39 Questions
What is the philosophical underpinning for autonomy?
Intrinsic and unconditional worth of all persons
Why is it mentioned that a rigid distinction between incapacity to make health-care decisions and incompetence is not of practical use?
Because it has the same practical consequences as a legal determination of incompetence
What do detractors of the principle of autonomy propose as an alternative concept?
Relational autonomy shaped by social relationships and complex determinants
What obligations does respecting the principle of autonomy impose on physicians?
To disclose medical information and treatment options necessary for patient self-determination
What is the primary responsibility of a practicing physician in patient care?
Benefiting the patient, avoiding harm, and respecting values and preferences
What does normative ethics attempt to answer?
The question of which general moral norms for guidance and evaluation of conduct should be accepted
What constitutes common morality, as mentioned in the text?
Some moral norms for right conduct that are common to human kind
What has an educational program been shown to improve, according to the text?
Learner awareness, attitudes, knowledge, moral reasoning, and confidence
What are the 4 fundamental principles of ethics mentioned in the text?
Beneficence, nonmaleficence, autonomy, justice
In what way does the principle of beneficence differ from nonmaleficence?
Beneficence emphasizes positive actions to benefit patients while nonmaleficence emphasizes avoiding harm
What is the primary focus of bioethics according to the text?
Research ethics, public health ethics, organizational ethics, and clinical ethics
Why is compliance with physician organizations' standards mentioned in the text insufficient from a moral standpoint?
The standards do not consider patient welfare or address important societal issues
What is the likely reason for physicians' resistance to conveying bad news to patients?
Concern that it may cause anxiety and loss of hope
What is the main exception to patient confidentiality mentioned in the text?
Reporting of infectious diseases
Which principle of distributive justice refers to distribution based on social and economic status?
Based on free-market exchanges
What is the role considered of primary importance when there are conflicts of interests, as mentioned in the text?
Fairness to the patient
What is the first requirement for informed consent?
The patient must be competent to understand and decide
What is the surrogate decision-maker of an incompetent patient expected to use to make decisions?
Substituted interests
Why has there been a marked shift in physicians' attitudes towards full disclosure of diagnoses in the US?
Increased accountability to society
What is a vital component in a physician-patient relationship according to the text?
Truth-telling
What is the term used for the rare and extreme form of patient autonomy that limits the physician's role?
Consumerism
In which situation does the principle of beneficence override that of nonmaleficence?
When a patient experiences pain and swelling from an indwelling intravenous catheter
What is the term for the action by a physician, intended to benefit a patient but contrary to the voluntary decision of an autonomous patient?
Hard paternalism
According to Pellegrino and Thomasma, how can beneficence be inclusive of patient autonomy?
By linking the best interests of the patients with their preferences
In Case 2, why does the patient refuse the recommended treatment?
He believes the surgery would kill him.
What best characterizes the conflict between autonomy and beneficence in Case 3?
The intensivist's suggestion to discontinue life-sustaining interventions.
Why is it mentioned that the term 'futility' is appropriate in Case 3?
To suggest that physiological futility is evident in the patient's condition.
What obligation does the physician have towards the patient in Case 2, despite the patient's refusal of treatment?
To offer continued outpatient visits, advice against fear-based decisions, and encouragement to seek a second opinion.
What does the son request of the doctor regarding the information about his mother's health?
To inform him of any serious life-threatening disease but not to inform his mother
Why does the author mention that the woman is a dependent of her son?
To emphasize the cultural perspective that gives authority to family members for decision-making
What is the physician faced with in this case?
Balancing multiple tasks including respecting cultural values, learning patient’s preferences, and complying with American norms
Why is it important for the physician to take a tactful approach to inform the patient directly about her diagnosis?
To respect the principle of autonomy and provide the patient with the option to delegate decision-making authority
What does the author suggest as the appropriate course of action for the physician?
To directly inform the patient (with a translator if needed) about her diagnosed disease
What does the principle of autonomy provide for the patient?
The option to delegate decision-making authority to another person
Why does the son instruct not to treat any cancer found in his mother?
Because he believes that she is too old and frail for cancer treatment
What are the key patient factors that can compromise decisional capacity, according to the text?
Anxiety, fear, pain, and lack of trust
What does the practical approach to problem-solving in ethics involve?
Clinical assessment, patient preferences, quality of life, and context
In Case 1 presented in the text, what ethical principles are at odds when the patient refuses treatment for bacterial meningitis?
Medical indications and patient preferences
What is the significance of using a logical and well-accepted model in clinical practice, as mentioned in the text?
It helps in identifying conflicting ethical principles and weighing them to arrive at an ethically right solution
Explore a medical case study of a 67-year old immigrant woman from southern India living in the USA with symptoms of nausea, lack of appetite, weight loss, dark yellow urine, and yellow skin coloration. Understand the challenges of communication and cultural differences in healthcare.
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