Medical Case Study: Jaundice Symptoms in an Immigrant Patient
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Questions and Answers

What is the philosophical underpinning for autonomy?

  • Doctrine of double effect
  • Intrinsic and unconditional worth of all persons (correct)
  • The use of appropriate drugs including opioids
  • Court decision by Justice Cardozo in 1914

Why is it mentioned that a rigid distinction between incapacity to make health-care decisions and incompetence is not of practical use?

  • Because it is determined by health professionals
  • Because it has the same practical consequences as a legal determination of incompetence (correct)
  • Because it serves the principle of autonomy
  • Because it is based on developmental, mental, or physical disorder

What do detractors of the principle of autonomy propose as an alternative concept?

  • Paternalism by physicians
  • Informed consent and truth-telling
  • Doctrine of double effect
  • Relational autonomy shaped by social relationships and complex determinants (correct)

What obligations does respecting the principle of autonomy impose on physicians?

<p>To disclose medical information and treatment options necessary for patient self-determination (D)</p> Signup and view all the answers

What is the primary responsibility of a practicing physician in patient care?

<p>Benefiting the patient, avoiding harm, and respecting values and preferences (C)</p> Signup and view all the answers

What does normative ethics attempt to answer?

<p>The question of which general moral norms for guidance and evaluation of conduct should be accepted (B)</p> Signup and view all the answers

What constitutes common morality, as mentioned in the text?

<p>Some moral norms for right conduct that are common to human kind (B)</p> Signup and view all the answers

What has an educational program been shown to improve, according to the text?

<p>Learner awareness, attitudes, knowledge, moral reasoning, and confidence (D)</p> Signup and view all the answers

What are the 4 fundamental principles of ethics mentioned in the text?

<p>Beneficence, nonmaleficence, autonomy, justice (C)</p> Signup and view all the answers

In what way does the principle of beneficence differ from nonmaleficence?

<p>Beneficence emphasizes positive actions to benefit patients while nonmaleficence emphasizes avoiding harm (A)</p> Signup and view all the answers

What is the primary focus of bioethics according to the text?

<p>Research ethics, public health ethics, organizational ethics, and clinical ethics (B)</p> Signup and view all the answers

Why is compliance with physician organizations' standards mentioned in the text insufficient from a moral standpoint?

<p>The standards do not consider patient welfare or address important societal issues (B)</p> Signup and view all the answers

What is the likely reason for physicians' resistance to conveying bad news to patients?

<p>Concern that it may cause anxiety and loss of hope (C)</p> Signup and view all the answers

What is the main exception to patient confidentiality mentioned in the text?

<p>Reporting of infectious diseases (C)</p> Signup and view all the answers

Which principle of distributive justice refers to distribution based on social and economic status?

<p>Based on free-market exchanges (D)</p> Signup and view all the answers

What is the role considered of primary importance when there are conflicts of interests, as mentioned in the text?

<p>Fairness to the patient (D)</p> Signup and view all the answers

What is the first requirement for informed consent?

<p>The patient must be competent to understand and decide (C)</p> Signup and view all the answers

What is the surrogate decision-maker of an incompetent patient expected to use to make decisions?

<p>Substituted interests (D)</p> Signup and view all the answers

Why has there been a marked shift in physicians' attitudes towards full disclosure of diagnoses in the US?

<p>Increased accountability to society (C)</p> Signup and view all the answers

What is a vital component in a physician-patient relationship according to the text?

<p>Truth-telling (B)</p> Signup and view all the answers

What is the term used for the rare and extreme form of patient autonomy that limits the physician's role?

<p>Consumerism (D)</p> Signup and view all the answers

In which situation does the principle of beneficence override that of nonmaleficence?

<p>When a patient experiences pain and swelling from an indwelling intravenous catheter (A)</p> Signup and view all the answers

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?

<p>Hard paternalism (A)</p> Signup and view all the answers

According to Pellegrino and Thomasma, how can beneficence be inclusive of patient autonomy?

<p>By linking the best interests of the patients with their preferences (C)</p> Signup and view all the answers

In Case 2, why does the patient refuse the recommended treatment?

<p>He believes the surgery would kill him. (C)</p> Signup and view all the answers

What best characterizes the conflict between autonomy and beneficence in Case 3?

<p>The intensivist's suggestion to discontinue life-sustaining interventions. (C)</p> Signup and view all the answers

Why is it mentioned that the term 'futility' is appropriate in Case 3?

<p>To suggest that physiological futility is evident in the patient's condition. (C)</p> Signup and view all the answers

What obligation does the physician have towards the patient in Case 2, despite the patient's refusal of treatment?

<p>To offer continued outpatient visits, advice against fear-based decisions, and encouragement to seek a second opinion. (A)</p> Signup and view all the answers

What does the son request of the doctor regarding the information about his mother's health?

<p>To inform him of any serious life-threatening disease but not to inform his mother (C)</p> Signup and view all the answers

Why does the author mention that the woman is a dependent of her son?

<p>To emphasize the cultural perspective that gives authority to family members for decision-making (B)</p> Signup and view all the answers

What is the physician faced with in this case?

<p>Balancing multiple tasks including respecting cultural values, learning patient’s preferences, and complying with American norms (A)</p> Signup and view all the answers

Why is it important for the physician to take a tactful approach to inform the patient directly about her diagnosis?

<p>To respect the principle of autonomy and provide the patient with the option to delegate decision-making authority (C)</p> Signup and view all the answers

What does the author suggest as the appropriate course of action for the physician?

<p>To directly inform the patient (with a translator if needed) about her diagnosed disease (A)</p> Signup and view all the answers

What does the principle of autonomy provide for the patient?

<p>The option to delegate decision-making authority to another person (D)</p> Signup and view all the answers

Why does the son instruct not to treat any cancer found in his mother?

<p>Because he believes that she is too old and frail for cancer treatment (B)</p> Signup and view all the answers

What are the key patient factors that can compromise decisional capacity, according to the text?

<p>Anxiety, fear, pain, and lack of trust (A)</p> Signup and view all the answers

What does the practical approach to problem-solving in ethics involve?

<p>Clinical assessment, patient preferences, quality of life, and context (C)</p> Signup and view all the answers

In Case 1 presented in the text, what ethical principles are at odds when the patient refuses treatment for bacterial meningitis?

<p>Medical indications and patient preferences (A)</p> Signup and view all the answers

What is the significance of using a logical and well-accepted model in clinical practice, as mentioned in the text?

<p>It helps in identifying conflicting ethical principles and weighing them to arrive at an ethically right solution (B)</p> Signup and view all the answers

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