Term
| names of the big three ethical theories |
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Definition
virtue theory, deontological theory, consequentialist theory
ETHICAL THEORY READING |
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Term
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Definition
judgement of agents are most basic
ETHICAL THEORY READING |
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Term
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Definition
judgement of actions are most basic
ETHICAL THEORY READING |
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Term
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Definition
judgement of consequences are most basic
ETHICAL THEORY READING |
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Term
| virtue theory: virtues can be applied to ___ (2) |
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Definition
human begins & objects
ETHICAL THEORY READING |
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Term
| virtue theory: three goals |
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Definition
-develop and defend conception of the ideal person
-develop and defend list of virtues necessary for being an ideal person
-defend a view of how persons can possess these virtues
ETHICAL THEORY READING |
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Term
| virtue theory: examples from the history of philosophy |
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Definition
- Aristotle - four cardinal virtues: courage, justice, temperance, and wisdom
- St. Aquinas & St. Augustine - faith, hope, and charity
ETHICAL THEORY READING |
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Term
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Definition
greek word for "duty"
ETHICAL THEORY READING |
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Term
| deontology regards the fundamental ethical task as ____ |
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Definition
Deontology regards the fundamental ethical task as one of doing the right thing (or avoiding the wrong thing)
ETHICAL THEORY READING |
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Term
| deontology commonly guides action with a set of moral principles or rule. Two types: |
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Definition
RULES OF PARTICULAR CIRCUMSTANCES & ABSOLUTE RULES
-rules may refer to particular circumstances: actions of type T are never (always_ to be performed in circumstance C
-rules may be absolute (prohibiting actions in all circumstances): actions of type T are never to be performed
ETHICAL THEORY READING |
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Term
| essential tasks of deontology (2) |
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Definition
-formulate and defend a set of moral rules
-develop and defend some method of determining what to do when rules conflict
ETHICAL THEORY READING |
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Term
| general types of deontology (2) |
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Definition
- Rule deontology: requires agents to perform actions that follow a rule
- Act deontology: do what's right rather than blindly following a rule
ETHICAL THEORY READING |
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Term
| the state of character most important for deontology is _____. why? define. exampes. |
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Definition
The state of character most important for deontology is conscientiousness
-It makes us to follow rules despite temptations to make an exception
-Conscientiousness is not an intrinsic good – its value is a result
-Examples: Ten Commandments, Kant’s categorical imperative, Stoics – natural law
ETHICAL THEORY READING |
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Term
| what is most important to consequentialism |
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Definition
judgement of value of consequences of actions are most important
ETHICAL THEORY READING |
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Term
| consequentialism: how should one act? |
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Definition
one should act to obtain the best result
ETHICAL THEORY READING |
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Term
| 3 goals of consequentialism |
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Definition
-Specify and defend things that are good in themselves
-Provide technique to measure and compare quantities of these intrinsic goods
-Defend policy for those cases where one cannot determine which of a number of alternative actions will maximize the good
ETHICAL THEORY READING |
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Term
| 2 types of consequentialism |
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Definition
-Act consequentialism: perform the action that will most likely maximize good consequences in the particular situation
-Rule consequentialism: follow those rules that will maximize good consequences
ETHICAL THEORY READING |
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Term
| consequentialism: instrumental vs. intrinsic |
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Definition
-Instrumental things are good only so far as they play a role in bringing about intrinsically good things
-Intrinsically good things are good by itself
ETHICAL THEORY READING |
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Term
| steps of clinical pragmatism framework |
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Definition
1. assessment
2. moral diagnosis
3. goal setting, decision making, and implementation
4. evaluation of results
APPENDIX 2 |
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Term
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Definition
ethics = a perspective form which to evaluate and live the moral life. question why certain actions are best
morality = what's right or wrong based on majority's beliefs
(what should i do?)
CHAPTER 1 |
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Term
| four basic ethical obligations that pertain to each case after establishment of the clinician-patient relationship |
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Definition
1. respecting the patient’s privacy and confidentiality
2. communicating honestly about all aspects of the patient’s diagnosis, treatment, and prognosis
3. determining if patient is capable of sharing in decision-making
4. conducting an ethically valid process of informed consent throughout the relationship
CHAPTER 1 |
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Term
| eight ethically relevant considerations and virtues for caring for patients |
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Definition
1. the balance between benefits and harms
2. disclosure, informed consent, and shared decision-making
3. the norms of family life
4. the responsibilities of physicians and nurses in the context of relationships with patients
5. professional integrity
6. societal norms of cost-effectiveness and allocation
7. cultural and religious variations
8. considerations of power
CHAPTER 1 |
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Term
| why is it important not to divorce ethical reasoning from clinical reasoning |
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Definition
theory vs. practice
CHAPTER 1 |
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Term
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Definition
integration of beliefs about values and purposes. important in determining whether treatment or care requested by patients or surrogates is ethically appropriate.
CHAPTER 2 |
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Term
| basic tenets of the nursing code of ethics (5) |
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Definition
patient advocacy. treat patient, not disease.
-participates in improving healthcare as a whole
-participates in advancement of nursing profession as a whole
-collaborates with other professionals
-be a good rep for nurses.
CHAPTER 2 |
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Term
| how law and ethics are similar yet different. |
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Definition
both concerned with identifying norms of conduct. BUT Law seeks to educate and to regulate by setting a minimal standard of conduct and establishing disincentives for ignoring that standard. Ethics supports many basic conduct required by law, but extends beyond the law to prescribe desirable conduct and articulate ideals and virtues we should aim for
CHAPTER 4 |
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Term
| privacy vs confidentiality |
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Definition
privacy - the ability to control information others have about us
confidentiality - process where a person's right to privacy is recognized and honored. a form of promise that is based on a trust relationship
CHAPTER 7 |
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Term
| negative vs positive right of privacy |
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Definition
Negative right - the right to be left alone.
Positive right - right to control access to and distribution of information on self
CHAPTER 7 |
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Term
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Definition
-duty to warn third parties who are at risk of injury by the patient
-exercise professional judgment on course of action to protect potential victims
CHAPTER 7 |
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Term
| Tarasoff v. Regents of the University of California |
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Definition
protecting private health information is a primary duty of the mental health professional, except when patient shares to therapist a threat concerning an identifiable third party
CHAPTER 8 |
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Term
| types of flawed disclosures and why they are flawed |
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Definition
5.
- “Just the facts” - just give facts. no emotion
- “There’s always hope” - making them too hopeful
- You can’t tell a patient everything - clinician's duty to tell what is meaningful, important, useful to the patient
- Omission - form of lying: remaining silent when speech would be ethically appropriate
- Evasion - change subject
CHAPTER 8 |
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Term
| when it is ethically appropriate and inappropriate to disclose or not to disclose information to a patient |
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Definition
let patient, by his or her questions, responses, and actions, guide the decision about how much information is helpful. consider the importance of the information to each patient's specific clinical situation, personal needs, future implications of the information, and so forth
CHAPTER 8 |
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Term
| communication elements necessary for an "ideal clinician-patient relationship" (6) |
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Definition
1. Choice
2. Competence
3. Compassion
4. Continuity
5. Lack of Conflict of Interest
6. Communication—a two-way street
CHAPTER 8 |
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Term
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Definition
competence - legal term
capacity - ability to make a decision
CHAPTER 9 |
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Term
| concepts of determining capacity |
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Definition
outcome, category, functional
CHAPTER 9 |
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Term
| determining capacity - outcome |
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Definition
person judged capable based on outcome of decision
If decision reflects values that reject conventional wisdom, capacity may be questioned.
This standard should be rejected.
CHAPTER 9 |
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Term
| determining capacity - category |
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Definition
person judged capable based on category/ status. Example: considered incapable if mentally ill/retarded, aged, minor, critically ill
This standard should be rejected.
CHAPTER 9 |
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Term
| determining capacity - functional |
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Definition
recognized functional ability as decision-maker
Functionally able:
1. Understanding relevant information
2. Communicating with caregivers about decision
3. Reasoning about relative alternatives, consequences against a background of personal values and beliefs
CHAPTER 9 |
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Term
| types of surrogate decision making standards for incapacitated patients |
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Definition
best interest, substituted judgment, other/professional
CHAPTER 9 |
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Term
| surrogate decision making standards for incapacitated patients - best interest standard |
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Definition
what would be in the person’s best interests if that person’s values are not ascertainable or person never was capacitated
CHAPTER 9 |
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Term
| surrogate decision making standards for incapacitated patients - substituted judgement standard |
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Definition
what the person him or herself would have wanted based on their values and preferences
CHAPTER 9 |
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Term
| surrogate decision making standards for incapacitated patients - other standards/professional standard |
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Definition
the physician decides. May subject patients to decision that conflict with their own values.
CHAPTER 9 |
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Term
| what a valid informed consent involves |
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Definition
Threshold elements (preconditions)
Information elements
Consent elements
CHAPTER 10 |
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Term
| threshold elements (preconditions) |
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Definition
capacity (to understand and decide)
voluntariness (in deciding)
CHAPTER 10 |
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Term
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Definition
Disclosure (of material information)
Recommendation (of a plan)
Understanding (of disclosure and recommendation)
CHAPTER 10 |
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Term
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Definition
Decision (in favor of a plan)
Authorization (of the chosen plan)
CHAPTER 10 |
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Term
| role the nurse has in the informed consent process |
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Definition
provide a major portion of information about treatment to patients, partly because they spend more time than the physician talking to the patient, either in formal educational process or in informal bedside conversation.
Evaluate valid informed consent: adequacy of disclosure; patient's understanding, capacity, voluntariness
CHAPTER 10 |
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Term
| informed consent vs assent |
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Definition
informed consent - given by parent
assent - informed consent of a minor under 14, not legal
CHAPTER 10 |
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Term
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Definition
- When a treatment simply won’t work (e.g., antibiotics for a viral infection)
- Quantitative futility: the likelihood of success of a treatment is extremely remote (CPR for a severely debilitated, imminently dying patient)
- Qualitative futility: when clinicians judge the quality of life after an intervention or the burdens of treatment to be greater than the benefits
CHAPTER 11 |
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Term
| when it is appropriate for clinicians to refuse to treat a patient (3) |
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Definition
To benefit their patients (when no treatment is in their medical best interest)
To be true to their own moral views or their consciences
To meet the interests of larger numbers of other patients or the interests of the greater society.
CHAPTER 11 |
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Term
| various definitions of death |
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Definition
whole-body definition of death, whole-brain definition of death
CHAPTER 12 |
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Term
| whole-body definition of death |
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Definition
Cessation of breathing and absence of heartbeat, higher-brain or neocortical definition of death
CHAPTER 12 |
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Term
| whole-brain definition of death |
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Definition
brain dead, although may be breathing or beating (heart) w/ or w/o help. coma, absence of reactions, flat EEG
CHAPTER 12 |
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Term
| higher-brain or neocortical definition of death |
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Definition
Persistent vegetative state (PVS) – brain stem survives, but patients have no (or little) neocortical function (no speech, no meaningful interaction)
CHAPTER 12 |
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Term
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Definition
physicians and other clinicians are not to accept suffering as a necessary evil.
-to achieve the best possible quality of life through relief of suffering, control of symptoms, and restoration of functional capacity while remaining sensitive to personal, cultural, religious values, beliefs, practices
1. respecting patients' goals and choices
2. using an interdisciplinary team to provide patients with comprehensive care
3. providing support to family caregivers
CHAPTER 12 |
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Term
| how clinicians should properly deliver bad news (6) |
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Definition
1. Get off to a good start by optimizing physical context, ensuring that all participants who should be in the meeting are there, making introductions/shaking hands/touching patient—addressing patient first
2. Find out how much patient knows about his medical condition by using open-ended questions
3. Find out how much patient wants to know about his clinical situation
4. Sharing information according to the patient's needs, desires; make a mutually agreed upon plan for the future
5. Responding to the patient's feelings
6. Planning and follow-through
CHAPTER 12 |
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Term
| euthanasia vs clinician-assisted suicide |
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Definition
Euthanasia - "good death." Bringing about the death of a hopelessly ill and suffering person in a relatively quick and painless way for reasons of mercy.
C-A suicide - when a doctor facilitates a patient's death by providing the necessary means and/or information to enable the patient to perform the life-ending act
CHAPTER 12 |
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Term
| ethical guidelines for deciding to forgo life-sustaining treatments when the patient is incapacitated |
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Definition
1. Physicians have a duty to make recommendations to other decision-makers based on benefit/burden assessments
2. Benefits and burdens should be assessed within the framework of the patient’s prior expressed wishes or known values, beliefs, and previous decisions about treatment, and a substituted judgment made if possible; if it is not possible, the best medical interest standard should be followed
3. Family members are usually the best source of information about a patient’s preferences, supplemented by information from other members of the clinical team
4. When the benefits of treatment are proportionate to or exceed the burdens, it is obligatory to give treatment (unless refused by the patient in an AD)
5. It is obligatory for clinicians to withhold and strive to withdraw treatments that clearly will harm or are harming the patient
CHAPTER 13 |
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Term
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Definition
- regulations ensure that handicapped infants received all potentially efficacious lifesaving treatment without consideration of quality of life.
- Regulations appeared to require maximal treatment in all cases except those in which treatment was futile because the infant was irreversibly and imminently dying
CHAPTER 14 |
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Term
| standards for making medical decisions when dealing with neonates, infants, and children |
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Definition
Shared process that involves surrogates (parents) and the clinicians involved in the infant’s care
CHAPTER 14 |
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