Test Ethics and Legal Considerations in Cancer Management, Radiation Safety and Protection Overview, Drug Administration and End-of-Life Care Overview, Radiation Safety and Medical Ethics Overview

Ethics

The customs of ideal behavior that people should follow.

Tort law

Liability and breaches of duty

Personal injury law

Historical Perspective of Medical Ethics

An overview of the evolution of medical ethics through various philosophers and texts.

Hippocratic Oath

An ethical code attributed to Hippocrates, outlining the duties and ethical standards for physicians.

Code of Hammurabi

An ancient Babylonian code of law that includes medical practices and ethical standards.

Plato

A philosopher known for his works on ethics, including 'The Republic'.

Patients' Rights

The entitlements of patients, including the right to life, health care, and informed consent.

Right to life

The most important value in the context of patients' rights.

Right to receive health care

A debated universal right regarding access to medical services.

Right to know

The principle of informed consent in medical ethics.

Principles of Biomedical Ethics

Key ethical principles including autonomy, nonmaleficence, beneficence, veracity, role fidelity, confidentiality, and justice.

Autonomy

Self-determination, which includes intention, understanding, and freedom.

Limits on autonomy

Factors that can restrict autonomy, including harm, offense, paternalism, legal moralism, and necessity.

Nonmaleficence

"To do no harm", a universal principle regardless of occupation.

Beneficence

"To do good", which includes conditions of mandatory action such as education and receiving payment.

Veracity

The ethical principle of telling the truth, which is the basis for informed consent.

Role Fidelity

The obligation to keep promises and maintain loyalty to patients, profession, employer, and self.

Confidentiality

The duty to keep secrets in relationships such as employee-patient, employee-employer, and employee-employee.

Justice

Fairness in the distribution of resources and whether justice means equality.

Teleology

Also known as consequentialism, where "the ends justify the means".

Deontology

Also known as Kantianism, where morality is based on reason and universal principles.

Natural law ethics

An ethical theory developed by Thomas Aquinas.

Virtue Ethics

Also known as character ethics, focusing on the person rather than the action or the consequence.

Four cardinal virtues of symposium

Aka Four high moral standards of symposium

Prudence(tienes que ser prudente/causious), Justice, Fortitude(courage in pain or adversity) Temperance.

William Bennett, The Book of Virtues

Includes virtues such as Self-discipline, Responsibility, Courage, Compassion, Friendship, Loyalty, Faith, Honesty, Perseverance, and Work.

Narrative ethics

Involves the use of paradigm cases.

what Binds all 7 bioethical principles

Confidentiality

Communitarianism

An ethical perspective associated with David Hume.

Ethics of Caring

Also known as feminist ethics, developed by Nel Noddings.

Maternal values

Values emphasized in the reaction to Western, male-dominated ethical theories.

Microethics

Involves scarce resource distribution theories such as Triage, Egalitarian, Entitlement, Fairness, Utilitarian, and Rights theory of justice.

Macroethics

Concerns the types of health care services, their distribution, and financing in society.

Patient-Provider Relationship Models

Defines patient's role and establishes boundaries and expectations.

Factors affecting relationship models

Include Society, Patient condition, and Physician preference.

Engineering model

Practitioner is viewed as a scientist, with patient making all decisions.

Priestly model

Practitioner is viewed as the only authority, making all decisions.

Collegial model

Practitioner is viewed as the patient's colleague, with equal say in decisions.

Paternalism model

A model where the practitioner makes decisions for the patient.

Advantages of Contractual Model

Compensates for flaws in other models; Shares ethical authority and responsibility.

Limitations of Contractual Model

Service is contingent on payment; No long-term commitment.

Agency Model

Similar to engineering model; Professional is a 'hired gun'.

Ideology of Advocacy

Professional is detached from patient's purpose; Professional is advocate for patient.

Problems of Agency Model

Third-party obligations; Immoral.

Paternalism Model

Similar to priestly model; Equates the professional-patient relationship to the parent-child relationship.

Justification of Paternalism Model

Professional has superior knowledge and knows what is best for the patient; Patient will eventually agree.

Limitations of Paternalism Model

Lack of autonomy.

Friendship Model

Similar to collegial model; Based on mutual trust.

Advantages of Friendship Model

Ideal human relationship.

Limitations of Friendship Model

One-way relationship; Lack of commitment.

Fiduciary Model

Recognizes the professional's superior knowledge, while retaining the patient's authority and decision making.

