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Ethical Dilemmas in Healthcare
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Surrogate pregnancy arrangements and associated legal rights of the surrogate and intended parents.
Legal context is based on surrogacy laws which vary vastly by state. Resolution of disputes involves contracts, parental rights, and potentially the Uniform Parentage Act.
Privacy issues arising from genetic testing and access to those results by third parties.
Legal context includes GINA and HIPAA privacy rules. Resolutions necessitate strict confidentiality protocols and careful disclosure policies.
End-of-life decision-making for an incapacitated patient without an advance directive.
Legal context involves understanding living wills, durable power of attorney, and consent laws. Considerations for resolution may include state-specific regulations, substituted judgment standard, or relying on best interests standards.
Access to experimental treatments for terminally ill patients ('Right to try' laws).
Legal context comprises federal 'Right to Try' legislation and FDA regulations. Considerations for resolution involve patient safety, informed consent, and potential effects on clinical trial integrity.
Mandatory vaccinations and the right to refuse based on personal beliefs.
Legal context is derived from public health laws and individual rights under constitutional law. Resolution needs to balance public health protections with personal autonomy and religious freedom.
Determining the competency of a mentally ill patient to make healthcare decisions.
Legal context includes mental health laws and standards for assessing competency. Resolution may involve psychiatric evaluations, legal guardianship, or conservatorship.
Withholding versus withdrawing life-sustaining treatment.
Legal context is based on the principle that there is no ethical difference between withholding and withdrawing treatment. Resolution requires adherence to patient autonomy and professional guidelines.
Patient confidentiality in the context of a minor seeking reproductive health care.
Legal context involves understanding the confidentiality rights under HIPAA, state laws related to minor consent, and case law surrounding patient privacy. Considerations for resolution include parental notification laws, mandatory reporting, and the mature minor doctrine.
Administering treatment without informed consent due to language barriers.
Legal context centers on informed consent laws and communication rights under the Civil Rights Act. Resolutions may involve providing professional interpreter services and understanding consent requirements.
Physician-assisted suicide in jurisdictions where it's legal.
Legal context includes Death with Dignity laws and ethical standards from medical associations. Resolutions must consider patient autonomy, incurability of illness, and thorough consent processes.
Allocation of scarce medical resources, such as organs for transplant.
Legal context is dictated by the National Organ Transplant Act and UNOS regulations. Resolution involves equitable allocation policies considering medical need, urgency, and patient compatibility.
Managing conflicts of interest between a physician's financial incentives and patient care.
Legal context involves the Stark Law and Anti-Kickback Statute that regulate financial relationships in healthcare. Resolutions require transparent disclosure and policies to prioritize patient welfare.
Use of placebo treatments without patient knowledge or consent.
Legal context revolves around informed consent and possible deception. Resolution requires balancing ethical concerns with clinical benefits and obtaining consent where appropriate.
Use of off-label medications without clear scientific evidence of efficacy.
Legal context encompasses FDA regulations and informed consent requirements. Resolutions should involve a thorough risk-benefit analysis and transparent patient communication.
Discrimination in healthcare settings based on race, gender, or sexual orientation.
Legal context draws from the Civil Rights Act, the Affordable Care Act, and other anti-discrimination laws. Resolution policies must promote equal treatment and access for all patients.
Prescription of addictive substances in the context of chronic pain management.
Legal context involves Controlled Substances Act regulations and prescription monitoring programs. Resolution requires careful patient assessment, monitoring, and consideration of non-addictive alternatives.
Denial of non-emergent care due to a patient's inability to pay.
Legal context arises from the Emergency Medical Treatment and Active Labor Act (EMTALA) and affordable care policies. Resolution implicates considerations of healthcare provider duties and patient financial assistance programs.
Refusal of blood transfusions for religious reasons, even when medically necessary.
Legal context involves the First Amendment, patient autonomy, and the need for medical consent. Resolution can depend on patient competency, age, and seriousness of the condition.
Handling potential medical errors and whether to disclose them to the patient.
Legal context includes professional standards for disclosure laid out by the Joint Commission and potential malpractice implications. Resolution involves balancing transparency with legal liability.
The use of artificial intelligence in clinical decision-making without full transparency to patients.
Legal context relates to informed consent laws and the principle of autonomy. Resolutions should focus on comprehensive disclosure of AI involvement and accuracy of the AI models used.
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