RX 321: Exam 1

Health

a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity

How does the concept of "health" differ among people?

People have their own meanings of what is healthy. Is pain or discomfort necessarily unhealthy? Does feeling too tired make someone "unhealthy?"

How can illness be described?

Biologically: the actual pathology that occurs in the body (objective)

Experientially: All components refer to symptoms. Symptoms can be defined as any subjective evidence of disease

Culture defines whether illness is:

-stigmatized

- considered a disability

- contestable (whether or not something is "really" an illness)

Medicalization

previously "normal" aspects of life are redefined as requiring medical intervention.

Stigmatization

the assignment of negative perceptions to an individual because of perceived differences from the rest of society

"health" through the lens of functionalism

- Health is vital to society

- the "sick role" defines appropriate behavior for the sick and caregivers

- medical providers play a role in legitimizing illness.

"health" through the lens of social constructionism

- health and illness are social constructions

- considers medicalization and demedicalization

- subjective norms about various illnesses

"health" through the lens of critical theory

- illness is used by those with powers to actively suppress others and maintain power

- medicalization enriches the elite of the healthcare system

- companies profit from illness

Diversity

all the ways in which people differ

Equity

fair treatment, access, opportunity, and advancement for all people. One's identity cannot predict the outcome.

Inclusion

a variety of people have power, a voice, and decision-making authority

Health Equity

equality in health

Health Disparities (inequalities)

indicator of general injustice in society

How is "health equity" different from "health disparities?"

health equity is defined as equality in health, whereas health inequality is defined as an indicator of general injustice in society

3 types of ethical problems

- Ethical distress

- ethical dilemma

- locus of authority problem

Ethical distress

the person making the decision feels blocked from doing what they believe is right

ethical dilemma

there are two morally correct courses of action that cannot both be followed

locus of authority problem

it is unclear who has the authority to make the decision OR the wrong entity has the authority

3 moral models or ethical frameworks for making ethical decisions

- utilitarianism

- duty-based

- virtue

Utilitarianism deliberative process

what kind of outcomes should I produce (or try to produce)?

duty-based deliberative process

what are my obligations in this situation, and what are the things I should never do?

virtue deliberative process

what kind of person should I be (or try to be), and what will my actions show about my chapter.

Utilitarianism focus

directs attention to the future effects of an action, for all people who will be directly or indirectly affected by the action

duty-based focus

directs attention to the duties that exist prior to the situation and determines obligations

virtue focus

attempts to discern character traits (virtues and vices) that are, or could be, motivating the people involved in the situation.

Utilitarianism's definition of ethical conduct

ethical conduct is the action that will achieve the best consequences

duty-based definition of ethical conduct

ethical conduct involves always doing the right thing: never failing to do one's duty

virtue definition of ethical conduct

ethical conduct is whatever a fully virtuous person would do in the circumstances

Utilitarianism motivation

aim is to produce the most good

duty-based motivation

aim is to perform the right action

virtue motivation

aim is to develop one's character

The 4 pillars of medical ethics

- autonomy

- beneficence

- non-maleficence

- justice

Autonomy

respect for the patient's right to self-determination

Beneficence

the duty to 'do good'

Non-Maleficence

the duty to 'not do bad'

Justice

to treat all people equally and equitably.

6 steps of the ethical decision-making process

Step 1: Gather relevant information

Step 2: Identify the type of ethical problem

Step 3: Use ethics theories to analyze the problems

Step 4: explore the practical alternatives

Step 5: complete the action

Step 6: evaluate the process and outcome

Bias

a particular tendency, trend, inclination, feeling, or opinion, especially one that is preconceived or unreasoned

Implicit bias

preferences or aversions to a person or a group which occurs on an unconscious level

Explicit bias

attitudes and beliefs we have about a person or groups on a conscious level

When may implicit bias occur?

When may explicit bias occur?

Biases arise because our brain is trying to solve problems that generally fall into four different groups, what are these groups?

- too much information

- not enough information

- need to act fast

- what should we remember

Privilege

certain social advantages, benefits, or degrees of prestige and respect that an individual has by virtue of belonging to certain social identity groups

Privilege in healthcare

-access to medications

- safe environment to exercise

- how to find information

- having a bank account

- how medical decisions are made

- impact of therapy changes

Which of the following social theories is defined by the idea that society produces meaning to things like health and disease?

A. Stigmatization

B. Functionalism

C. Critical theory

D. Social constructionism

D. Social constructionism

Using functionalism, how would someone describe health?

A. Health is a basic human right.

B. Health is important in that it enables people to be productive members of society.

C. Health differs between peoples because it's created by society.

D. Health is only defined as the absence of illness, which is used by those in power to suppress others.

B. Health is important in that it enables people to be productive members of society.

Which of the following terms describes the idea that some people view a particular set of symptoms as a disease?

A. Health

B. Stigmatization

C. Illness

D. Medicalization

D. Medicalization

Which of the following terms is defined as "all the ways in which people differ?"

