Podcast
Questions and Answers
What is the ethical principle that emphasizes respect for a patient's ability to make decisions about their own healthcare?
What is the ethical principle that emphasizes respect for a patient's ability to make decisions about their own healthcare?
In the context of informed consent, which of the following is NOT typically a requirement for valid consent?
In the context of informed consent, which of the following is NOT typically a requirement for valid consent?
Which ethical principle focuses on ensuring fair distribution of healthcare resources?
Which ethical principle focuses on ensuring fair distribution of healthcare resources?
When a healthcare provider chooses not to disclose a patient's sensitive information to protect their privacy, which ethical principle are they primarily upholding?
When a healthcare provider chooses not to disclose a patient's sensitive information to protect their privacy, which ethical principle are they primarily upholding?
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Which ethical challenge arises when a healthcare worker knows the right thing to do but is unable to act on it due to external pressures?
Which ethical challenge arises when a healthcare worker knows the right thing to do but is unable to act on it due to external pressures?
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What is a necessary element of informed consent?
What is a necessary element of informed consent?
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Which of the following best describes a characteristic of patient competency in the context of informed consent?
Which of the following best describes a characteristic of patient competency in the context of informed consent?
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How must information be presented to ensure patient comprehension during the informed consent process?
How must information be presented to ensure patient comprehension during the informed consent process?
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What principle of healthcare does confidentiality primarily support?
What principle of healthcare does confidentiality primarily support?
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Which statement best reflects the 'Need to Know' test in patient information confidentiality?
Which statement best reflects the 'Need to Know' test in patient information confidentiality?
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Which aspect is not included in the informed consent process?
Which aspect is not included in the informed consent process?
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Which ethical principle is directly violated if a patient is coerced into making a medical decision?
Which ethical principle is directly violated if a patient is coerced into making a medical decision?
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What is the primary purpose of HIPAA in the context of healthcare?
What is the primary purpose of HIPAA in the context of healthcare?
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What is the primary focus of the principle of autonomy in medical practice?
What is the primary focus of the principle of autonomy in medical practice?
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Which of the following is critical in ensuring informed consent in healthcare?
Which of the following is critical in ensuring informed consent in healthcare?
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What is the fundamental ethical principle that focuses on 'doing no harm'?
What is the fundamental ethical principle that focuses on 'doing no harm'?
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How does the principle of justice relate to patient care?
How does the principle of justice relate to patient care?
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What is a key principle of beneficence in healthcare?
What is a key principle of beneficence in healthcare?
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In relation to patient confidentiality, which of the following statements is true?
In relation to patient confidentiality, which of the following statements is true?
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Informed consent is primarily about ensuring that patients:
Informed consent is primarily about ensuring that patients:
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Which of the following describes a key outcome of fostering patient autonomy?
Which of the following describes a key outcome of fostering patient autonomy?
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Which of the following best illustrates the concept of patient autonomy?
Which of the following best illustrates the concept of patient autonomy?
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What challenge is associated with balancing beneficence and non-maleficence in patient care?
What challenge is associated with balancing beneficence and non-maleficence in patient care?
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Justice in healthcare primarily emphasizes:
Justice in healthcare primarily emphasizes:
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What is a common misconception regarding patient autonomy?
What is a common misconception regarding patient autonomy?
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Which of the following best defines informed consent?
Which of the following best defines informed consent?
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What does the principle of privacy and confidentiality in healthcare ensure?
What does the principle of privacy and confidentiality in healthcare ensure?
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Which of the following actions would likely violate a patient's autonomy?
Which of the following actions would likely violate a patient's autonomy?
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What aspect does the concept of privacy concern specifically in healthcare?
What aspect does the concept of privacy concern specifically in healthcare?
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The principle of non-maleficence means that healthcare providers should:
The principle of non-maleficence means that healthcare providers should:
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Which scenario could lead to a breach of confidentiality?
Which scenario could lead to a breach of confidentiality?
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Healthcare decisions should be guided by the principle of beneficence because it focuses on:
Healthcare decisions should be guided by the principle of beneficence because it focuses on:
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Which of the following best describes the concept of justice in healthcare, particularly regarding diversity?
