Medical Case Study: Jaundice Symptoms in an Immigrant Patient

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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?

To disclose medical information and treatment options necessary for patient self-determination Signup and view all the answers

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

Benefiting the patient, avoiding harm, and respecting values and preferences Signup and view all the answers

What does normative ethics attempt to answer?

The question of which general moral norms for guidance and evaluation of conduct should be accepted Signup and view all the answers

What constitutes common morality, as mentioned in the text?

Some moral norms for right conduct that are common to human kind Signup and view all the answers

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

Learner awareness, attitudes, knowledge, moral reasoning, and confidence Signup and view all the answers

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

Beneficence, nonmaleficence, autonomy, justice Signup and view all the answers

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

Beneficence emphasizes positive actions to benefit patients while nonmaleficence emphasizes avoiding harm Signup and view all the answers

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

Research ethics, public health ethics, organizational ethics, and clinical ethics Signup and view all the answers

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 Signup and view all the answers

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

Concern that it may cause anxiety and loss of hope Signup and view all the answers

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

Reporting of infectious diseases Signup and view all the answers

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

Based on free-market exchanges 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?

Fairness to the patient Signup and view all the answers

What is the first requirement for informed consent?

The patient must be competent to understand and decide Signup and view all the answers

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

Substituted interests Signup and view all the answers

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

Increased accountability to society Signup and view all the answers

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

Truth-telling 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?

Consumerism Signup and view all the answers

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

When a patient experiences pain and swelling from an indwelling intravenous catheter 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?

Hard paternalism Signup and view all the answers

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

By linking the best interests of the patients with their preferences Signup and view all the answers

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

He believes the surgery would kill him. Signup and view all the answers

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

The intensivist's suggestion to discontinue life-sustaining interventions. Signup and view all the answers

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. 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?

To offer continued outpatient visits, advice against fear-based decisions, and encouragement to seek a second opinion. Signup and view all the answers

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 Signup and view all the answers

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 Signup and view all the answers

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 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?

To respect the principle of autonomy and provide the patient with the option to delegate decision-making authority Signup and view all the answers

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 Signup and view all the answers

What does the principle of autonomy provide for the patient?

The option to delegate decision-making authority to another person Signup and view all the answers

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 Signup and view all the answers

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

Anxiety, fear, pain, and lack of trust Signup and view all the answers

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

Clinical assessment, patient preferences, quality of life, and context 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?

Medical indications and patient preferences 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?

It helps in identifying conflicting ethical principles and weighing them to arrive at an ethically right solution Signup and view all the answers