Confidentiality & Duty to Warn
Why is confidentiality important in the healthcare context?
Confidentiality is important in the healthcare context because it protects patients privacy rights, specifically HIPPA laws and their right to privacy. Also it ensures patient complete autonomy in their choices
What are better patients?
Advocates of full disclosure believe informed patients are better patients
What is informed consent?
This is defined as the action of an informed rational person regarding medical treatment or experiment.
What are the two forms of consent discussed by Fadden and Beauchamp:
They discussed sense 1 consent being individual as the patient can actively understand the procedure and Sense 2 where the patient legally authorizes consent.
Sense 1 can be made without sense 2, an example could be that in Levine with cultural norms. Such as women are often not decision makers so one may go through sense 1 in explaining procedure to women but skip the signing authorization in sense 2, in fact legal signing of sense 2 is more solely in the western world because it is required here (in America)
Belmont Principle covers what 3 principles?
respect, beneficence, and justice
Should a commitment to confidentiality always be absolute or are there exceptions?
NOT absolute and there are exceptions. One is in emergency situations in which the risk is higher then the benefit, If breeching confidentiality will help the situation, and if it an immediate threat
The authority of persons to control who may possess and use information about themselves is called a right to privacy.
What are the key criteria needed to establish informed consent? (there are 5)
(1) patient is competent to decide (2) adequate disclosure of information (nature) (3) understand the risks and benefits of the procedure (4) decides about treatment voluntarily (5) consents to treatment
what is equipose?
the state of genuine uncertainty within the expert medical community regarding the comparative therapeutic merits of different arms in a clinical trial
what is justice?
The Belmont principle that protects vulnerable populations and was influenced by Tuskegee is justice
What is Tarasoff v. Regents of the University of California?
This legal case established that confidentiality ends where public safety begins.
An implication of this incident was that while confidentiality was respected in order to protect the patient to set up good physician and patient trust within psychotherapy, ultimately ended in harm and death of an innocent person. When it comes to a threat of safety to another, confidentiality should be breached because that is when the risk ratio overweight's the benefits of confidentiality.
what is epistemic justice?
Epistemic justice is making sure every patient is heard and respected with fair distribution of knowledge/recognition regardless of background. Epistemic injustice applies to healthcare in the aspect of patient physician relationship
What is competence
A patient must be able to decide. This requirement is known as competence
what is competence?
A patient must be able to decide and be in a rational state of mind. This is called
what is beneficence
The Belmont principle that requires a
favorable risk > benefit ratio is beneficence
What is Duty to Warn?
This duty requires physicians to breach confidentiality when there is an immediate threat to others.
what does it mean to be in an emergency situation and how does that affect a patients autonomy?
In emergency situations, information may be temporarily withheld but must be delivered when this condition changes.
What is informed consent and why is it important in Bioethics?
Informed consent is action of informed rational person regarding medical treatment or experiment. It is important in Bioethics because informed consent is needed in order to ensure that individuals are getting care that is beneficial, or more benefit then risk.
key features of NUREMBURG:
Belmont Report key features?
Should healthcare professions always tell patients the truth? (no correct answer but practice defending your answer)
ultimately yes. Truth telling respects people's autonomy and even if communication regarding the whole truth is impossible physicians have an obligation to try and convey patients the essential and relevant information.
The arguments against full disclosure, like patient would not want to or in an emergency situation should be handled as information is kept but promised to be delivered at a safer time (when emergency is at bay) or kept from patient WITH their consent to this.
Withholding truth without patient consent risks violating WHAT core ethical value.
autonomy
What does Reynolds think are 3 important things for clinicians to know about disability?
key features of HELINSKI
How would ethic codes like Belmont report should be updated: