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Social/Behavioral > Law and Medicine > Flashcards

Flashcards in Law and Medicine Deck (21):
1

Laws

Statues --> laws
Case law --> decisions from the court rooms

2

Ethics

Professions (oaths)
Best Practices
Local Culture
Personal Values

3

Professional Values

first, do no harm (non-maleficence)
Respect patient (autonomy)
Benefit the patient (beneficence)
Use resources wisely (justice)
Be honest

4

Dr. - Patient Relationship

based in ethics of personal and professional values
- reflects the locus of power
- Paternalistic
- Informative
- deliberative (negotiated)

5

When can you decline treatment?

Scope of practice (legal and ethical)
Clinical Skills (legal and ethical)
Exposure to infection (legal, not ethical)
Torture/Execution (ethical, legal?)
Referral (not legal or ethical to refuse referral)
Reproductive health (ethical and legal)

6

Conscience Clause

legally permit professionals to NOT provide certain medical services, based on MD's personal beliefs
- it is legal, but is it ethical?

7

Proxy or surrogate

person appointed by person as decision maker

8

Guardian or conservator

person appointed by courts as decision maker --> trumps everything else

9

Substituted judgement

decisions based on patient preferences
- many sources of guidance (wills, AD, verbally)

10

Best Interests

decisions based on what is best for patient

11

Responsibility to treat

EMTALA --> legal obligation to treat and get patients stable regardless of what they have done
Good Samaritan --> do what you are trained for, legal exposure if you harm them or walk away

12

Death with Dignity

legal in Oregon, Washington, Montana, Vermont, New Mexico
- self-administered medication
- requested more than used
- balance between autonomy and beneficence
- euthanasia is not legal
Intent and Double Effect

13

Futility

non-beneficial care --> professionals are not obliged to provide care they judge to be non-beneficial
- assessing futility --> Goals of care?
- cost/benefit considerations

14

Foregoing medical interventions

when an intervention is likely to offer little benefit to patient --> facilitated by dr-patient trusting relationship

15

Resolving boundary issues

consultants/committees
courts
landmark cases

16

Ethics committees

consulted when there is a difference in opinion
- findings are advisory --> give info back to Dr. and patient

17

Conflicting interests

doing one thing IMPACTS another
- financial, intellectual
AVOID conflicts and disclose conflicts

18

Competing interest

can arrange to do both

19

Privacy

limited government role
- family decisions, planning
termination of life-sustaining treatment

20

Confidentiality

government is involved
HIPAA
- EXCEPTIONS
public health reporting -> conditions/infections
at risk individuals -> Tarasoff, abuse, genetic conditions
impaired professionals -> goes to medical board
Minors -> sex, mental health, drug/alcohol

21

Legal liability

Risk Management --> best interest of hospital not you
Scope of practice/competence
Informed consent
Negligence --> different than malpractice
Medical Errors --> different ways to deal with it
Harm