Lecture 6-autonomy Flashcards Preview

Bioethics 1-6, 10, 11 > Lecture 6-autonomy > Flashcards

Flashcards in Lecture 6-autonomy Deck (27):

Informed consent requires disclosure

Disclosure involves providing the relevant treatment information to patients


Informed consent requires disclosure
-Acceptable exceptions?

-Therapeutic privilege (Very limited)


Informed consent requires disclosure
-Exceptions-emergency example?

Mass casualty


Informed consent requires disclosure
-Exceptions-Waiver example?

Patient tells you what to do in advance


Informed consent requires disclosure
-Exceptions-Incompetency example?

Unconscious patient


Informed consent requires disclosure
-Exceptions-Therapeutic privilege?

-*Very limited*
-If necessary for decision making, must present serious harm


Informed consent requires voluntariness
-What can constrain voluntariness?

-Voluntariness involves the right a patient has to make treatment decisions free from undue influence
-Internal and external factors constrain voluntariness


Informed consent requires voluntariness
-External factors include?



Informed consent requires voluntariness
-External factors include

-Physical restraint/sedation


Informed consent requires voluntariness
-External factors include

-Implicit/explicit threat
-deliberate distortion of information to influence patient decision making-violates both the 'informed' and 'consent' aspects of informed consent


3 ways autonomy can get messed up?

-Autonomy and actions
-Autonomy and options
-Autonomy and decision making


Autonomy and actions
-Cases in which?

-Cases in which we are influenced by physical force or coercion (institutionalization)
-Example-patient is restrained legally or patients in nursing care facilities


Autonomy and options
-Autonomy requires?

-Autonomy requires that we have genuine options to decide between (access to care, awareness of alternatives)
-Example-patient who does not have adequate healthcare to receive a particular treatment


Autonomy and decision making
-Autonomy requires?

-Autonomy requires that our relevant options be made known to us (disclosure)
-Example-physician does not tell patient about all potential options intentionally


Truth telling and medicine
-Exposes the?

Exposes the pressure point between autonomy and paternalism


Reasonable restrictions on autonomy?

-Harm principle
-Principle of paternalism
-Principle of legal moralism
-Welfare principle


Reasonable restrictions on autonomy
-Harm principle?

Prevention of harm to others


Reasonable restrictions on autonomy
-Principle of paternalism?

Prevention of harm the individual themselves


Reasonable restrictions on autonomy
-Principle of legal moralism?

-The prevention of law breaking including for the punishment of law breaking
-Acceptable to restrict someone's autonomy when they are breaking a law and when they are in jail their autonomy is highly restricted
-Assumption: the function of law is to enforce morality


Reasonable restrictions on autonomy
-Welfare principle

-Benefit to others
-Small restriction of autonomy of one person provides maximum benefit for others
-Example of this would be taxation-restrict income to provide services for everybody
-Assumption-We'd have to give up a negligible amount of autonomy to provide extreme benefit for others


Truth telling and medicine
-When might we want to protect the patient from the truth?

When a patient is extremely emotional


When might a patient want us to protect them from the truth?

Patient says not to tell them the results of a test before they have had a chance to talk to their family


Protective deception does not equal?

-preference for ignorance
-rather, protective deception involves considering whether the disclosure itself would cause suffering (either physical or emotional)


Protective deception does not equal preference for ignorance
-In severe enough cases?

In severe enough cases, such suffering may require the exercise of "therapeutic privilege"


Therapeutic privilege

An uncommon situation whereby a physician may be excused from revealing information to a patient when disclosing the information to the patient would pose a serious psychological threat, so serious a threat as to be medically contraindicated


What circumstances evoke "therapeutic privilege"?



Informed consent requires what 3 things?

Informed consent requires disclosure, voluntariness, and capacity