Lecture 1- Medical Ethics Flashcards
(39 cards)
Define: Clinical ethics
a practical discipline that provides a structured approach for identifying, analyzing, and resolving ethical issues in clinical med
What four topics should EVERY clinical case be analyzed?
a. medical indications
b. patient preferences
c. quality of life
d. contextual features, defined as the social, economic, legal, and administrative context in which cases occur.
Define Medical Indications
the diagnostic and therapeutic interventions that are appropriate to treat the problem
Define: Clinical Judgment
The process by which discerning clinicians, faced with clinical uncertainty attempt to make consistently good decisions. The “art of medicine.
Medical status includes what 5 things?
a. Nature of the dz
b. Prognosis
c. Treated or not
d. Tx alternatives
e. Goals of the intervention
What Four ethical issues that depend heavily on the indications for or against medical interventions?
a. Medical futility
b. CPR and do not resuscitate
c. Good care of the dying
d. The definition of death
Define: Patient preferences
In all med. tx the pt’s preferences that are based on the pt’s own values and personal assessment of benefits and burdens are ethically relevant.
What are the 8 Patient Preferences?
a. What does the pt want?
b. What are the pt’s goals?
c. Has the pt been provided enough info?
d. Does the pt comprehend?
e. Is the pt consenting voluntarily?
f. Is the pt coerced?
g. If not, who has the authority to make decisions?
h. What is to be done if no surrogate can be found?
Define: Quality of Life
The goal of medical intervention is to restore, maintain, or improve the quality of life.
Define: Contextual Features
Deals with social, legal, economic, and institutional circumstances in which a particular case of pt care occurs. Contextual factors, such as costs and reorganization of health care, have created conflicts of interest for clinicians.
The context of care is related to the clinical case in at least these 2 ways:
- It establishes the limits and conditions in which decisions take place.
- It is itself influenced by decisions made by and about the pt.
Define: Justice
Justice concerns the fair and equitable distribution of burdens and benefits to the participants in social institutions
Define: Loyalty and the Multiple Responsibilities of Physicians
Loyalty is a sustained commitment to the welfare of persons or to the success of an endeavor, requiring an investment of effort and sometimes even a subordination of self-interest.
Define: Allegiance and Advocacy
Clinicians owe allegiance to their pts, that is they must respect their pt’s preferences and privacy and respond to their health and informational needs. This allegiance is an expression of loyalty.
Define: Fiduciary Duty
A fiduciary owes undivided loyalty to those served and must work for their benefit. Fiduciaries must avoid financial conflicts of interest that could prejudice their clients’ interests.
Define: Conflict of Interest
Often used to describe a situation in which a person might be motivated to perform actions that his or her professional role makes possible but that are at variance with the acknowledged duties of that role.
Define: Role of Interested Parties
The primary interested parties in a clinical relationship are the pt and the clinician.
How does the Family, Relatives, and Friends of the Pt fit into the picture?
It is common in family medicine to say “the family is the pt.” This phrase recognizes that in all illness, causal and curative factors can be found in the personal relationships that surround the pt. These other parties may constitute a number of differing roles concerning the pt: providing emotional or living support, providing info, serving as an interpreter of the pt’s values, or paying bills. The moral cooperation of these others should be sought and encouraged, their moral roles and claims must occasionally be sorted out.
What role does the The Family of a Child Pt have?
In peds, families are of central importance. The primary responsibility of parents must be the welfare of their child.
When can Clinician Confidentiality be breached?
Confidential info may be divulged to appropriate persons when a clinician is aware that lack of that info places some identifiable person at high risk of serious harm.
When does Confidentiality and Public Welfare intersect?
Confidentiality must be broken in certain disease or exposure dilemmas where the causative agent or the exposure must be reported to the local Health Department. This is to attempt to protect the general public from such infections as Meningitis or preventing a person with a heart disorder from driving a motorized vehicle. This moral concept also surfaces when an individual tests positive for HIV, the clinician is obligated to ensure that partners of the infected pt are informed.
When are Legal Implications and Confidentiality involved?
Most jurisdictions have statutes requiring clinicians to report cases of certain types, such as STDs, gunshot and knife wounds, and suspected child, partner, and elder abuse. These statutes attempt to protect the general public’s welfare.
Why is Professionalism Important
1) PA’s need Expert knowledge
2) PA’s need to avoid self interest
Define: PROFESSIONALISM
PROFESSIONALISM is the expression of positive values and ideals as care is delivered. Foremost, it involves prioritizing the interests of those being served above one’s own.
