont…

A

legalized physician-assisted death

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9
Q

Defining death

A

irreversible cessation of all brain functions including the brain stem

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10
Q

Physician-assisted suicide

A

Is an action in which a physician voluntarily aids a patient in bringing about his/her death

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11
Q

Withholding of tx

A

Is a decision not to initiate tx or medical intervention for the pt

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12
Q

Withdraw of tx

A

Is a decision to discontinue tx or medical care

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13
Q

Malpractice

A

negligence of a professional person

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14
Q

Intentional Torts

A

Assault and battery, false imprisonment, defamation of character, invasion of privacy, infliction of mental distress

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15
Q

Fraud billing scam

A

A pharmacist dispensed the generic equivalent of a drug and billed for the higher cost brand name.

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16
Q

Fraud self-referrals

A

Dr. L ordered unnecessary highly expensive lab tests for his patients. Dr. L referred his pts to a private lab, in which he owned 30%

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17
Q

Senate: select committee on ethics

A

Authorized to receive and investigate

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18
Q

Emergency medical tx and Active Labor Act of 1986

A

Is a federal law that requires anyone coming to an emergency department to be stabilized and treated, regardless of their insurance status or ability to pay, but since its enactment in 1986 has remained an unfunded mandate.

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19
Q

Ethics in Pt Referral Act of 1989

A

A fed law, Stark law, prohibits referrals by a physician to a clinical lab in which the physician has a financial investment

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20
Q

Independent contractor

A

Responsible for their own negligent acts

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21
Q

Caregivers Rights

A

Nurse in operating room refuses to participate in an elective abortion

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22
Q

Ethical theories

A

Attempt to introduce order into the way people think about life and action

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23
Q

Consequential ethics

A

Rightness and wrongness of an action is based on the consequences or effects of the action

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24
Q

Non-maleficence

A

-avoid causing harm
-not concerned with improving others
-well-being but with avoiding the infliction of harm

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25
Q

Intrinsic value

A

Something that has value in and of itself

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26
Q

Instrumental value

A

Something that helps to give value to something else

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27
Q

Partial reasoning

A

Involves bias for or against a person based on ones relationship with that person

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28
Q

2 million people die in the US every year…

A

80% in hospitals/LTC, 70% of those decide to forego life-sustaining treatment

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29
Q

Passive euthanasia

A

life saving treatment is withdrawn/withheld, allowing person to die a natural death; treatment recognized as futile.

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30
Q

US Supreme Court, in two unanimous and separate decisions ruled:

A
  1. laws prohibiting assisted suicide are constitutional
  2. laws allowing Dr’s to assist in suicide of their terminally ill pts is constitutional
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31
Q

Development of law

A

tradition, culture, customs, beliefs

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32
Q

Why laws change…

A

political climate, social changes, religious beliefs, and values change

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33
Q

Public laws

A

Relationships between individuals and government

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34
Q

Private laws

A

relationships between individuals

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35
Q

government organization legislative branch

A

enact laws, amends or repeals existing legislation, creates new legislation

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36
Q

Government organization judicial branch

A

resolves legal disputes, supreme court, nations highest court; 8 associate justices and 1 chief justices

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37
Q

Assault

A

deliberate threat, coupled with apparent ability to do physical harm to another. Actual contact not necessary

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38
Q

Battery

A

intentional touching of another’s person in socially impermissible manner without persons consent

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39
Q

Defamation of character

A

Involves communication to someone other than the person defamed that tends to hold that persons reputation up to scorn and ridicule -> slander

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40
Q

Subpoena

A

A legal order requiring the appearance of a person and or the presentation of document to a court or administrative body

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41
Q

Kinds of evidence

A

direct evidence, demonstrative, documentary, exam of witnesses, expert witnesses

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42
Q

Trial procedure

A
  1. closing statement
  2. judges charge to the jury
  3. jury deliberation
  4. damages
  5. appeals
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43
Q

A principle of law

A

no one can lawfully do that which tends to be injurious to public

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44
Q

XIV Amendment: US Constitution

A

citizenship rights and equal protection of the laws and was proposed in response to issues related to former slaves following the American Civil War

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45
Q

Privacy Act of 1974

A

Establishes a code of fair info that governs the collection, maintenance, use and dissemination of info about individuals that is maintained in systems of records by federal agencies.

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46
Q

Agency for HC Research and Quality

A

US government agency that functions as part of the Department of Health and Human Services to support research to help improve the quality of healthcare

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47
Q

Org ethics codes

A

Provides guidelines for behavior that help carry out on org. mission, vision, and values
–help to build trust, increase awareness of ethical issues, guides decision making, encourage staff to seek advice and report misconduct when appropriate.

