Term
| Ten Ethical Considerations for Case Discussions |
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Definition
1. Beneficence
2. Non-maleficence
3. Autonomy
4. Cost-effectiveness
5. Sanctity of Life
6. Family
7. Culture & Religion
8. Provider/Pt Relationship
9. Professional integrity of provider
10. Justice |
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Term
| 5 Components of Decision Making Capacity |
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Definition
1. Can understand and process the prognosis, diagnosis and treatment
2. Can weigh the benefits, burdens and risks associated with treatment
3. Can apply values to making the decision
4. Can communicate their decision
5. [The decision they make is consistent over time] |
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Term
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Definition
1. DMC is an all or nothing phenomenon
2. Lack of DMC never changes |
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Term
| 3 Parts of Informed Consent |
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Definition
| DMC, Disclosure, Voluntariness |
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Term
| Two standard of Disclosure |
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Definition
Professional Practice standard (provider sets the standard)
Reasonable Person (patient sets the legal standard) |
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Term
| 3 Exceptions to Informed Consent Requirement |
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Definition
1. Emergency Care
2. Therapeutic Exception
3. Waiver of consent |
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Term
| Ethical Requirements for Breaking Confidentiality |
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Definition
| physical harm to an identifiable person, a benefit will result, it is a last resort, generalizable (you would be ok with it if you were the pt) |
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Term
| HIPAA (Health Insurance Portability Accountability Act) |
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Definition
| federal privacy regulations |
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Term
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Definition
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Term
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Definition
| irreversible cessation of all clinical brain function, including the brain stem |
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Term
| Difference between Minimally Conscious States & Vegetative States |
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Definition
Minimally Conscious State (MCS)- severely altered state of consciousness but still has some awareness of environment
Vegetative State (VS)- "wakefulness w/o awareness"; no awareness of self or environment but still have some brainstem function
Difference is consciousness! |
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Term
| Key Outcome of Quinlan ruling (LST) |
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Definition
| Surrogates could refuse LST for on behalf of incapacitated (VS) patients even if the patient will die |
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Term
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Definition
| Statement a person makes when they have DMC about how treatment decisions should be made at some point when they no longer have DMC |
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Term
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Definition
Judgement used to make decisions when the pt's wishes are known or can be inferred (based on pt preferences or interests)
Example: conversations about what happened on tv |
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Term
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Definition
| Used by surrogate when don't know what patient would want |
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Term
| 3 Formal Conditions for Futility |
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Definition
1. Goal
2. Action aimed at achieving the goal
3. Virtual certainty that action will fail |
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Term
Withholding vs. Withdrawing treatment
(Moral Distinction) |
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Definition
NO moral difference b/c all relevant moral factors are the same:
Provider's duty to respect the pt's wishes
Consequences
Intentions
Cause of death
Potential for abuse |
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Term
| Macro Allocation of Resources |
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Definition
determine the amount of resources to allocate to specific services
Ex: how much to spend on dialysis this year? |
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Term
| Micro Allocation of Resources |
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Definition
Determine the amount of resources to allocate based on particular persons
Ex: Which person receives the organ? |
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Term
| 6 Principles of Rationing Scarce Resources and Examples |
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Definition
Treating People Equally:
1- A lottery
2- First come/first served
Favoring the worst off:
1- Sickest first
2- Youngest first
Maximizing Benefits:
1- Saving the most lives
2- Using prognosis or life years remaining |
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Term
| What is DNR and when does it apply? |
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Definition
| Do Not Resuscitate- applies only in cardiac arrest settings and only to CPR performance |
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Term
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Definition
DNR- does not include the life sustaining treatments that might go along with CPR; such as intubation, cardioversion or other treatments
DNI- do not intubate; does not specify anything about CPR and CPR is usually not effective without intubation |
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Term
| Euthanasia vs. PAS vs. Withdrawal of Treatment |
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Definition
Euthanasia- provider administers agent of death
PAS- patient administers agent of death
Withdrawal of LST- physician assists the person in death but the cause of death is the disease |
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Term
| Un-controlled Donation after Cardiac Death vs Controlled Donation after Cardiac Death |
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Definition
Uncontrolled DCD- death is sudden (i.e. MVA); organs depleted of blood
Controlled DCD- death is planned (i.e., withdrawal of LST); can plan for donation and retrieval |
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