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Principles 2 Test 2

Informed Consent

What 3 things must be present for it to be considered informed consent? information and knowledge, comprehension and understanding, freedom and voluntary participation
In what circumstances are there exceptions to the rule that all 3 necessary constructs must be present for informed consent? minors, the mentally impaired, comatose patients
Under the information and knowledge construct of informed consent, what 4 things should the patient understand clearly in regard to anesthesia? the purpose, the risks and benefits, alternative procedures, anticipated or expected results
What is the term for the consent provided by the patient simply showing up the day of surgery? Or by freely lending an arm for an IV start? implied consent
Explain how informed consent reaches beyond implied consent. Informed consent involves telling them risks vs. benefits and informing them of alternative anesthesia options so that they are allowed to make an informed decision about their own medical care.
True or False: you should present the information the same way each time to every patient you encounter False! This does not account for different levels of understanding
What is a good question to ask the patient to ensure that they have comprehension and understanding of what you have informed them about? Which option do you choose for your anesthesia and why are you choosing that option?
Does the CRNA have to enumerate every single risk of anesthesia? No, but it should be broadly inclusive ("from itching to death") and should be targeted toward their specific issues (i.e. neck problems, dental implants, PONV)
_________ implies that the subject understands the situation and no coercion or undue influence has been used. Freedom
Is the CRNA legally allowed to state his or her opinion or judgement about what is best for the patient? Yes! even if that opinion differs from the surgeon or MDA
What right or premise is informed consent based on? that people are responsible for their own destinies, and everyone of sufficient she and soundness of min has the right to decide what is done to their body
A patient drives himself to ER after having been stabbed and passes out before anyone can get any information from him. Going ahead and treating him medically is done under what type of consent? presumed consent
If a person gives implied consent to anesthesia and surgery do we still need a formal written, informed consent? absolutely!
In terms of consent, what is a proxy? when a patient is unable to given consent and another person makes the decision for them
A proxy can also be called what? a substitute informed consent
What are the two specific conditions for proxy consent? (1) patient unable to offer true and informed consent; (2) person offering proxy consent must determine what the incompetent patient would have wanted if he/she were able to make the decision
Why is the proxy decision not always absolute? because the proxy may make decisions that do not promote the patient's well being
Typically a minor is considered to be a patient under 18. In what 3 cases can a minor make their own medical decisions (even if parents disagree)? if the minor is (1) married; (2) pregnant; (3) has children
For proxy consent, if no evidence exists about what the patient would chose for him or herself, what is the proxy to base their decision on? what a reasonable person would choose
What are 4 concepts related to consent? assault, battery, negligence, abandonment
What is the definition of assault? In criminal and tort law, the threat or use of force on another that causes that person to have a reasonable apprehension of imminent harmful or offensive contact
Is aggravated assault criminal or tort in nature? criminal
What is conditional assault? where a term or condition is placed on a threat... "give me your money or your life, your choice"
In medical law terms, what is assault? an act that creates an apprehension in another of an imminent, harmful, or offensive contact
In medical law terms, what is battery? unpermitted, unprivileged intentional contact with another person
While ________ is an essential aspect of battery, it must be absent for assault. contact
What is negligence? the failure to exercise the standard of care that a reasonably prudent person would have exercised in the same situation.
Identify the type of negligence: negligence of an independent contractor, for which the employer is typically not liable. collateral negligence
Identify the type of negligence: a patient does not share important information about a health condition; the medical professional does not perform care that would be reasonably prudent for a patient with this health condition. comparative negligence
Identify the type of negligence: two to more parties acting independently but causing the same damage concurrent negligence
Identify the type of negligence: plaintiff's own negligence played a part in causing the plaintiff's injury and that is significant enough to bar the plaintiff from receiving damages contributory negligence (has been superseded in most placed by comparative negligence)
Identify the type of negligence: gross negligence so extreme that it is punishable as a crime; an example is drunk driver killing a pedestrian in an accident criminal negligence
Identify the type of negligence: a conscious voluntary act or omission in reckless disregard of a legal duty and of the consequences to another party, who may typically recover exemplary damages gross negligence (aka wanton, willful, reckless)
Identify the type of negligence: negligence resulting from a party's special relationship with another party who is originally negligent; negligence of one person charged to another imputed negligence
Identify the type of negligence: failure to exercise the great care of an extraordinarily prudent person, resulting in liability in special circumstances in which lack of ordinary care would not result in liability slight negligence
Define medical abandoment. when the caregiver-patient relationship is terminated without making reasonable arrangements with an appropriate person so that care by others can be continued
Created by: Mary Beth