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48
Q

Respondeat Superior

A

A legal doctrine holding employers liable for wrongful acts of their employees

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49
Q

Prohibiting termination

A

Disability, age, race, creed, color, religion, sex, national origin, pregnancy, feeling of safety complaints with OSHA

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50
Q

Statutory Consent

A

An emergency in most states eliminates the need for consent

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51
Q

Sherman Antitrust Act

A

Was the first federal act that outlawed monopolistic business practices

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52
Q

Quill vs Vacco

A

The supreme court found that neither the assistant suicide ban nor the law permitting pts to refuse medical tx treats anyone differently from anyone else/draws any distinctions between persons

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53
Q

Pt self-determination Act of 1990

A

-pts has right to formulate advance directives
-HC providers receiving federal funds under Medicare need to comply with regulations

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54
Q

Burden of Proof

A

Plantiff is required to show that defendant violated legal duty

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55
Q

AMA Code of Ethics

A

Pts have the moral and legal rights to determine what will be done with their own person

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56
Q

Executive branch: US Office of Government Ethics

A

-OGE exercises leadership in executive branch to prevent conflicts of interest
-Resolves those conflicts of interests
-Fosters high ethical standards for employees
-Strengthens public confidence in government buisness

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57
Q

HR: Common Ethical Issues

A

gifts between employees, conflicting financial interests, remedies for financial conflicts of interest, misuse of position

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58
Q

Substituted judgement

A

form of surrogate decision making where the surrogate attempts to establish what decisions the pt would have made if that pt were competent to do so

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59
Q

Healthcare proxy

A

A doc that allows a person to appoint health care agent to make tx decisions in event they become incompetent and unable to make decisions for themselves

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60
Q

Surrogate Decisions Making

A

An agent who acts on behalf of a pt who lack capacity to participate in a particular decision

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61
Q

Durable power of attorney for healthcare

A

An agent makes health and professional care decisions for the pt in events that pt becomes unable to make their own decisions

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62
Q

Preparation of witnesses

A

The manner of which a witness handles questioning at a deposition or trial is often as important as the facts of the case

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63
Q

Breach of duty

A

Failure to perform an adequate history and physical in the ED, such as, failure to properly diagnose a pt at risk for Ebola and discharging the pt back into the community

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64
Q

Injury/actual damage

A

actual damages must be established

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65
Q

Infliction of mental distress

A

Conduct that is so outrageous that goes beyond bounds tolerated by decent society

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66
Q

Kinds of contracts

A

employment, exclusive, commercial ethics, and non-competitions

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67
Q

Discovery

A

Process of investigating the facts of a case before trial

68
Q

Beneficence

A

-principle of doing good
-demonstrating kindness
-showing compassion
-helping others

69
Q

US judicial code of conduct

A

provides guidance for judges on issues

70
Q

Administrative law

A

public law is issued by administrative agencies to direct enacted laws

71
Q

Virtue ethics

A

focuses on the inherent character of a person rather than on this specific actions he/she performs

72
Q

conscientiousness

A

One who has moral integrity and a strict regard for doing what is considered the right thing to do

73
Q

In re Storar

A

every human of adult years and sound mind has the right to determine what shall be done with his/her own body

74
Q

Discernment

A

Ability to make a good decision without personal biases

75
Q

Standard of care

A

Actual performance of an individual in a given situation will be measured against what a reasonably prudent person would or would not have done

76
Q

Ultra Vires Act

A

Acting beyond its scope for authority

77
Q

AMA Code of Medical Ethics

A

Pt has the right to receive info from physician and to discuss the benefits, risks, and costs of appropriate treatment alternative

78
Q

Futility of tx

A

-physician recognizes that effects of tx will be of no benefit to the pt
-morally, the physician has a duty to inform the pt when there is little likelihood of success
-the determination as to futility of medical care of scientific decisions

79
Q

Common law principles

A

precendent, res judicata, stare decisis

80
Q

Bill of rights

A

amendments to the US constitution were added to protect rights of citizens; freedom of rights, right to keep and bear arms, freedom of speech

81
Q

Advance Directives

A

-pts have a right to make decisions about their healthcare
-with their physicians may agree to a proposed tx choose among offered tx, or say no to tx

82
Q

Negligence

A

Commission or omission of an act that a reasonably prudent person would or would not do under given circumstances