Which of the following best describes the concept of justice in healthcare, particularly regarding diversity?
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What must a covered entity ensure when using, disclosing, or requesting protected health information?
What must a covered entity ensure when using, disclosing, or requesting protected health information?
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Which of the following is NOT a recommended practice for protecting patient confidentiality?
Which of the following is NOT a recommended practice for protecting patient confidentiality?
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How does precision medicine emphasize the treatment approach?
How does precision medicine emphasize the treatment approach?
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What potential concerns relate to data storage and sharing in healthcare?
What potential concerns relate to data storage and sharing in healthcare?
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What is a key aspect of informed consent in relation to confidentiality?
What is a key aspect of informed consent in relation to confidentiality?
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Which of the following misconceptions could affect a patient's autonomous decision-making?
Which of the following misconceptions could affect a patient's autonomous decision-making?
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What principle is emphasized by the Precision Medicine Initiative?
What principle is emphasized by the Precision Medicine Initiative?
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Which factor contributes to the duty of beneficence in healthcare?
Which factor contributes to the duty of beneficence in healthcare?
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What is a common misconception regarding patient privacy?
What is a common misconception regarding patient privacy?
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In the context of justice in healthcare, which concern is most relevant?
In the context of justice in healthcare, which concern is most relevant?
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Study Notes
Final Exam Review - PT 8351
- The exam format is similar to the midterm, including multiple choice, short answer questions, a Respondus Lockdown environment, and approximately 50 questions.
- Dr. Ward's lectures and Whitman-Walker Health information are not testable.
- Implicit Bias VoiceThread Reflections are part of the assessment.
- Topics include Ethics, Genomics/Precision Medicine, Professional Boundaries, Evidence-Based Practice (EBP), Payment.
Types of Ethical Challenges
- Dilemma (Right vs. Right): Knowing the right course of action but lacking the power to execute it due to financial or institutional barriers. Two morally correct options are possible but cannot be followed simultaneously.
- Distress: Knowing the right choice but not having the power to perform it, often due to financial, institutional or social obstacles.
- Temptation (Right vs. Wrong): Standing to gain from making a wrong decision.
- Silence: Not speaking up about a challenge to values, possibly when someone is in moral distress.
Key Clinical Ethics Concerns
- Autonomy: Patient's capacity to freely make their own decisions independently and with dignity. Informed consent is crucial in this.
- Justice: Treating patients fairly and equitably, ensuring access to research and clinical care, and recognizing past exploitation and abuse.
- Beneficence/Non-maleficence: Doing no harm and balancing risks and benefits of treatment, considering how to weigh the costs and challenges with potential benefits.
- Privacy/Confidentiality: Protecting patient information and understanding its limits, such as communication confidentiality and maintaining patient secrets.
Autonomy
- Patients have the ability to exercise freedom and self-determination/agency.
- It is a crucial guiding principle in the practice of medicine.
- Evidence suggests that patients who have a sense of control and autonomy are more likely to have positive outcomes.
Informed Consent
- Informed consent is a process where a healthcare provider discloses information to a competent patient for treatment, enabling a voluntary choice to accept or refuse.
- Necessary components of informed consent include: Nature of decision/procedure, reasonable alternatives, risks/benefits/uncertainties of treatment options, assessment of patient understanding, acceptance of intervention by the patient, costs and timeframes, and possible treatment alternatives.
- It is central to patient autonomy
Three Considerations for Informed Consent
- Competency: Patient or surrogate must be competent.
- Coercion: Patient must be participatory in the decision, not just passively signing a form.
- Comprehension: Patients must understand the presented information in lay terms.
Tips for Practice (Informed Consent)
- Informed consent laws vary by state. Refer to relevant state statutes and regulations.
- Documentation should include that the patient was informed about the treatment plan, understood the information, and consented to the treatment (POC).
What is "Confidentiality"?
- Privacy is the right to keep health information private.
- Confidentiality is the duty to maintain the privacy of patient information.
- Federal regulations, such as HIPAA (1996), protect patient confidentiality while balancing that right with the need for appropriate healthcare.
- Protected Health Information (PHI) includes both electronic and paper-based medical records.
