JMU HTH 423 Dr. Ott Walter Final Exam

Physicians are expected to engage in behaviors that demonstrate _____ and virtue in their actions

excellence

Natural law uses practical ______ as a tool to decide what is good or evil

reason

_______ guarantees 12 weeks of unpaid leave for birth, adoption, foster, medical illness or care of sick family member

FMLA

When a person is ________ to make his/her decisions and his/her wishes are not known, substitute judgment is used in place of full autonomy

not competent

If we take _______ steps to help others, we are practicing beneficence.

positive

When a physician tries to _______ someone into making a decision, it prevents free choice and violates autonomy

coerce

________ is exception confidentiality in healthcare

child abuse/greater good/mental health/elder abuse

When someone receives _______ under the law, it is called procedural justice.

due process

The state of va will pay state employees ____ of 12 weeks under FMLA

8

Texting a friend about a patient, accessing confidential information and leaving confidential information unattended are all examples of _______ of confidentiality

breaches

______ rights reign in the government; ______ rights empower government

In healthcare, people with life threatening emergencies are treated first. This is an example _______ justice based on need

negative, positive, distributive

Ethical ______ introduce order in the way people think about life. They are the foundations of ethical analysis and provide guidance in the decision - making process.

theories

The theory of ethical relativism holds that _____ are relative to the norms of one's culture

ethics

According to Gostin (2001), "ethics _____ public health involves taking a stand for the goals, interventions, and reforms that are most likely to achieve the moral aims of public health."

for/with/in

The ______ identified respect for persons when working with human subjects

belmont report

Bioethics is the study of social, ethical, and ________ issues that arise in biomedicine and biomedical research.

legal

_____________ & equity issues in public health state that governments can try to change lifestyle behavior choices, but ultimately adults have the right to engage in risky behavior as long as they.

health promotion

________ programs are an example of harm prevention programs.

needle exchange

How can healthcare professionals achieve confidentiality for their patients?

professional silence

Match the types of ethics with their example.

Legalizing euthanasia

medical ethics

Sugar tax

public health ethics

Vaccine distribution

public health ethics

Genetic testing

medical ethics

Tuskegee syphilis study

research ethics

Alternative energy sources

environmental ethics

Describe the difference between metaethics and normative ethics

Normative ethics: distinguishing right from wrong (basic)

meta ethics: using case concepts and theories to distinguish right from wrong

You are the obstetrician of a 27-year old single woman referred to you late in her first trimester after a positive pregnancy test. She admits to a history of heroin addiction, with several unsuccessful attempts "get off it" in community-based programs, as well as to currently using. Although buying and using heroin is illegal, she has no criminal record. The heroin use poses developmental risks to the fetus as well as the risk of fetal addiction. You live in a state that defines drug abuse while pregnant as criminal child endangerment with mandatory reporting and mandatory treatment.

Discuss what a deontologist would do in this situation.

- as a deontologist, the individual may not want to treat this individual because they are inflicting harm on their fetus.

- Since drug abuse during pregnancy is considered a criminal child endangerment in your state, the obstetrician will have to put those feelings of anger aside and must report the case and treat the individual.

A 38-year-old patient is 37 weeks pregnant with an uncomplicated pregnancy but is completely miserable. She is experiencing swollen legs, lower back pain, intermittent contractions and fatigue. She is asking to be induced. Explain which ethical principle the physician should consider first?

Nonmaleficence, inducing is not necessary for someone who is uncomfortable and not experiencing any complications. It could be dangerous to induce without a reason to do so.

As part of an international medical partnership, you are assigned to help train Dr. K, a Kenyan physician who is visiting the United States to learn HIV treatment protocols that he can take back to his country to help bolster HIV treatment there. About halfway through his two-month stay, Dr. K tells you in confidence that he does not believe the health care system in Kenya will improve; there is too much government corruption and an incapacitating lack of infrastructure. Instead of returning home, Dr. K hopes to obtain a better job through the United Nations or in Togo so that he can earn more and provide for his family, including his two young children. This is an example of.....

brain drain

What are the five required forms under HIPAA to protect patients' health?

The privacy rule

Patient signature

Release of information

Trading agreement

Contract agreement

Match the ethical theory with the appropriate example.

Authority based

You follow public health experts recommendations to wear a mask to prevent spread of COVID-19

Consequentialism

Lying to a patient before a surgery is okay because it will make them feel better

Deontological

It is wrong to lie to a patient no matter what

Egoism

Obstetricians schedule patients' cesarean sections to match their preferred work hours.

Natural law

A healthcare provider refuses to participate in an abortion procedure because it goes against their religion.

Virtue

As a nurse you try to balance compassion for those who need medical care and for those who are marginalized.

________ is a legal document under which individual entities can be jointly liable for some action on the basis of being part of a shared enterprise

Enterprise liability

______ and ______ are two laws that protect people with living with HIV/AIDS

ADA, HIPAA

Improper and negligent conduct is known as _______

malpractice

The _______ prohibits sex based wage differences between men and women if they are employed int he same place and perform similar jobs

equal pay act (EPA)

______ is responsible for regulating the health and safety conditions of most private and public work environments.

OSHA

_______ is practiced in an attempt to avoid liability in malpractice lawsuits

Defensive medicine

Spinal fusion surgery is an example of _______

ineffective treatment

When an error occurs in medicine what are most families/patients looking for from the providers?