83
Q

Meta-ethics

A

the study of the origin and meaning of ethical concepts

84
Q

Benchmark darling case

A

the court in this case enunciated a “corporate negligence doctrine” under which hospitals have a duty, for example, to provide adequately trained medical and nursing staff

85
Q

Causation

A

Must be a reasonable, close and casual connection between the defendant’s negligent conduct and resulting damages suffered

86
Q

Subpoena duces tecum

A

a written command to bring records, does, or other evidence described in the subpoena to a trial or other investigative proceeding

87
Q

Subpoena an testificandum

A

orders the appearance of a person at a trial or other investigative proceeding to give testimony

88
Q

In re Spring

A

Pts mental impairment and his/her medical prognosis with or without tx must be considered prior to seeking judicial approval to withdraw/withhold tx from an incompetent pt

89
Q

Tort law

A

is a wrong, other than a breach of contract, committed against a person or property for which a court provides a remedy, generally in the form of monetary damages

90
Q

Nonfeasance

A

failure to act when there is a duty to act -> failure to prescribe antibiotics when indicated and respond to emergency call

91
Q

House of Reps Committee of Ethics

A

-Designated to “supervising ethics office” for the House of Reps
-Only standing committee of the House of Reps with its membership divided evenly by party

92
Q

The Non-consequential ethical theory

A

Denies that the consequences of an action are the only criteria for determining the morality of an action

92
Q

Misfeasance

A

improper performance of an act -> wrong sided surgery, leaving an instrument in a pts body

92
Q

Deontology Ethics

A

-“duty based ethics”
-Involves ethical analysis according to a moral code of rules, religious/secular. Deon is derived from the greek work meaning ‘duty’

92
Q

Malfeasence

A

execution of an unlawful/improper act -> performing a partial birth abortion when prohibited by law, performing a procedure without having proper credentials

92
Q

Healthcare Quality Improvement Act

A

A fed law that was enacted to create a national tracking system of physicians with a history of medical malpractice payments or advice. National Practioner Data Bank

93
Q

Applied Ethics

A

the philosophical search (within western philosophy) for right and wrong within controversial scenarios

94
Q

Normative Ethics

A

is prescriptive in that it attempts to determine what moral standards should be followed so that humane behavior and conduct -> euthanasia and abortion

95
Q

Descriptive ethics

A

also known as comparative ethics, is the study of what people believe to be right and wrong and why they believe it

96
Q

Sources of public policy

A

legislation: admin rules, regulations, decisions, judicial decisions, professional code of ethics may contain an expression of public policy

97
Q

Fidelity

A

being true to out commitments and obligations to others

98
Q

Ethical Relativism

A

actions can be considered right and wrong depending on the accepted norms of the society in which they are practiced -> slavery may be considered an acceptable practice in one society and unacceptable in another

99
Q

Sarbanes - Oxley Act of 2002

A

The Sox Act mandated strict reforms to improve financial disclosures from corporation and prevent accounting fraud

100
Q

In re Dinnerstein

A

“no code” orders are valid to prevent the use of artificial resuscitative measures on incompetent terminally ill pts

101
Q

In re Quinlan

A

-constitutional right to privacy protects pt’s right to self-determination
-a state interest does not justify interference with ones right to refuse treatment

102
Q

What form of ethics is globally based vs. individual?

A

Macro ethics while micro ethics focuses on individual

103
Q

Morality ethics

A

is a class of rules held by a society to govern conduct

104
Q

Philosophical ethics

A

Inquiry of ways of life and rules of conduct

105
Q

What are considered virtue ethics

A

freedom, fairness, fidelity

106
Q

What virtue of ethics is the ability to make a good decision without personal bias?

A

discernment

107
Q

Fidelity

A

faithfulness, being true

108
Q

Honesty

A

confidence that a person will act with the right motives

109
Q

Which ethical theory bases right and wrongness on the intention and not the outcome

A

non-consequential ethics

110
Q

Utilitarian ethics

A

greatest good for the greatest number for people, maximizing happiness (form of consequential ethics)

111
Q

Relativism

A

morality is relative to the norms of the culture

112
Q

A decision made for another person that they believe is in their best interest is an example of _______.

A

Paternalism

113
Q

Justice

A

obligation to be fair

114
Q

What is the process of forming conclusions, judgements or inferences?

A

reasonings

115
Q

2 types of reasonings and defintions

A

Partial reasoning - bias for or against an individual based on your relationship
Circular reasoning - an individual that has already made up their mind

116
Q

What legislation allows for individuals to ensure that they are informed of their rights to choose medical care?

A

Pt Self-Determination Act of 1990

117
Q

A case may be brought forward when it is determined that there was harm suffered as a result of being born. What wrongful case can be brought?

