Professional Issues FInal
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What is the primary ethical principle associated with a patient's right to make their own decisions in medical care?

  • Non-maleficence
  • Autonomy (correct)
  • Beneficence
  • Justice

    • What ethical concern is represented by the hospital's choice to use a cheaper implant to increase profit?

  • Beneficence
  • Autonomy
  • Privacy
  • Justice (correct)

    • What is the main reason a surgical resident might be concerned about using a cheaper implant?

  • The lifespan may be shorter compared to other implants. (correct)
  • It may lack privacy protections.
  • It violates patient autonomy.
  • It is less profitable.

    • Which ethical principle emphasizes the necessity of minimizing harm while maximizing benefits in treatment decisions?

    <p>Beneficence/Non-maleficence</p> Signup and view all the answers

    What defines a dilemma in ethical challenges?

    <p>Having two morally correct courses of action that cannot both be followed.</p> Signup and view all the answers

    In the context of informed consent, which action best respects a patient’s autonomy?

    <p>Allowing them to choose from a range of treatment plans.</p> Signup and view all the answers

    What ethical concern is raised when a medical professional does not maintain patient confidentiality?

    <p>Privacy/Confidentiality</p> Signup and view all the answers

    How is moral distress characterized in ethical challenges?

    <p>Knowing the right action but being unable to perform it.</p> Signup and view all the answers

    How can healthcare providers foster a sense of control in patients?

    <p>By providing comprehensive information to support decision-making.</p> Signup and view all the answers

    What is an example of temptation in ethical challenges?

    <p>Receiving gifts from a company in exchange for recommendations.</p> Signup and view all the answers

    What is a necessary component of the informed consent process?

    <p>Assessment of patient understanding</p> Signup and view all the answers

    What could be a consequence of failing to consider justice in medical treatment decisions?

    <p>Unequal access to care for different patient populations.</p> Signup and view all the answers

    Which scenario exemplifies silence in ethical challenges?

    <p>Employees feeling pressured to bill more units without voicing concerns.</p> Signup and view all the answers

    Which aspect is NOT a consideration in the informed consent process?

    <p>Availability of insurance coverage</p> Signup and view all the answers

    What financial concern may influence ethical decision-making?

    <p>The obligation to maximize profits for the practice.</p> Signup and view all the answers

    How should information be presented to a patient for informed consent?

    <p>In layperson's language</p> Signup and view all the answers

    Which aspect is NOT a characteristic of ethical challenges?

    <p>Clear guidelines that dictate the right course of action.</p> Signup and view all the answers

    What might constitute an ethical challenge in a professional setting?

    <p>Pressuring staff to achieve financial quotas at the expense of ethics.</p> Signup and view all the answers

    What principle is reflected in the legal standing of patient privacy under HIPAA?

    <p>Autonomy</p> Signup and view all the answers

    What does the 'Need to Know' test imply regarding patient information?

    <p>Only relevant parties may access patient information</p> Signup and view all the answers

    What psychological effect can silence surrounding ethical issues inflict on professionals?

    <p>Feelings of isolation and moral distress.</p> Signup and view all the answers

    Which of these must be documented in the informed consent process?

    <p>Patient's full understanding of the procedure</p> Signup and view all the answers

    Informed consent requires the patient to be able to do what?

    <p>Make a voluntary choice</p> Signup and view all the answers

    What distinguishes competent patients in the informed consent process?

    <p>They can understand and evaluate information</p> Signup and view all the answers

    What is the main purpose of the Genetic Information Non-Discrimination Act (GINA) 2008?

    <p>To protect individuals from discrimination based on their genetic information.</p> Signup and view all the answers

    Why is it challenging to interpret genetic research findings?

    <p>Research is progressing at a rapid and complex pace.</p> Signup and view all the answers

    Which group has historically had the lowest participation in genome-wide association studies?

    <p>African American and Latino participants.</p> Signup and view all the answers

    In what context is sexual harassment defined?

    <p>When submission is linked to employment decisions or creates a hostile environment.</p> Signup and view all the answers

    Which strategy is considered unsuccessful when dealing with sexual harassment?

    <p>Ignoring the problem.</p> Signup and view all the answers

    What is a key indicator of a 'hostile' work environment?

    <p>Open discussions of inappropriate topics in the workplace.</p> Signup and view all the answers

    How does the Civil Rights Act, 1964 (Title VII) relate to sexual harassment?

    <p>It protects employees against workplace discrimination, including sexual harassment.</p> Signup and view all the answers

    What term refers to unwelcome sexual behavior affecting an individual's work performance?

    <p>Sexual harassment.</p> Signup and view all the answers

    What is the primary aim of the 'minimum necessary' rule regarding protected health information?

    <p>To limit the use and disclosure to only what is essential.</p> Signup and view all the answers

    Which of the following actions is NOT recommended for maintaining patient confidentiality?

    <p>Discuss patient cases with family members without permission.</p> Signup and view all the answers

    What is a crucial aspect of ensuring confidentiality when using an interpreter?

