dxtxpx
Forum Guru
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Posts: 1,233
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Define Autonomy.
Obligation to respect pts as individuals and to honor their preferences in medical care
"Legally, what does informed consent require?"
"- discussion of pertinent information- obtaining the patient's agreement to the plan of care- freedom from coercion"
Pt autonomy vs. beneficence: when does autonomy win out?
"If pt makes an informed decision, ultimately, the pt. has the right to decide."
What 3 proofs are required for a sucessful malpractice civil suit for neglegence?
"- Dr. breach of duty to patient- pt. suffers harm- breach of duty causes harm Note--beyond reasonable doubt not needed, just more likely than not"
What are the 4 exceptions to confidentiality?
"- potential harm to others is serious- likelihood of harm is great- no alternative means exist to warn or to protect those at risk- Drs. Can take steps to prevent harm"
What are the 4 exceptions to informed consent?
"- pt. lacks decision-making capacity (not letally competent)- implied consent in an emergency- therapeutic privelege--withholding information when disclosure would severly harm the pt or undermine informed decision-making capacity- waver--pt. waves "
What are the 5 signs of a pt's decision-making capacity?
"- pt. makes and communicates a choice- pt. is informed- decision remains stable over time- decision consistent w/ pt's values and goals- decision not a result of delusions or hallucinations"
What are the types of written advance directives?
"- LIVING WILLS--pt. directs Dr. to withhold/withdraw life-sustaining tx if the pt develops terminal disease or enters a persistent vegetative state- DURABLE POWER OF ATTORNEY--pt designates a surrogate to make medical decisions in an event pt. loses decision"
What is beneficence?
Dr. have special ethical responsibility to act in the pt's best interest. Pt. autonomy may conflict with beneficience
What is confidentiality?
Confidentiality respects pt. privacy and autonomy. Disclosure to family and friends should be guided by what pt. would want. Pt can waive right to confidentiality (i.e. to insurance co.)
What is nonmaleficence?
"Do no harm. But, if benefits of intervention outweigh risks, pt may make an informed decision to proceed."
What must patients understand in informed consent?
"- risks- benefits- alternatives, which includes no intervention"
When is an oral directive valid?
"Incapacitated patient's prior oral statements commonly used as guide, but problems arise from variance in interpretation. if pt was INFORMED, directive is SPECIFIC, pt. MAKES A CHOICE and decision is REPEATED over time, the oral directive is more valid."
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