[10.30a] Ethics in the Practice of Psychiatry & Insanity (Part 1) V2.pdf

Widely shared social conventions about right and wrong

What are the social conventions that form a stable consensus in all moral communities?

False

True or False: Morality differs significantly from one culture to another according to the source.

Respecting religious beliefs and not killing

Name two universal moral standards mentioned in the source.

Equality, Human Dignity, and Freedom of Religion

List three human rights from the Universal Declaration mentioned in the morality section.

Ethos

Which Greek word refers to the distinguishing character, sentiment, or moral nature of a person?

Ethics

Which term covers a narrower range of conduct compared to morality?

Standards of conduct for common dilemmas

How does the source define ethics for specific groups like doctors or businessmen?

Psychiatric Ethics

Which specific branch of ethics deals with problems like involuntary admission and confidentiality?

Mental Health Act

Which act provided standards for practitioners to protect patients from arbitrary admission by relatives?

Legal but not moral

A physician s actions can be ethical but not necessarily legal, or what else?

Forensic Psychiatry

Which field of psychiatry deals with the intersection of crime and courts of law?

Equal

What is the relative hierarchy of the four basic bioethics principles?

Conscience and values

Ultimately, ethical decision-making depends on the determination of what two internal factors?

Beneficence

Which principle is defined as doing what is best for the patient?

Bonum and facere

What are the Latin roots for the term beneficence?

Non-maleficence

Which principle involves not doing harm to the patient?

Primum non nocere

What is the famous Latin phrase for non-maleficence?

Inflicting necessary pain for surgery

Give an example where non-maleficence allows for harm to achieve a therapeutic end.

Non and malum

What are the Latin roots for non-maleficence?

Autonomy

Which principle refers to freedom from external constraint and voluntary decision-making?

Autos and nomos

What are the Greek roots for the term autonomy?

Justice

Which principle requires that people be accorded what is fair, due, or owed?

Equals treated equally and unequals treated unequally

How did Aristotle define justice?

Egalitarian and Utilitarian

What are the two perspectives/strategies of justice mentioned?

Egalitarian strategy

Which strategy emphasizes the equal worth of persons and fair opportunity for all?

Utilitarian strategy

Which strategy focuses on social efficiency and maximal benefit to patients?

Medical utility

Choosing a younger, healthier patient for a kidney transplant over an older one focuses on what type of utility?

Social utility

Choosing a philanthropist over a criminal for a transplant focuses on what type of utility?

Autonomy

The bioethical principle of Justice deals with fairness; which principle deals with respecting decision-making capacity?

Morality

What are widely shared social conventions about right and wrong?

Dedication to competent service with compassion

What is the first responsibility listed in the Principles of Medical Ethics?

Report them

What is a physician s responsibility regarding colleagues who are deficient in character or competence?

Seek changes in the law

What should a physician do if law requirements are contrary to the best interests of the patient?

Safeguard patient confidences

What must a physician do within the constraints of the law regarding patient information?

Throwing instruments at colleagues

What inappropriate behavior by surgeons was mentioned as a violation of professional respect?

Talents of other health professionals

When indicated, a physician should use what to provide appropriate care?

Continued medical education

Patients have a right to the latest treatment options, which is made possible through what physician activity?

Choose whom to serve

In non-emergency situations, what freedom do physicians have regarding their practice?

Strong countertransference

When may a psychiatrist rightfully refuse to see a non-emergency patient?

Boundaries

What term refers to the limits of appropriate behavior in the doctor-patient relationship?

Absence of physical contact

What is the primary boundary regarding physical touch in psychiatry?

Confidentiality, circumscribed appointment length, and asymmetry of self-disclosure

Name three structural boundaries mentioned in psychiatry.

Asymmetry of self-disclosure

What boundary is violated when a psychiatrist overshares personal issues during a session?

Declining lavish gifts

What is the boundary regarding the acceptance of houses or luxury cars from patients?

Dr. Baltazar Reyes

Which Father of Philippine Psychiatry famously declined a house in Urdaneta Village?

Clinics

Where should patients be seen to maintain professional boundaries?

Patient becomes a benefactor

How does accepting a lavish gift alter the character of the doctor-patient relationship?

Conflict of interest

What is created when a doctor feels the need to please a patient because of a gift?

