KSUCPM Medical Ethics Exam

nihilists

no moral truths

relativists

ethical theories are relative to culture, religion, etc.

descriptive theories

tells us how things are

normative theories

tells us how things ought to be

Utilitarian thoery

(Mill) most happiness for the most people; results-based

Duty-based theory

(Kant) generalize the act; ask if it was universally done all the time would it be morally right; absolute

virtue ethics

(Aristotle) mean between excess and deficiency; live well in all areas of life

autonomy

self-governance, control your own path

veracity

patient and doctor must tell the truth

beneficence

do good but can't do all good, don't do harm but can't avoid all harm

confidentiality

patients won't trust doctors if they feel like their info was not private

justice

who gets healthcare, how to distribute scarce resources

role fidelity

doctor's role is to provide skilled medical care, provide scientific, treatments, risks, benefits, not to be the moral decision-maker

"Giving Doctors Orders"

medical professionals don't seem professional sometimes

paternalism

someone else has control over your decisions

too much autonomy

can be harmful (futile care, end-of-life care, etc.)

engineering model

simply treat the body and not the person

priestly model

doctor is in charge and has patient's best interest (never question your doctor)

colleagial model

doctor and patient are in it together

contractual model

patient hires the doctor to do a service and tell doctor what to do

standards for disclosure

professional community standard, reasonable patient standard, patient-centered standad

Types of informed consent

written, verbal, implied

types of futility

quantitative (treatment has small chance of helping) or qualitative (benefit is poor)

exceptions to patient confidentiality

suspected child abuse or drug abuse, gun or knife injuries, poison, industrial accidents

HIPAA

legally bind doctors to protect patient confidentiality

AMA code of ethics

put patient care first, report other doctors violating this

formal justice

equals must be treated equal and unequals must be treated unequally

material justice

relevant characteristics and morally relevant criteria used to determine distribution

fair opportunity rule

no person granted or denied benefits based on undeserved advantage or disadvantage

egalitarian theory

equal access (based on John Rawls)

utilitarian theory of justice

justifies government interference in healthcare if it benefits the most people

libertarian theory

personal rights to social and economic liberty; government out of the way

natural life span

anticipate death around 78-82 and provide palliative care after this point

managed care

plans that coordinate care through a primary care physician

types of managed care plans

PPOs

EPOs

HMOs

IPA

Staff Model HMO

biological life

basic state of something as animate (plants and animals)

biographical life

events and circustances that differentiate us from non-human animals and make you unique

three parts of biographical life

social life, intellectual life, biological life

brain death

no brain stem functions remain, all major functions are controlled by machine

PVS

brain stem functions still intact but in a constant state of unconsciuosness

ordinary care

reasonable hope of benefit without excessive cost or pain

extraordinary care

doesn't offer reasonable hope of benefit and is costly or painful

advanced directives

living will, death-with-dignity, right-to-die statutes, durable power of attorney for health

substituted judgement

decision made based on what the patient would have wanted or indicated he or she wanted

passive euthanasia

allowance of a deadly process to proceed without intervention

active euthanasia (physician assisted suicide or aid in dying)

requires actions to speed up death

Death with Dignity Act

Oregon act that gives a patient the right to take their own life

types of pain difficult to relieve

neuropathic pain, episodic pain, sensation of choking/inability to breathe, humiliation, sadness, fear

duty-based argument for and against euthanasia

human dignity and autonomy; human dignity not to kill others and physician commitment to extending life

utilitarian based argument for and against euthanasia

alleviation of pain and suffering, helping families avoid agony of watching a loved one suffer; slippery slope arguments

virtue-based argument for euthanasia

show mercy, compassion, kindness for those suffering

religious based argument against euthanasia

only God/gods can determine when someones life should end

hospice

emphasis on palliative care and patient and family psychological health

steps after medical error

disclosure, apology, offer of compensation, prevention

types of genetic manipulation

testing (predict or diagnose disorder), engineering (DNA altered), selection (traits selected and other eliminated)

Baby K case

court ruling allowed family full autonomy even though it was futile care

Tuomey Healthcare case

hospital fined $39 million for $237 million in fraudulent claims

Karen Quinlan case

court ruled surrogates have legal and moral right to decide for an incompetent patient

Nancy Cruzan case

court ruled patient must decide or provide "clear and convincing" evidence of what patient wants

Terry Schaivo case

motivations of other people involved don't matter legally, only morally

Bartling and Bouvia cases

patient has right to refuse treatment even if not terminally ill

Joseph Sikewicz case

no way to explain treatment to him so he would understand so he wasn't treated

Brittany Maynard case

moved to Oregon to participate in death with dignity act

Behringer v. Medical Center case

surgeons privacy was violated by hospital but hospital was right in revoking his surgery privileges