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75 terms

Bioethics exam

STUDY
PLAY
List the 5 principles of bioethics
respect for persons

beneficence

nonmaleficence

utility

justice

"Real Boys Never Use Jewels"
List the 3 theories of bioethics
deontological (duty-based)

consequential theory (consequence-based)

virtue theory (character-based)
List the 4 professional competencies of bioethics
cognitive

integrative

relational

moral

"Caring Is Really Manly"
Name 3 sources of ethical guidance for physicians and medical students
ethics consultant

SGU's Student Manual

clinical ethics committees
Specify 3 duties that doctors have to patients
...
Specify 3 duties that doctors and medical students have to society
protection of public health

protection of global health

promotion of equitable distribution of scare health resources
List 3 potential conflicts of interest in medicine
pharmaceutical companies paying medical professionals, patient advocacy groups, researchers, continuing medical education providers

advertising medical care

overtreatment/undertreatment (pre-payment)
Medical informatics
branch of biomedical and health informatics that has to do with understanding and promoting the effective organization, analysis, management, and use of information in health care, and transforming healthcare through information technology
Identify 2 ethical concerns about the use of information communication technology (ICT) in medicine
reduce patients to data sets or objects

some web sites provide unreliable information that could harm patients

some online support groups may be misleading, which could weaken patient trust in physicians and medicine
List the 5 elements of informed consent as these apply to clinical practice and medical research
decision-making capacity

disclosure

understanding

voluntariness

authorization
Name 3 challenges to obtaining informed consent
uncertain mental or legal status

coercive influences

incomplete understanding by patient
Name 3 barriers to effective pain relief
taboos against opioids

cultural stereotypes

doctors that do not know how to respond accordingly or effectively to pain
Describe 3 aspects of virtue and character in medicine and medical education
virtue is developed through habitually leading a moral life

virtue and character is gained through experience

altruism
Describe 3 methods used in bioethics
analysis

reasoning

fact finding
Identify 3 impacts of climate change on health
increased incidence of malaria, dengue fever, other diseases

reduced food yields and water supplies

changing patterns of infectious disease including HIV
Formulate ethical arguments for and against physician assisted suicide
FOR

beneficence requires doctors to relieve unbearable suffering

respect for persons requires honoring a patient's informed wishes

AGAINST

sanctity of life

may lead to acceptance of euthanasia

patients change their minds once pain is controlled
Tuskegee
...
Explain the implication of the goals of medicine described in the course companion
prevent disease and injury

promote and maintain health

relieve pain and suffering

care for and about patients

avoid premature death

pursue a peaceful death for patients
Explain the role of culture, and bias, in medicine and patient care
avoid cultural biases

understanding how patient's culture affects their understanding of disease

reduce miscommunication which can lead to poor outcomes
Define ethics
a science of morals in human conduct
Define bioethics
application of ethics to medicine and all life sciences
List at least 3 aspects of cognitive competencies
knowledge

information management

application of information to real-life situations

use of tacit knowledge and personal experience

self-directed acquisition of new knowledge

recognition of gaps in one's own knowledge

ability to generate useful questions

awareness of, and ability to make adjustments for, one's own biases
List at least 3 aspects of integrative competencies
incorporation of scientific, clinical, and ethical judgment

appropriate use of reasoning strategies

linking of interdisciplinary and clinical knowledge

managing uncertainty

examining and refining one's own reasoning strategies
List at least 3 aspects of relational competencies
communication skills

handling conflict

teamwork

teaching others
List at least 3 aspects of moral competencies
attentiveness

critical curiosity

awareness of thought and emotion

recognition of, and response to, cognitive and emotional biases

willingness to acknowledge and correct errors
Define morality
conforming to accepted rules and standards guiding human behavior
Define law
an enacted or customary rule in a community that is recognized as enjoining or prohibiting certain actions
Define philosophy
use of reason and argument in seeking truth and knowledge of reality, especially of the causes and nature of things, and of the principles governing existence
Define culture
the customs and achievements of a particular civilization
Define informatics
the science of processing data for storage and retrieval
What is the harm principle?
violations of respect for persons are justified when these prevent harms to others
Which bioethics principle encompasses confidentiality, harm principle, and paternalism?
respect for persons
List 4 subcomponents of respect for persons
autonomy

