bioethics final

united network for organ sharing (UNOS)

legal entity responsible for allocating organs or transplant in the US

If there are two people who need a lung transplant, one is 36, a smoker, and has been waiting 2 years, and the other is 17, a nonsmoker, and has been waiting 4 months, they would determine who would get the organ.

National organ transplant law 1984

law forbidding interstate sale of organs to keep the process quick and local

If there are two people, one 30 minutes away, the other 2 hours away and across state lines, this law would determine that the person closer and in state would get the organ.

Institutional review board

a board of people overseeing research including people with the goal of protecting their rights + well being

Say there is a doctor who is conducting research on a new diet that could help someone who has T2D get their sugars under control. The IRB would ensure that participation is voluntary, they have informed consent, there is no unnecessary risk, and patient confidentiality is protected.

therapeutic research

Research that may directly benefit the research subject

An example would be nutrition therapy. Say there is a study ongoing to help find a diet that lowers the sugar levels of a T2D. If the research is successful and helps the subjects, then it is directly beneficial.

In vitro fertilization

couples with viable gametes have their fertilization occur outside the mothers body.

It is important for medical practioners to know what IVF is because it should be offered to couples who are struggling to conceive. Understanding this process means communicating with them exactly what the process is like and making sure they have informed consent.

Preimplantation genetic diagnosis (PGD)

the process of scanning embryos for genetic abnormalities before uterine transplantation

a couple with a history of colon cancer can screen and use selective reduction to keep only those free of the colon cancer genes.

Therapeutic sterilization

sterilization that occurs because the mothers health is in danger and the treatment to better her health causes sterilization as a side effect.

If a woman has cancer and undergoes chemotherapy and radiation therapy, damage to the ovaries can cause to infertility.

cardiac death

death when the heart stops functioning

Important for a medical practitioner to know because it is a signal to start CPR unless they have a DNR order.

persistent vegetative state (PVS)

a long lasting brain condition where there is a state of deep unconsciousness w/ few responses.

It is important for a medical practitioner to know what this is because it is not uncommon and it can directly effect any treatments plans based on their advance directives. The professional should know how to best advance in this scenario.

active euthanasia

intentional killing of the terminally ill

An example would be a doctor giving a lethal injection to a patient with stage 4 lung cancer.

defensive medicine

a doctor ordering extra tests or treatments to cover their bases and protect from lawsuits

If there is a patient with chest pain and the doctor believes it is a non-cardiac issue, they might order an ECG, chest x-ray, and a CT scan still.

eugenics

sterilization of certain categories of persons with genetic impairments.

an example would be lowering the occurrence of people with epilepsy.

informed consent

a process where patients are given all the risks, alternative treatments, and benefits about a medical treatment or procedure

Say there is a T2D patient who is part of a study testing out different diets to see their effect on the blood sugar. Before the study begins they have been notified of all the possible risks, benefits, and they know the research design and they have signed a consent form.

palliative care

medical care focused on keeping patient comfortable and alleviating symptoms

Palliative care on a patient with COPD would look like providing O2 therapy, physiotherapy, and opioids.

abandonment

physicians have the right to chose which patients to treat but not to drop them once they have accepted them into their care.

Say a physician has a patient with complex symptoms but can’t determine the cause, they could be charged with abandonment for dropping them without formal notice of withdrawal.

noncompliant patient

a patient who doesn’t follow the recommended treatment plan made by their physician

an example would be a lung cancer refusing to quit smoking

malfeasance

a medical professional performing a wrong / illegal act

a nurse prescribing a medication / treatment

direct cause

One of the four D’s of negligence is direct cause, which relates to a medical practitioner haviing directly caused an injury to a patient

an example would be a doctor improperly closing a would causing an infection

morbidity rate

the number of sick people with a specific disease in a population / given location

if 100 people get a rash in a population of 1000 people than the morbidity rate would be 10%

autopsy

a postmorten exam of the organs / tissues to determine cause of death

an example would be if a body came in for autopsy, and it was found that there was a broken hyoid bone, a reasonable conclusion would be that the person was strangled to death.

ethnocentric

thinking your way of seeing / experiencing the world is superior to the ways of other cultures.

an example would be a person from England believing they are better than Americans because their culture is better.

civil rights act

an act prohibiting discrimination in employment based on gender, race, religion, and national origin.

an example of this would be that it is illegal to fire someone for being a woman.

occupational safety + health act (OSHA)

employer required to provide safe working conditions + protect employees from hazards

an example would be that health care facilities must provide PPE for their employees.

electronic health record (EHR)

an electronic version of documentation relating to a patient collaborated on by all providers.

It is important that a medical practitioner knows what a EHR is because keeping accurate medical records is important for patient health and to protect from lawsuits.

Health insurance portability and accountability act (HIPPA)

a law protecting healthcare information regarding privacy and insurance portability

an example of a HIPPA violation would be a for a doctor to share information regarding patients health to patients employer.

protected health information (PHI)

any individually identifiable information relating to past, present, or future physical / mental conditions

examples of this would be name, adress, SSN, biometric identifiers, etc.

deidentifying

removing descriptive information about a person from their PHI

An example of when this would be used is when reporting communicable diseases

privileged communication

private information shared between patient and provider that is legally protected from disclosure

an example would be a conversation between the two regarding a medical condition and the treatments available

epidemic

a large disease outbreak within a community

an example would be a measles outbreak isolated to Bristow, VA

pandemic

an epidemic that goes worldwide

an example would be the spread of COVID-19 .

quarantine

isolation of a person who has been exposed to an infectous disease

an example would be if someone were to hang out with a person who tested positive for covid, they would need to quarantine even with no symptoms

self-isolation

isolation of a person when they are sick with an infectious disease

if a person tests positive with COVID, then they would stay home until they received a negative test

triage

the sorting of patients according to their immediate medical need

say there were two people, one with the flu and the other impaled with a metal pole, the person impaled would be first in the order of action.