An apology

Health Ethics Committee

develops standards and policies for addressing ethical issues that arise in patient care

Current evidence based decision

Reliance on scientific evidence

current evidence based decision

Physicians need to understand certain rules of research and scientific evidence evaluate and apply medical literature and clinical guidelines

Traditional authority based decision

Medical training and common sense are sufficient to enable physicians to evaluate new tests and treatments

Current evidence based decision

Physicians should use information derived from systematic, reproducible, and unbiased studies to increase their confidence in the true prognosis, efficacy of therapy, and usefulness of diagnostic tests

Traditional authority based decision

Reliance on expert medical opinions

Current evidence based decision

Clinical experience and expertise in a given subject area is sufficient to enable physicians to understand and and apply clinical practice guidelines

Mature minor doctrine

Minors "capable of understanding or appreciating the consequences of the medical procedures" may consent to non-emergency medical procedures based on health care provider's evaluation of the child's: age, maturity, experience, general conduct as an adult, intelligence, training, economic independence, freedom from control of patients

Mandatory reporting laws

in various states that require healthcare workers to report communicable diseases. You also have a duty to report physical, sexual, or emotIonal abuse or neglect to children, older adults, or mentally ill, whether you suspect it or have actual evidence

Questions to never ask during an interview:

How old are you? Are you pregnant? Are you planning on becoming pregnant?

Ways to show respect to the newly dead:

math problem, location of morgue, inconsistent hospital policies, retrieval of newly dead, final disposition of remains

Serious adverse events

any expected or unexpected occurrence related or unrelated to a medical intervention that results in death, a life threatening event, inpatient hospitalization or extension of existing hospitalization or a persistent or significant disability/ incapacity or a congenital anomaly/ birth defect

Preventable adverse events

hospital acquired conditions that result in serious harm to a patient

What is one way to close the gap between consistently knowing the best treatment for patients and providing the best day to day care with the best knowledge?

Insist physicians utilize the treatments supported by the most research

Using antidepressants in children and adolescents is an example of _______

misused treatment

_________ describes the procedures, actions, and processes a healthcare practitioner is permitted to undertake in keeping with the terms of their professional license

Scope of practice

Failure to directly supervise a patient after aquatic therapy while they independently walk besides the pool to sit down is an example of ______

negligence

______ guarantees 12 week of unpaid leave for birth, adoption, foster, medical illness or care of a sick family member

FMLA

The PCORI conducts research and compares _______ interventions to discern which treatments and medical products work best

medical

Improper and negligent conduct is known as _______

malpractice

Study linking autism with the MMR vaccine is an example of ________ and is one reason healthcare providers are hesitant to use evidence baked practice

fraudulent

_______ have guidelines that employers should follow during the employment interview process

EEOC

In a situation where a patient is deemed _______ to make a medical decison, their healthcare proxy is responsibe for making the decision to withdraw treatment

incompetent

Three main sources of stem cells include:

embryonic, adult, cord blood

________ cells have the potential to develop into any organ or tissue in the body

Embryonic stem

Human genome project:

mapping the human DNA sequence

Ethical implications:

Genetic testing: match samples from crime scenes

Genetic information nondiscrimination act: protests based on information gained from genetic testing

Eugenics is the study of how to increase occurrence of desirable characteristics within the human population

Sterilization: some laws required sterilizing patients as mentally ill

Copying cells to create an organism with the same genetic content is cloning

Uniform anatomical gift act:

Allows anyone over 18 to be an organ donor

National organ transplantation act:

registering and matching organs

_______ maintains a computer database of patients waiting for organ transplants

UNOS

______ is federal regulatory law that protects healthcare professionals from discrimination if they refuse to participate in sterilization procedures or abortion due to religious or personal inquiries

Conscious Clause

Ethical issues

Patient bill of rights: patient has right to decide to participate in study

Informed consent: risks involved

ADLS

getting out of bed, toileting, bathing, dressing, eating

IADLS

taking medication, preparing meals, managing finances, chores

provide care that allow as much independence as possible while managing their chronic illness and preserving human dignity

Palliative care programs

killing patient with active means (injecting)

Active euthansia

written statement detailing person's desires if they are no longer able to express informed consent

Living will

designates an individual to make medical decisions for you

Medical power of attorney

kindness that requires action on part of the nurse to benefit others

Beneficence

optimizing quality of life

Palliative care

intentionally letting a patient die by with holding artificial life support

Passive euthansia

health care is given for conditions where it is seen to be curable

Curative care

patient is completely unresponsive

Persistent vegatitive state

painless killing of patient suffering

Euthansia

If a minor does not have a parent or legal guardian, the court will appoint a _______

guardian ad litem

legally binding to help patient make wishes known about end of life issues

Advanced directives (DNR order, living will, power of attorney, and Uniform anatomical gift act)

unexpected catastrophic event or situation that depletes the survival resources and supplies in a relatively short time frame

Disaster

security at airports, boarders, cyberspace, public awareness

Department of homeland security

responding and recovering from disaster responses

FEMA

assists in biological, natural, and chemical related events; researches aftermath to improve response time and provides education on preparedness

CDC

responds to immediate need and relieves suffering when disaster strikes local; activates training volunteers to provide services in variety of disaster situations

American red cross

biases contribute to ignoring warnings and not taking protective action

Ostrich paradox

suggests a plan to address all hazards

Hospital emergency management

requires equal care and preparedness

Social justice