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Flashcards in Quality, Safety, and Ethics Deck (24)
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1
Q

True or false: A surrogate can change a patient’s advanced directive after the patient becomes incapable of making medical decisions, based on the surrogate’s own preference.

A

False

2
Q

This is the collaborative process among phsyicians, patients, and surrogates that discuss end-of-life (EOL) care and decisions.

A

Shared decision making

3
Q

3 steps in shared decision making?

A

Information exchange
Deliberation
Decision

4
Q

Are withholding and withdrawing life support considered equivalent in the US?

A

Yes

5
Q

Is euthanasia and allowing death to occur considered equivalent?

A

No

6
Q

This is when there is rationale for providing relief of pain and other symptoms even when this may have the forseen (but unintended) consequence of hastening death. Eg: administering opiates before terminal extubation.

A

Doctrine of “double effect”

7
Q

When are treatments considered “futile”?

A

When there is no beneficial physiologic benefit

8
Q

What distinguishes inappropriate/inadvisable treatment from futile treatments?

A

Treatments which unlikely benefit, beneficial effect with extreme cost and uncertain or controversial benefit are considered inappropriate and inadvisable but not futile

9
Q

True or false: If a patient is paralyzed, you should reverse the muscle relaxant prior to starting withdrawal of life- sustaining treatments.

A

True; you always want to be able to assess pain and discomfort

10
Q

True or false: Food and fluids can be withheld legally and ethically and withdrawn if congruent with a patient’s goals of care.

A

True

11
Q

True or false: Advance directives are not portable—they are valid only in the state where they were written.

A

True

12
Q

What does the Uniform Determination fo Death Act state about brain death?

A

If a pt meets neurologic criteria of breath death as defined by loss of the functional activity of the brain stem and cerebral cortex, the pt is legally deemed dead.

13
Q

This is the principle that a patient has the right to make an informed and uncoerced decision on medical treatment

A

Autonomy

14
Q

What are the 4 things that need to be disclosed in informed consent?

A

Diagnosis
Nature and purpose of treatment
Risk of treatment
Treatment alternatives

15
Q

This is the principle to “do no harm” in treatment of patients.

A

Nonmaleficence

16
Q

This is the principle of actions that promote the well-being of others.

A

Beneficence

17
Q

This is the principle that refers to the fair distribution of limited health resources

A

Justice

18
Q

This is the scientific discipline that focuses on the structures, processes, and outcomes of health care delivery

A

Quality improvement

19
Q

True or false: Physicians are not obligated to continue providing mechanical ventilatory support after brain death.

A

True

20
Q

Obtaining informed consent prior to a procedure is respecting which of the four basic principles of medical ethics?

A

Autonomy

21
Q

What is The Belmont Report?

A

A statement created by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research that summarizes basic ethical principles and guidelines for research involving human subjects; three core principles identified are respect for persons, beneficence, and justice.

22
Q

This is the safe, timely, effective, eifficient, equitable and patient centered care that has the components of structure, process, and outcome

A

Quality health care

23
Q

The integration of what device can significantly lower frequency of errors, which improves outcomes, patient safety, and efficacy of resource utilization

A

Checklists

24
Q

There was a lot of common sense stuff in this chapter, such as

A

Residents working a lot sucks
Have good patient:physican
Attendings are ultimately responsible for everything
Dont be an alcoholic