NEVER

Under current guidelines, when is a sexual relationship with a patient acceptable?

Taking advantage of a fiduciary relationship

Why is sex with a patient considered unethical even if the relationship is terminated?

Transference

Recalling a pattern the patient experienced when younger, a sexual relationship is considered a form of what?

Explore the patient s past relationships

How can a doctor benefit the patient if the patient initiates sexual hints?

Business

Asking a patient who is head of the SEC for stock projections is a violation of what type?

Ideological

Spending session time talking about the doctor s own personal beliefs is what type of violation?

Social

Becoming a godparent or ninang for a patient s wedding is what type of violation?

Financial

A patient asking to borrow money from a doctor is what type of violation?

Worst possible care

Treating a patient as a VIP often results in what quality of medical care?

Healthcare workers are too scared to tell them what is necessary

Why might a VIP patient die in a hospital setting?

Conflict of interest

Treating patients as VIPs to earn more money presents what ethical case?

Boundary crossings

What are actions that cross professional limits but are potentially beneficial to the patient?

Cookie

What specific gift might a doctor accept from a schizophrenic patient to develop a relationship?

Histrionic

Which type of patient would a doctor refuse a cookie from because the doctor is cute?

Confidentiality

What is the therapist s responsibility not to release treatment information to third parties?

Privilege

What is the patient s right to prevent disclosure of treatment info in judicial hearings?

Judicial hearings

Practically, when does privilege occur compared to general confidentiality?

Physicians cannot testify against them

What specific court-related right does privilege grant the patient?

Suing the physician

When is privilege automatically waived by the patient?

Right to life

A patient s right to confidentiality ends where the right of another person to what begins?

Suicide or homicide

Information can be released without consent if the patient plans to do what?

HIV status and child abuse

Name two conditions where reporting is mandatory regardless of confidentiality.

Confidentiality endures after death

Does the duty of confidentiality end when the patient dies?

Patient s estate

To whom does the patient s information belong after they pass away?

Beneficence

Which bioethics principle aims to do good and alleviate disease?

Incompetence or impaired physicians

Through what two ways can a patient be mistreated by a doctor?

Consultations and sticking to field of expertise

Name two ways to prevent physician incompetence.

Improve medical knowledge and learn about drug recalls

What are two benefits of attending yearly medical conventions?

Patient is not responding to treatment

When should a physician recommend a consultation with another doctor?

Pride

What should not get in the way of good patient care when recommending a consult?

Identify that she is watching out for their best interest

According to Dr. Go-Chu, why do patients return after a referral?

Keep patient confidentiality

What is the primary requirement when discussing a case with peers for advice?

Adult psychiatrist

What is Dr. Go-Chu s specific field of expertise?

Child or geriatric psychiatrists

To whom would Dr. Go-Chu refer pediatric or geriatric patients?

Hospital manpower is low

When might a specialist be unable to defer a patient outside their expertise?

Dementia

Name one mental illness mentioned that can lead to a physician becoming impaired.

Report them

What is the responsibility of a physician who becomes aware of an impaired colleague?

Physician wellness programs

What protocol exists in hospitals to help involved impaired physicians?

Insanity and Competence to stand trial

What two different things are assessed in the criminal aspect of forensic psychiatry?

Mental state at the time of the crime

What does an insanity assessment look at?

Here and now assessment of the suspect

What does a competence to stand trial assessment look at?

Legal construct

Is insanity a psychiatric diagnosis or a legal construct?

Excuses mentally ill defendants from legal responsibility

What is the function of the insanity construct in law?

Legal case

Insanity is only an issue if there is a what?

Five-year-old child playing with a gun

What example is used to explain why intent is necessary for criminal responsibility?

Actus reus

What Latin term refers to the criminal act itself?

Mens rea

What Latin term refers to a guilty mind or intent?

Wild Beast Test (1723)

Which test required a man to be totally deprived of understanding like an infant or an animal?

Irresistible Impulse Test (1840)

What test was used when Edward Oxford attempted to assassinate Queen Victoria?

Could not resist the impulse

Why was Edward Oxford found not guilty by reason of insanity?

Shape of his head

Besides alcoholism, what physical factor did experts cite for Oxfords lack of impulse control?

Policeman-at-the-elbow test

What is the common name for the Irresistible Impulse Test?