Setting the Stage Flashcards

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1
Q

Personal Morals

A

Define one’s personal character

The fabric of who you are

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2
Q

Professional Ethics

A

Social System in which morals are applied
Standards or codes of behavior expected by a group to which one belongs
Rules or principles/ways of thinking that guide actions

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3
Q

What are the first four goals of medicine?

A

Promotion of health/disease prevention
Maintenance/improvement of quality of life
Cure of disease
Prevention of untimely death

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4
Q

What are the second four goals of medicine?

A

Improvement of functional status/maintenance of compromised status
Education/counseling regarding condition/prognosis
Avoidance of harm to patient in course of care
Providing relief and support near time of death

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5
Q

Classify these as either Medical, Ethical, or Legal questions: Should we? Do we have to? Can we? Are we prohibited from?

A

Should we? (Ethical)
Do we have to? (Legal)
Can we? (Medical)
Are we prohibited from? (Legal)

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6
Q

Codes of Ethics

A

Professional Organizations

Summarize principles and behavior expected by all members of a discipline

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7
Q

Osteopathic Pledge of Commitment

A

I pledge to:
Provide compassionate, quality care to my patients;
Partner with them to promote health;
Display integrity and professionalism throughout my career;
Advance the philosophy, practice and science of osteopathic medicine;
Continue life-long learning;
Support my profession with loyalty in action, word and deed;
Live each day as an example of what an osteopathic physician should be.

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8
Q

AMA Physician Charter: Fundamental Principles

A

Primacy of patient welfare
Patient autonomy
Social justice

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9
Q

AMA Physician Charter: Professional Responsibilities/Commitment to

A
Professional competence
Honesty with patients
Maintaining appropriate relations with patients
Improving quality of care
Improving access to care
Just distribution of finite resources
Scientific knowledge
Maintaining trust by managing conflicts of interest
Professional responsibilities
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10
Q

What are the main sources of Ethical Conflict?

A

Different:

Facts, Values, Emotions, Reasoning, Loyalties, Perceptions

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11
Q

Different Reasoning examples

A

Consequences

Liability

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12
Q

Different Loyalties examples

A

Patient
Institution
Society

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13
Q

Different Values examples

A

Culture

Religion

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14
Q

Virtue Ethics

A

Oldest/most durable theory of ethics (~4000 years old)
Moral norms govern right action
Emphasizes the agent who performs the action

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15
Q

Virtue

A

Character trait which disposes habitually to excellence in intent and performance
“Don’t even have to think about it”

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16
Q

What is the current ethical trend?

A

To link Virtue Theory with Four Principles

17
Q

What are the 8 Virtues?

A
Prudence-Wisdom
Justice
Fortitude
Temperance
Fidelity to Trust
Compassion
Integrity
Effacement of self-interest
18
Q

Cardinal Virtues

A

Prudence-Wisdom
Justice
Fortitude
Temperance

Cardinals “Just Play during Freezing Temperatures”

19
Q

Prudence-Wisdom

A

Practical wisdom
Aritstotle, “Possessing moral insight”
Capacity to make the right decision, at the right time, for the right reasons
BOTH AND rather than EITHER OR

20
Q

Justice

A

Only one that is both a Virtue and Principle
Strict habit of rendering what is due others
Challenge for clinicians, as emphasis is not on individual patient
Focus on pattern of distribution of the good

21
Q

Fortitude

A

Sustained moral courage
Resisting temptation to diminish patient good through self-fear/social or bureaucratic pressure
Being an advocate for patients

22
Q

“Never practice medicine out of fear” (Which virtue)

A

Fortitude quote

23
Q

Temperance

A

Is a victory over desire
Greatest temptations in society are excesses of all sorts
Plato, “Doing good in one’s business or affairs”

24
Q

Fidelity to Trust

A

Finding out who patient is and how they want to meet challenges of illness, disability, and death
Most serious outcome of erosion of trust is emergence of an ethic of distrust

25
Q

Compassion

A

Cognitive aspect of healing to fit the UNIQUE predicament of patient
Idea of CO-SUFFERING
Most widespread criticism of medicine

26
Q

Integrity

A

Integration of all the virtues into a whole and prudentially judge the relative importance in each situation of principles, rules, guidelines, precepts, and the other virtues in reaching a decision to act

27
Q

Intellectual Integrity

A

Know what you know and admit what you do not know

28
Q

Effacement of Self-Interest

A

One of the least popular virtues in medicine

Tremendous narcissism of our age makes it difficult for many to put the needs of others first

29
Q

What are the two basic approaches to solving ethical problems?

A
  1. Ethics of Care (Virtue Ethics)

2. Principle-Based Ethics

30
Q

Ethics of Care (Virtue Ethics)

A

Applications of the Virtues
Clinicians hold THEMSELVES ACCOUNTABLE for well-being of patient
Emphasis is on QUALITY CARE as a moral obligation

31
Q

Principle-Based Ethics

A
  1. Beneficence (positive actions; need not always be followed; “healing, make whole again, benefit patient”)
  2. Nonmaleficence (negative prohibitions of actions; MUST be followed; avoid harm)
  3. Autonomy (self-determination; informed consent; patient empowerment to make decision)
  4. Justice (Obligation to be fair)
32
Q

Principle-based Drive Analysis

A

Rational, analytic, problem-solving focus
No general conception of the good on individuals
Focus on ACTION
Central Question: “What am I Obligated to do?”
Reduces ethics to QUANDARIES or DILEMMAS
More LEGALISTIC FRAMEWORK

33
Q

Four ways to evaluate Ethical Problems

A
  1. Medical Indications (good ethic decisions always begin with good information)
  2. Patient preferences
  3. Quality of Life
  4. Contextual features