Fiduciary Model Actions

Professional provides various courses of action: Risks/benefits, Recommended best option, Patient consents.

Consent

Most important fundamental patient right.

Implied Consent

When patient can’t consent but consent is implied like giving someone CPR.

Consent Form

Includes: Time frame, Patient's name, 24- to 48-hour waiting period, Procedure, Expiration of consent, Description, Risks/benefits, Side effects, Reasonable alternatives, Signature lines, Date.

Therapist Role

Witness consent (this does not exclusively belong to the therapist; other members of the team may witness patient consent); Ensure consent is signed before starting treatment; Ensure patient understands the procedure.

HIPAA

Health Insurance Portability and Accountability Act of 1996, also known as Kennedy-Kassebaum Act.

Primary purposes of HIPAA

Streamline electronic health care information and ensure integrity, confidentiality, and availability of individually identifiable health information.

Four Major Components of HIPAA

Electronic transactions and code sets standards,

privacy standards,

employer identifier standard,

and security standards.

Electronic Transactions and Code Sets Standards

Standardizes content and format of electronic transactions.

Benefits of Electronic Transactions and Code Sets Standards

Efficiency, quality, and cost.

Limitations of Electronic Transactions and Code Sets Standards

Conversion expense.

Privacy Standards

Control the use of identifiable patient data.

Covered entities vs. business associates

Distinction between those who provide treatment and those who handle patient data.

Required actions for Privacy Standards

Privacy official, notice of privacy practices, acknowledgment form, authorization form, business associate contract, training program, and security safeguards.

Employer Identifier Standard

Adopt a system of unique identifiers for providers and payers.

Security Standards

Preserve the integrity of protected health information through administrative, physical, and technical safeguards.

Treatment of a pregnant patient

0.1% of pregnancies are complicated by cancer.

Dr. Elisabeth Kübler-Ross's stages of grief

Shock, denial, anger, bargaining, depression, testing, acceptance.

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Negative connotation of death

Euphemisms such as 'deceased,' 'expired,' 'passed on,' or 'passed away'.

Life expectancy vs. life span

Life expectancy refers to the average period a person may expect to live, while life span refers to the maximum length of time a human can live.

Causation vs. association

Causation implies a direct cause-effect relationship, while association indicates a correlation without direct causation.

Advance Directives

Decisions concerning future care made by individuals in the event they become incompetent or unable to give or withhold consent.

Patient Self-Determination Act

Requires informing patients about their right to refuse treatment and educating staff and the public.

Limitations of Advance Directives

Less than 20% of Americans have advance directives, additional paperwork, and potential contradiction of later wishes.

Durable power of attorney

Written designation of a person to give or withhold consent for a patient.

Living will

Also known as health care choices directives.

DNR

Do Not Resuscitate order necessary to prevent CPR, with only 15% of CPR attempts being successful.

Hospice

An organization that provides medical care and support services to terminally ill patients and their families.

Services provided by Hospice

Daily access to nursing and home health staff, counseling and spiritual support, and palliative care.

Eligibility for Hospice

Limited life expectancy, home health, and discontinuation of all curative treatments.

Ethical Issues of Hospice

Concerns regarding referral, communication, abandonment, and cost from the perspective of physicians and patients.

Referral

The process of directing a patient to another physician or specialist for further care.

Communication

The exchange of information between physicians and patients regarding care and treatment.

Abandonment

The termination of a physician-patient relationship without proper notice or transfer of care.

Cost

The financial implications associated with medical care and treatment.

Refusal

The act of a patient declining medical treatment or intervention.

Informed consent

The process by which a patient is educated about and agrees to a medical procedure or treatment.

Statutes

Written laws enacted by legislative bodies.

Regulations

Rules made by executive authorities to enforce statutes.

Case law

Law established by the outcome of former court cases.

Criminal law

A system of law concerned with the punishment of those who commit crimes.

Misdemeanor vs. felony

Misdemeanors are less severe offenses than felonies, which are more serious crimes.

Civil law

A system of law concerned with private relations between members of a community.

Tort

A wrongful and/or unreasonable act committed against a person or property.

Intentional torts

Torts that are committed with intent to cause harm.

Liability

The state of being legally obliged and responsible to act or not act.

Assault

An act that causes another person to fear that he or she will be touched in an offensive or harmful manner.

Battery

The actual act of harmful or unwarranted contact with another person.

False Imprisonment

The illegal detention of an individual without consent.

Intentional Infliction of Emotional Distress

Conduct that intentionally or recklessly causes severe emotional distress to another.