A

wrongful life

118
Q

Wrongful conception

A

negligent sterilization/defective contraceptive device

119
Q

Wrongful birth

A

improper sterilization resulting in birth

119
Q

T/F: all states have endorsed the uniform anatomical gift act

A

True

120
Q

T/F: The National Organ Procurement Act allows for sale of organs in the US based on need of individuals

A

False

120
Q

Eugenic Sterilization

A

Sterilization that is involuntary in some classifications on ind

121
Q

What is the primary purpose of HIPAA

A

Secure personal medical information

121
Q

T/F: Elective sterilization is typically voluntary

A

True: 3 different types - elective, voluntary eugenic

121
Q

Voluntary sterilization

A

Therapeutic if life or health jeopardized by pregnancy

122
Q

T/F: The Tuskegee Study of Syphilis was completed in an ethical manor

A

False: African American men were told they was no cure for syphilis and thought they were receiving care but instead involved in untreated investigation

123
Q

What is the term used when an individual is given the authority to act on another’s behalf?

A

Attorney - in - fact - POA
–> establishes authorization

123
Q

T/F: Death with Dignity is present in more than 8 states at the present time

A

True: NJ, OR, WA, MT, VT, CA, DO, HI, NM, ME, DC

123
Q

The FDA was impacted greatly in which of the following?

A

When the Cures Act was passed allowing for biomedical research and enhanced medical product development

124
Q

Surrogate decision maker

A

agent makes decisions based on pts morals and religious beliefs

125
Q

Principal

A

the other person in this scenario giving the authority to another

126
Q

Guardian

A

court declares someone incompetent and appoints guardian

127
Q

Who makes up an ethics committee

A

-multidisciplinary team with persons from within an organization and community
-members that are vetted for their ability to handle conflict

128
Q

T/F: An omission under negligence would be considered administration of a medication to the wrong pt.

A

False

129
Q

T/F: An example of an intentional tort is assault and battery

A

True

130
Q

Assault

A

infringement on mental security of an individual

131
Q

Battery

A

Intention touching and another’s person

132
Q

Which is more severe? manslaughter or murder?

A

murder - unlawful killing of another

133
Q

Burden of Proof in a criminal case must be proven:

A

beyond a reasonable doubt

134
Q

Legislatively imposed time constraints that restrict when legal action must be commenced is termed what?

A

Statute of limitations

135
Q

14th Ammendment

A

State cannot act to deny any person equal protection of law

136
Q

Civil Rights Act

A

-rights ensured by the US population
-rights of people in a free society

137
Q

EMTALA

A

Medicare participating hospitals must provide emergency services

138
Q

Privacy Act of 1974

A

Safeguards individual privacy from misuse of fed records and to give individual access to their own records

139
Q

Ethics in Pt Referral Act of 1989

A

Prohibits Dr’s who have ownership interest of compensation arrangements with clinical lab from referring to that lab

140
Q

False Claims Act

A

Includes civil and criminal components with or without intent

141
Q

A person that has a relationship of trust or confidence with another is called what?

A

Fiduciary

142
Q

What is true of a CEO and what is not?

A

-True: must follow code of ethics, lead org thru day to day operations, appointed by the governing body of the org
-False: lead administrative staff only

143
Q

What is the lowest level of engagement within the profession

A

emergency medical responder

144
Q

Employment at will

A

either employer or employee may terminate

145
Q

Equal Pay Act

A

EST in 1963, addressed wage discrimination based on gender, equal pay for similar work

146
Q

Y/N: can HC providers refuse to participate in medical care or tx?

A

yes

147
Q

T/F: consent can be verbal, written or implied

A

true

148
Q

T/F: a person that is mentally incompetent cannot legally consent to a procedure

A

true

149
Q

What items would be considered a restraint?

A

A seatbelt that a pt cannot remove, a bed rail that runs the length of the side of the bed, a chest harness to allow for upright posture in a chair

150
Q

If its reported that further tx is futile what is known?

A

further tx will not result in improvement - hospice or palliative care

151
Q

Therapy tx billed that was not covered by a therapist, billing items not provided. Would this be considered fraud?

A

yes

152
Q

Governing body of medicaid?

A

CMS - Centers for Medicare and Medicaid Services

153
Q

If a company engaged in an activity that was outside of their scope, what term would best be used to describe this?

A

Ultra vires - means beyond the power

154
Q

Indemnification

A

means to compensate someone for harm or loss

155
Q

Assumption of risk

A

Accepting risk that is known

Principles of HC - 350 (2 decks)

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