Sharing Patient Information
- Providers may share patient information if relevant to someone's role in the patient's care, using the "need to know" test.
- The "minimum necessary" rule applies in sharing patient information. The provider must only share the minimum amount of protected health information needed.
Summary for Confidentiality
- Confirm patient identity.
- Avoid discussing patient cases without permission (unless necessary).
- Protect records and do not leave computer screens in view of unauthorized individuals.
- Use secure methods for sharing patient information, including encrypted routes.
- Ensure interpreters understand confidentiality.
- Track changes in telehealth technology and jurisdiction regulations.
Key Trend: Going Beyond Genetics/Genomics
- Precision Medicine aims to provide the correct treatment to the correct person at the correct time.
- The Precision Medicine Initiative received funding from the 2015 Presidential call.
- Precision Medicine has potential to marry America's history of innovation with individual health needs.
Your Potential Concerns
- School and company policies for data storage and sharing.
- Potential for discrimination and stigmatization based on genetic information.
- Concerns around privacy, ownership, and counseling.
- Concerns about the accuracy and interpretation of evolving genetic understandings.
Genetic Information Non-Discrimination Act (GINA) 2008
- Protects against discrimination by employers and health insurance companies related to genetic information.
- Prohibits employers from requesting, requiring purchase or using genetic information about employees and candidates. This includes work study and athlete employees.
Genomics Failing on Diversity
- Genome-wide association studies have shown a significant underrepresentation of diverse groups (African American, Latin Americans, etc.).
Sexual Harassment
- Unwelcome sexual advances, requests for sexual favors, verbal or physical conduct of a sexual nature, when a submission to such conduct affects employment decisions, unreasonably interferes with work, or creates a hostile work environment
- Covered under Civil Rights Act of 1964 (Title VII) (employers with more than 15 employees).
Successful/Unsuccessful Strategies (for Sexual Harassment)
- Successful: Distraction, avoidance, direct confrontation, behavioral contracts, transfer of care, use of chaperones.
- Unsuccessful: Ignoring the problem, making jokes, giggling, being indirect language-use.
Hostile Environment
- Open discussions of a sexual nature within earshot of employees or patients.
- Promotion due to favoritism related to sexual issues
- Patient harassing therapist for dates.
- Employees sharing inappropriate material online/on computers in workplace (pornographic materials or photos).
- Managers failing to address the behavior.
- Tolerance of dirty jokes and sexual slang.
Review of Part 1 (Payment)
- Key payment terms include PPOs (more choice, incentives to visit in-network providers), HMOs (closed networks, lower copays), HDHPs (cost shift to employee), Copay, Deductible, Prospective Payment, Fee for Service.
- Payment implications for physical therapy practice.
Health Insurance Terms
- Premium: The amount paid monthly by a beneficiary for health care insurance coverage.
- Benefits: The covered health care services under a health insurance plan. Benefits and excluded services are defined in state insurance plans.
- Deductible: The amount a patient pays out of their pocket before insurance benefits begin.
- Co-Pay: The fixed amount paid for each visit to a specialist or doctor.
- Co-Insurance: The percentage a patient pays after meeting the deductible.
- Fee-for-service: The model where payment is tied to each specific service rendered.
Secondary/Supplemental Insurance
- Secondary insurance covers care not covered by the primary insurance.
- Supplemental insurance can add additional coverage for co-insurance and co-pays.
Health Insurance Models
- PPO: Preferred Provider Organization
- HMO: Health Maintenance Organization
Managing Financial Risk
- Employer considerations include increasing employee premiums, limiting healthcare providers' acceptance, or employing methods requiring more co-pays
- Employee considerations include utilizing in-network providers, the differences between high- and low-deductible plans, and co-pays.
- Payers consider factors like limiting coverage types, capping office visits, and the importance of strong documentation.
- Delivering quality care effectively, and efficiently.
Value-Based Payment models
- Pay for performance, bundled payments, capitation, and shared risks and savings.
EBP (Evidence-Based Practice)
- EBP definitions, steps, hierarchy of evidence, types and format for clinical questions, intervention vs diagnosis vs prognosis, foreground vs. background, searching for evidence, website/databases, and citation formats (AMA vs. APA).
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