veracity

fidelity

avoidance of killing
What is the 5th vital sign
documented pain level
Which bioethics principle encompasses pain management?
beneficence
What is utility?
representation of the greatest benefit/harm ratio that can be obtained
What is equipoise?
genuine uncertainty about which arm of a clinial trial will provide the most benefits or harms to patients, research subjects, or future patients
Author of "My Father's Death"
Susan M. Wolf
Author of "Organized Obfuscation: Advocacy for Physician-Assisted Suicide"
Daniel Callahan
Author of "Physician-Assisted death in the United States: Are the Existing "Last Resorts" Enough?"
Timothy E. Quill
If the harms and benefits are proportionate, is nonmaleficence or beneficence more important?
nonmaleficence
Which is the most important: beneficence, nonmaleficence, respect for patient's autonomy
respect for patient's autonomy
1914 Schloendorff vs. NY Hospital Society
operation without consent is an assault
1957 Salgo vs. Leland Stanford Jr.
patient not informed about procedure risks
1960 Nathanson vs. Kline
negligent radiologist failed to inform patient of procedure risk
1972 Canterbury vs. Spence
informed consent must be clear and understood
Terminal sedation
administration of large doses of sedatives
Phase I
safety

dosage range

side effects

20-80 people
Phase II
safety

efficacy

side effects

100-300 people
Phase III
efficacy

side effects

1000-3000 people
Phase IV
post marketing
Therapeutic misconception
belief that a drug is efficacious when it has not been conclusively proven to be so
Therapeutic misrepresentation
implying that a drug is efficacious when it has not conclusively been proven to be
Ethical relativism
beliefs and practices in a given culture are ethical if they represent traditional norms and values in that culture
Telehealth
provision of healthcare informaiton and/or services from a provider in a different location than the patient or person seeking information
Distance medicine
provision of healthcare services, clinical information, and/or education over distance and time using information communication technology.
What is the difference between telehealth and distance medicine?
telehealth is centered around the delivery of information that can be done by non-physicians

distance medicine is specific to the provision of medical care by physicians or qualified members of the healthcare team
Telemedicine
another word for distance medicine
What is another name for deontological theory?
Kantianism
How does deontological theory view patient confidentiality?
requires physicians to uphold their duty to maintain patient confidentiality under all circumstances
Deontological theory
people should adhere to rules and regulations regardless of outcome
What is the difference between consequential theory and utilitarian theory?
consequential theory aims at goodness

utilitarian theory aims at happiness
Name 2 philosophers that promoted the utilitarian theory
John Stuart Mill

Jeremy Bentham
Supererogatory
going beyond what is required or expected
Consequential theory
people should seek to maximize benefits to the maximum number of people
Name a philosopher who is associated with the virtue theory
Aristotle
What professional standards provide guidance on conflicts of interest?
Institute of Medicine (IOM)
What is substituted judgment?
regarding a patient unable to make medical decisions about himself or herself, an attempt to ascertain what the patient would have wanted if he/she understood the present circumstances and prognosis
What is VSED?
voluntarily stopping eating and drinking
"the well-being of the human subject should take precedence over the interests of science and society"
Declaration of Helsinki
"The voluntary consent of the human subject is absolutely essential"
Nuremberg Code
What does IRB stand for?
Institutional Review Boards
What report was commissioned in response to the Tuskegee study?
Belmont Report
During which phase of the Tuskegee study did the PHS start offering free transportation for "special treatment?
Phase II
Professionalism
to publicly profess expertise and commitment to a particular area