Medical Decision Making and Informed Consent in Nursing

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30 Questions

What does the principle of non-maleficence mainly focus on?

Preventing harm to others

According to the Hippocratic Oath, what is a key commitment related to non-maleficence?

Avoiding treatments that cause harm or wrong patients

How might a nurse demonstrate adherence to the principle of non-maleficence?

Performing multiple checks before medication administration

In what scenario might a surgeon act in accordance with non-maleficence?

Choosing not to perform a risky surgery based on potential harm

Which is NOT a type of harm mentioned in the context of non-maleficence?

Emotional benefit

How does the Principle of Double Effect contribute to ethical decision-making in healthcare?

Evaluates actions where harm may be an unintended consequence

What is the main shift in medical decision making from the past to current times?

Doctors and patients jointly make decisions

What is a key responsibility of nurses regarding informed consent?

Explaining treatment options to patients

What is one factor that the ability to give informed consent depends on?

Adequate disclosure of information

When might Proxy Consent be used?

When the patient is incapable of giving informed consent

What must a patient understand to give informed consent?

The purpose of treatment, risks involved, and treatment alternatives

What does a competent surrogate provide in terms of medical decision making?

Gives proxy consent for medical procedures

What is the psychological reason mentioned for undergoing plastic surgery?

To address psychological issues caused by distorted physical attributes

According to the principle of totality, what is the basis for preserving life?

Following natural laws

Which of the following is NOT mentioned as an artificial means of preservation?

Preservation through prayers

What is the main purpose of applying simple heat or cold in preservation according to the text?

To maintain the health or life of the person

Which preservation method involves a sawdust bed mixed with zinc sulphate?

Drying

'Cavity injections' in preservation involve injecting fluids into which part of the body?

Body cavities

What distinguishes Rowena's act of taking a contraceptive pill from an indirect act?

Rowena's act is directly willed

How does the use of a condom differ from the rhythm method regarding preventing conception?

The condom is an arbitrary and determinate means

What characterizes the positive method of contraception?

It employs arbitrary and determinate means

Why is the rhythm method considered a negative method in contraception?

It allows the natural process to continue without interference

What differentiates contraception based on 'before, during, and after sexual intercourse'?

The timing of when the contraceptive method is taken

Why does Elaine take prescribed medication for endometriosis under the principle of double effect?

To heal endometriosis as the primary goal, with sterility as an unintended side effect

What is the main difference between major mutilation and minor mutilation?

Major mutilation destroys the functional integrity of the human body, while minor mutilation does not.

Why is excision of healthy organs usually not morally allowed?

It poses a grave serious danger to the health and life of the patient.

In what situation may the removal of a healthy organ be morally permitted?

When it stimulates further disease progression in another organ, posing a serious danger.

Why is excision of healthy organs seen as a form of mutilation?

Because it destroys the functional integrity of the human body.

What makes an excision of a healthy organ sometimes morally allowed?

If it prevents progression of disease in another organ, risking the patient's health.

Which type of mutilation involves procedures that diminish but do not destroy the functional integrity of the human body?

Minor Mutilation

Study Notes

Non-Maleficence

  • Refraining from doing something that harms or injures someone, means "do not inflict harm" to prevent, remove, or not risk harm.
  • Patients have a right not to be harmed, and healthcare professionals have an obligation not to harm them.
  • Harm can be physical, mental, psychological, social, financial, or spiritual.

Principle of Double Effect

  • A set of ethical criteria to evaluate the permission of acting when one's otherwise legitimate act may also cause an effect one would otherwise be obliged to avoid.
  • Example: relieving a terminally ill patient's pain, but also possibly shortening their life.
  • Patient's ability to give informed consent depends on:
    • Adequate disclosure of information
    • Patient freedom of choice
    • Patient comprehension of information
    • Patient capacity for decision making
  • Meeting these requirements satisfies three necessary conditions:
    • The individual's decision is voluntary
    • The decision is made with an appropriate understanding of the circumstances
    • The patient's choice is deliberate and carefully considered
  • When a patient is not capable of giving informed consent, a competent surrogate (e.g. family or guardian) acts on their behalf.
  • Example: unconscious, insane, or minor patients.

Preservation of Bodily Functional Integrity

  • The functional integrity of the person may be sacrificed to maintain their health or life when no other normally permissible means is available.
  • Example: using artificial means of preservation, such as simple heat or cold, powders, or immersion.

Principle of Totality

  • Based on the natural law that life is to be preserved and maintained.
  • Example: using artificial means of preservation, such as simple heat or cold, powders, or immersion.

Contraception

  • Can be done before, during, or after sexual intercourse to preclude the possibility of conception.
  • Ethical concerns may arise if there is coercion, lack of informed consent, or if the procedure is forced.

Types of Mutilation

  • Major Mutilation: destroys the functional integrity of the human body, making it incapacitated of its natural function.
  • Example: hysterectomy for the purpose of avoiding procreation.
  • Minor Mutilation: diminishes but does not destroy the functional integrity of the human body.
  • Example: tonsillectomy, ribs resection, blood donation, tooth extraction, circumcision.

Excision of Healthy Organs

  • Not morally allowed, as it provides no sufficient reason and attacks the integrity of the human body.
  • However, sometimes morally allowed in cases where the continued existence of a healthy organ may stimulate further disease progression, posing a grave danger to the patient's health and life.

Learn about the shift towards participative medical decision making where patients are more involved. Understand nursing responsibilities in obtaining informed consent from patients. Explore the importance of adequate disclosure of information in the consent process.

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