health and society

• Consequentialism Moral based on the consequence of the action.
• Deontology Moral based on the actions adherence to the rules/duties"
• Virtue ethics Right act is one a virtuous person would do, that express the virtues such as compassion and honesty.
• What is the definition of medical professionalism? A set of values, behaviours and relationships that underpins the trust that the public has in doctors."
• Describe the regulatory role of the GMC? To protect, promote and maintain the health and safety of the public by ensuring properstandards in the practice of medicine.
• Outline the role of medical schools and the GMC in ensuring students and doctors fitness topractice? • GMC sets its guidance for what medical graduates need to accomplish in Tomorrow'sDoctors.• This is taught by the medical schools.• This is examined formally in various exams taken throughout the course, reflectiveessays, learning to give feedback and self-reflection, attendance and punctuality, plagiarism.
• Benefits of good communication? • More accurate diagnosis.• More accurate data gathering.• Increased adherence with treatment regime.• More effective patient-doctor relationship.• Increased patient-doctor satisfaction.
• Consequences of poor communication? • Inaccurate diagnosis.• Less recognition of ICE.• Non-adherence to treatment.• Decreased satisfaction with doctor.• More complaints.
• What makes science social? • Decisions about research funding.• Pharmaceutical industry - profits.• Ethical issues.• Nature of scientific work - communication.
• What is eugenics? • Improving a population by controlled breeding.• Encourages good genetics, discourages bad genetics.
• Issues with eugenics? • Thinking about the future based on genetics.• Designer babies.• Genetic screening - health insurance, employment, and civil liberties.• Many conditions are polygenic."
• What is patient centred care? Care that is responsive to the wants, needs, and preferences of the patient.
• 6 criteria of patient centred care? • Explores patients main reasons for visit. +establishes rapport• Seek integrated understanding of patients world - looks at the whole person.• Finds common ground on problem and mutually agrees on management.• Enhances prevention and health promotion.• Enhances the continuing relationship between the patient and the doctor.• Is realistic i.e "
• How does patient centered care enhance heath prevention/promotion? allows a doctor to find the methods of health promotion and preventative care which most appropriately match a patient’s world.
• What is the sick role? States the rights and responsibilities for patient and doctors when they have a consultation.
• What is the patient expected to do in the sick role? • Must want to get well as quickly as possible.• Should seek professional medical advice and cooperate with the doctor.• Allowed to stop normal activities and responsibilities e.g. work.• Regarded as being in need of care and unable to get better alone.
• What must the doctor do to uphold the sick role? • Apply a high degree of skill and knowledge.• Act for welfare of patient, not self interest.• Be objective and emotionally detached.• Be guided by rules of professional practice.
• Criticisms of the sick role? • Symptom iceberg - Patients do not necessarily act on symptoms and go see the doctor.• Chronic illness and MUS - If cause unknown, patients can't enter sick role due touncertainty.• People try to label themselves as sick.• Conflict between best interests for the patient and cost to society in allocation ofresources.
• What 4 sources are used when making a clinical decision? • Patient preferences• Available resources (studies)• Research evidence (guidelines/systematic reviews)• Clinical expertise (others)
• Why is evidence-based decision making important? • Deals with uncertainty.• Medical knowledge is incomplete/shifting.• Patients will receive most appropriate treatment.• Constant need for innovation and improvement.• Improving efficiency of healthcare services.• Reduces practice variation.
• What are the sources of NHS funding? • Tax finance.• Some user charges e.g. prescriptions, parking
• How is the NHS organised? • Smaller Integrated care boards (ICB's) that are clinically-led statutory NHS bodies responsible for the planning andcommissioning of health care services for their local area• Public hospitals and GPs - Sellers.
• What is flat of the curve medicine? increased expenditure on healthcare produces no further benefit
• What are meta-ethics? Study of moral concepts, e.g. right and wrong.
• What is normative ethics (moral theory)? Study of the means of deciding what is right and wrong.
• What is applied ethics? Application of moral theory.
• What are the 3 main types of moral theory? • Consequentialism - Moral based on the consequence of the action.• Deontology (duty based) - Moral based on actions adherence to the rules.• Virtue ethics - Right act is one a virtuous person would do.
• What are the 4 ethical principles? • Autonomy - Respect the patient as an individual to make choices.• Non-maleficence - Not permitted to harm patients.• Beneficence - Act in a way that positively benefits patient (act in patients best interests).• Justice - Treat people fairly and equitably.
• What is the difference between disease and illness? (the 2 agendas) What is the difference between disease and illness?• Disease - What is wrong with the body.• Illness - Looks at the way that the patient experiences the disease."
• why is important to address disease and illness • Disease - Means you treat the correct condition, improves biomedical health.• Illness - Can discover how illness is impacting patients life, patient more satisfied,enhances doctor-patient relationship.
• What is autonomy? • Informing patients with capacity to make their own decisions.• Respecting wishes regarding patients treatment.
• What ethical principles should you think about when assessing patients best interests? • Beneficence - Act to positively benefit patient.• Non-maleficence - Act in a way as not to harm the patient.
• What does it mean to act in a Patient's best interest Actions that seek to provide an overall benefit for the patient. Takes into account impact on daily life, family, ability to communicate and future implications
• What potential difficulties that might occur when assessing best interest? 4 - lack capacity to communicate with Dr- Dr and Pt views differ- uncertain future consequences- weighing up conflicting goods"
• informal carers An informal carer is any person, such as a family member, friend or neighbour, who is giving regular, ongoing voluntary assistance to another person without payment.
• What is paternalism? Interference with a patients autonomy of action/information in order to benefit them e.g coercion + witholding info
• exceptions to paternalism - to prevent serious harm e.g psychological distress- treatment of infants/children who lack capacity- adults with mental health problems- when treatment provides no overall benefit
• What is coercion? Persuading patient to do something by force or threats (e.g. forcing to eat).
• What is the Bolam test? Test of negligence, determines standard of care.
• Where can you look at disease distribution? - Globally- Regionally- Locally