    <p>Ensure the interpreter understands the importance of patient confidentiality.</p> Signup and view all the answers

    Which statement reflects an essential principle of precision medicine?

    <p>It seeks to tailor treatments to individual patients based on their unique characteristics.</p> Signup and view all the answers

    In the context of precision medicine, what was President Obama's call for funding in 2015?

    <p>$200 million to support the Precision Medicine Initiative.</p> Signup and view all the answers

    Which concern is associated with the handling of health data for institutions?

    <p>Preventing discrimination and stigmatization in various forms.</p> Signup and view all the answers

    What crucial question should an individual consider before undergoing counseling?

    <p>Am I capable of making this decision independently?</p> Signup and view all the answers

    What is emphasized about the delivery of patient information?

    <p>Utilizing only encrypted routes to send information.</p> Signup and view all the answers

    What percentage of costs does supplemental Medicare insurance typically cover?

    <p>80%</p> Signup and view all the answers

    Which health plan model limits coverage exclusively to in-network providers?

    <p>HMO</p> Signup and view all the answers

    What is a major drawback of the Pay for Performance model?

    <p>It can incentivize unnecessary costly procedures.</p> Signup and view all the answers

    In a Capitation payment model, what do providers assume responsibility for?

    <p>The health of a defined patient population.</p> Signup and view all the answers

    What is a characteristic feature of Bundled Payments?

    <p>Providers receive a fixed fee for all services related to a procedure.</p> Signup and view all the answers

    Which of the following is NOT a strategy employers may use to manage financial risk?

    <p>Increase profit margins</p> Signup and view all the answers

    What is the primary benefit of using In-network providers for employees?

    <p>Lower out-of-pocket costs.</p> Signup and view all the answers

    Under which payment model is financial responsibility pooled for a defined patient population?

    <p>Capitation</p> Signup and view all the answers

    Study Notes

    Final Exam Review - PT 8351

    • The exam format will be similar to the midterm and include multiple choice, short answer questions, and a Respondus Lockdown format.
    • There will be approximately 50 questions.
    • Topics covered include: ethics, genomics/precision medicine, professional boundaries, evidenced-based practice (EBP), and payment.
    • Dr. Ward's lectures and Whitman-Walker Health are not testable.
    • The exam assesses topics from implicit bias VoiceThread reflections.

    Types of Ethical Challenges

    • Dilemma (Right vs. Right): Situations with two possible morally correct choices, but follow-through with one choice may result in missing the other. Possible issues include financial or institutional barriers.
    • Distress: Knowing the correct choice of action to take but being unable to act on it due to barriers (financial or institutional).
    • Temptation (Right vs. Wrong): Standing to benefit from a morally wrong decision.

    Case Examples of Ethical Challenges

    • A wheelchair company offers tickets to an NFL game to influence a recommendation, even if the chairs cost more than comparable models.
    • An employee is asked to inflate time spent on an official task to increase company earnings, with pay raises as an incentive.
    • A patient refuses to disclose information about a family matter to their parents.
    • A student notices a surgical resident/practitioner performing a procedure using an inferior implant to increase profit margin at the expense of patient care.

    Key Clinical Ethics Concerns

    • Autonomy: A patient's right to self-determination/freedom with respect to their choices; adequate informed consent for genetic testing. Fair, equitable treatment and access to clinical care; addressing potential historical exploitation and abuse.
    • Beneficence/Non-maleficence: First do no harm, balancing potential risks and benefits in treatment decisions; privacy and confidentiality, including understanding the limits of these duties.

    Autonomy

    • Patients have the ability to exercise their freedom in a given situation.
    • Self-determination (personal agency) is a guiding principle in the medical practice.
    • Evidence shows that patients who feel in control and have autonomy are more likely to recover from illness.
    • Informed consent is the process for a healthcare provider to disclose appropriate information to a competent patient so they can decide whether or not to accept treatment.
    • Includes the nature of the procedure, reasonable alternatives, risks, benefits, and chances of complications.
    • Includes assessing patients' understanding of the intervention, acceptance of treatment terms, costs, and possible alternatives.
    • This is a core component of patient autonomy.
    • Competency: Patients or surrogates must be competent to make their own decisions.
    • Coercion: The patient must participate actively in the decision-making process, not just sign a form.
    • Comprehension: The patient must understand the information presented—layman's terms.

    Tips in Practice

    • Informed consent laws vary by state.
    • Consult state statutes and regulations for specific requirements.
    • Documentation must include that you informed the patient of the procedure proposed and the patient understood the information provided, and gave consent.

    Confidentiality

    • Privacy refers to an individual's right to keep their health information private.
    • Confidentiality is the responsibility of anyone entrusted with health information to keep that information secret.
    • Federal law (HIPAA, 1996) balances the individual’s right to privacy with the health care needs.
    • Protected health information (PHI) can be electronic or paper-based.
    • Sharing patient information is limited to those whose roles require it for their direct patient care. (Use the "Need to Know" test)
    • Follow the “minimum necessary" rule: Only share the minimum amount of information required.

    Summary for Confidentiality

    • Confirm patient identity at first encounter.
    • Never discuss cases without patient or necessary provider permission.
    • Protect records and screens from unauthorized access. Use secure communication methods to send protected health information.
    • Communicate with qualified interpreters to ensure understanding of confidentiality.
    • Track changes, including telehealth practices, and regulatory changes.

    Key Trend: Going Beyond Genetics/Genomics

    • Focus on individualized treatment for patients at appropriate times with appropriate medical care.
    • The Precision Medicine Initiative has received funding to enable this approach.
    • Aim to combine insights from biological science with patient characteristics to ensure the best medical care for each patient.

    Your Potential Concerns

    • School/company policies to ensure the proper handling and storage of sensitive patient data
    • Stigmatization, especially related to discrimination concerning genetic information
    • Privacy and insurance concerns.
    • Ownership concerns
    • Capability in making such decisions independently without outside family members
    • Evolving research and understanding about genetic markers in interpretation

    Genetic Information Non-Discrimination Act (GINA) 2008

    • Protects against discrimination based on genetic information by employers and health insurance companies.
    • Prohibits employers from requesting, requiring, or purchasing genetic information related to employees or candidates.
    • Includes work study students

    Genomics Failing on Diversity

    • A significant number of studies have focused on participants of European descent, with limited diversity in other groups.
    • Asian and African American participation in genome-wide association studies remains relatively low.
    • Descriptors for ethnicity are often outdated or lack nuance in many studies.

    Sexual Harassment

    • Includes unwelcome sexual advances, requests for sexual favors, and verbal or physical conduct of a sexual nature.
    • Submission to such conduct is a condition of employment or used for employment decisions.
    • Conduct unreasonably interferes with performance or creates a hostile environment.
    • Covers employers with more than 15 employees.

    Successful Strategies for Inappropriate Patient Behavior

    • Distraction
    • Avoidance
    • Direct confrontation
    • Behavioral contracts
    • Transfer of care
    • Use of chaperones

    Hostile Environment Creation

    • Open discussions within earshot of others (patients or coworkers) about inappropriate sexual topics.
    • Promotion of an employee based on inappropriate sexual favoritism
    • Patient consistently asking a therapist for a date.
    • Sharing of pornography on an office computer.
    • Supervisors or managers ignoring or accepting inappropriate behaviors from coworkers.
    • Use of dirty jokes or sexual slang.

    Part 1 Review of Payment

    • PPO: Offers more choices; incentivized in-network providers
    • HMO: Closed-network; lower co-pays compared to PPOs
    • HDHP: Shifts costs to employees
    • Copay: Fixed patient cost per visit
    • Deductibles: Out-of-pocket cost before insurance takes over
    • Prospective Payments: Predetermined payment system
    • Fee-for-Service: Fixed fee for each service provided; quantity-based
    • Includes various insurance terms.

    Health Insurance Terms and Definitions

    • Premium: Monthly payment for health care coverage (no premium for Medicare Part A and B or Medicaid).
    • Benefits: Covered health care services and procedures per plan.
    • Deductible: Amount patient pays before insurance covers costs.
    • Co-pay: Fixed amount paid for each visit to specialists
    • Co-Insurance: Percentage of patient's payment after deductible and co-pay are met.
    • Fee-for-service: Fixed fee for services, dependent on the quantity. of services, not quality of care.
    • Secondary Insurance: Coverage from additional plans.
    • Supplemental Insurance: Additional insurance policies or plans beyond the primary plan.

    Managing Financial Risks

    • Employer perspective: Increased employee premium costs, limitation of network providers/types, higher co-pays.
    • Employee perspective: Use in-network providers, higher/lower deductibles, and co-pays.
    • Payer perspective: Coverage restrictions, limitations on visits, clinic documentation and outcomes measurements

    Value Based Payment Models

    • Pay-for-performance: Financial bonuses from successful care; often implemented as an overlay on fee-for-service payment.
    • Bundled payments: Single, predetermined payment for multiple services (e.g., surgery).
    • Capitation: Providers assume financial responsibility for a patient population; fixed premium payments.
    • Shared savings: Providers share in savings generated by lowering overall service costs
    • Shared risk: Providers share in the costs of care exceeding a pre-set budget

    EBP Definitions and Steps

    • Define EBP
    • Hierarchy of evidence levels for research findings
    • Types and format for clinical questions
    • Intervention vs. Diagnosis vs. Prognosis
    • Foreground vs. Background questions
    • Searching for evidence (relevant websites, databases)
    • Appropriate citation formats (e.g., AMA, APA)

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    Final Exam Review PT 8351 PDF

    Description

    Test your knowledge on key ethical principles in medical practice. This quiz covers topics like patient autonomy, informed consent, and ethical dilemmas in healthcare decisions. Challenge yourself to think critically about ethics in the medical field.

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