A. Diversity

B. Equity

C. Accessibility

D. Inclusion

A. Diversity

Which of the following principles of justice relates to the idea that equals should be treated equally?

A. Fairness

B. Equality

C. Righteousness

D. Desert

A. Fairness

Which of the following measures is used in public health to measure the health of a population? (Select all that apply)

A. Quality of life

B. Morbidity

C. Disability

D. Mortality

E. All of the above

E. All of the above

Which of the following terms describes differences in health outcomes?

A. Health unfairness

B. Health disparity

C. Health injustice

D. Health inequity

B. Health disparity

You have a sum of money to either fund a very expensive treatment for 1 patient with a rare disease or 5 patients with a very common and easy-to-treat disease. Which of the following moral theories would say that the 5 should be treated in order to maximize happiness?

A. Deontology

B. Utilitarianism

C. Care-based ethics

D. Virtue ethics

E. Rights-based ethics

B. Utilitarianism

In the following example, which of the ethical pillars does the pharmacist choose to prioritize in making the decision?

A patient presents to the pharmacy a prescription for 50 MS Contin 100 mg tablets with directions to "take as directed." After speaking with the patient, the pharmacist realizes that the patient may intend to take all of the tablets at once to end his life. The pharmacist, who does not condone suicide, ultimately decides to fill the prescription.

A. Justice

B. Beneficence

C. Non-maleficence

D. Autonomy

D. Autonomy

Which of the following types of ethical problems results from a situation where it is unclear who has a decision to make?

A. Ethical distress

B. Locus of authority problem

C. Ethical dilemma

B. Locus of authority problem

Which of the following mental shortcuts can result in stereotyping?

A. Need to act fast

B. What should we remember?

C. Too much information

D. Not enough meaning

D. Not enough meaning

A patient presents to the pharmacy asking for you to contact their doctor for a prescription for ivermectin because "everyone" says it works great for preventing COVID. What type of cognitive bias might this represent? (NOTE: Ivermectin is not effective for the prevention or treatment of COVID-19.)

A. Overconfidence bias

B. Framing

C. Explicit bias

D. Herd mentality

D. Herd mentality

Which of the following examples represents a privilege someone might have in their "invisible knapsack"?

A. Calling a pharmacy and getting an automated greeting in a language you don't understand before being instructed to "Press 2" for your native language

B. Telling the pharmacist that you lost half of your medicine, and the pharmacist allowing you an early refill without questioning your motives

C. Reading about how a medication was studied in a widely diverse group of patients, making the results applicable to many different people

D. Finding topical creams with separate pigments that allow all patients to adjust the tint to match their own skin tones, rather than pre-pigmented cream

B. Telling the pharmacist that you lost half of your medicine, and the pharmacist allowing you an early refill without questioning your motives

Which of the following best describes someone WITHOUT privilege?

A. Belonging

B. Marginalized

C. Biased

D. Normative

B. Marginalized

Which of the following statements best describes cultural humility?

A. Practicing cultural humility contributes to belief in stereotypes.

B. We need to learn as much as we can about every culture.

C. It emphasizes continued development.

D. Belief that one may become optimally knowledgeable about another's culture.

C. It emphasizes continued development.

Which of the following words best describe someone WITHOUT privilege?

A. Marginalized

B. Normative

c. Belonging

d. Biased

A. Marginalized

What type of cognitive bias might be represented in the example below:

A patient presents to the pharmacy asking for you to contact their doctor for a prescription for ivermectin because "everyone" says it works great for preventing COVID. (NOTE: ivermectin is not effective for the prevention of treatment of COVID-19)

A. Framing

B. Explicit bias

C. Overconfidence bias

D. Herd mentality

D. Herd mentality

Which of the following terms is defined as "all the ways in which people differ"?

A. inclusion

B. accessibility

C. diversity

D. equity

C. diversity

Which of the following principles of justice relates to the idea that equals should be treated equally?

A. Equity

B. Fairness

C. Righteousness

D. Desert

B. Fairness

Using functionalism, how would someone describe health?

A. Health is a basic human right.

B. Health is important in that it enables people to be productive members of society.

C. Health differs between peoples because it is created by society.

D. Health is only defined in the absence of illness, which is used by those in power to suppress others.

B. Health is important in that it enables people to be productive members of society.

Which social theory is defined by the idea that society produces meaning to things like health and disease?

A. Social constructionism

B. Functionalism

C. Critical Theory

D. Stigmatization

A. Social constructionism

Which ethical pillar embodied in the phrase "do no harm"?

A. Autonomy

B. Beneficence

C. Justice

D. Non-maleficence

D. Non-maleficence

Which of the following ethical frameworks defines conduct as something done by a virtuous person?

A. Virtue ethics

B. Utilitarianism

C. Duty-Based ethics

D. Autonomy

A. Virtue ethics

Which of the following terms describes the idea that some people view a particular set of symptoms as a disease?

A. Illness

B. Health

C. Stigmatization

D. Medicalization

D. Medicalization