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Q. What is the traditional model of medicine?
A. Scientific medicine. Biomedical model. Diagnosis + treatment modality. Curative model. Restoring normality.
Q. Name crises in scientific medicine:
- A. Chronic illness, disability, viral diseases
- - Escalating costs
- - Iatrogenic effects (infections, medication side effects)
Q. Name evidence of medical dominance:
- - Professional autonomy
- - Decision making in resource allocation
- - Control over allied health
- - Administrative influence
- - Political influence
Q. Hospitals are the example of the ______ model?
A. Curative model.
Q. What funds healthcare?
Q. Caring for is the ___ aspect?
A. Task aspect. Doing what is required.
Q. What is required for the caring for task aspect?
A. Skills/knowledge, awareness and understanding of procedures and equipment.
Q. What is the Caring about aspect?
A. Relational aspect. Manner in which caring is performed.
Q. The task aspect is also known as caring FOR or caring ABOUT?
Q. The relational aspect is also known as caring FOR or caring ABOUT?
Q. What is required in the relational aspect?
A. The manner in which caring is performed. The quality of the relationship between those providing care and patient. Communication.
Q. Caring for can be performed without and sense of caring about? T/F
Q. Relational aspect is not necessary for task aspect. T/F?
Q. Five examples of new bodies?
- 1) The composite body
- 2) The cyborg
- 3) The brain true site of self in brain
- 4) The medical body diagnostic focus at molecular levels e.g. DNA, stem cell research
- 5) The external womb
Q. What are the three women in the external womb?
A. The genetic mother. The nurturing mother. The surrogate mother.
Q. Culture of the clinic. What is the practitioners perspective?
A. Disease perspective.
Q. Who identified the disease/illness perspectives in cultures of the clinic?
A. Kleinman et al.
Q. What is the disease perspective? Who has it?
A. The practitioner. Health practitioners have their own world view in terms of disease and healing modalities. A deviation from the norm. Diseases are entities.
Q. What is the mind-body dualism?
A. Both mind and body but separate entities.
Q. What is reductionism?
A. Focussing on what information you need to diagnose.
Q. What is the patients perspective?
A. Illness perspective.
Q. What is the illness perspective? Who has it?
A. A threat to sense of self and identity. The patient. I am sick. Based on the subjective response of the individual and those around him or her, to being unwell. The experience of being unwell.
Q. For the patient, what influences the meaning of symptoms and illness?
A. Personality, social, cultural and economic factors.
Q. Practitioner brings many explanations for illness. T/F?
A. False. Practitioner brings a single causal explanation based on symptoms and diagnostic procedures.
Q. Patient brings a single explanation for illness. T/F?
A. False. Patient brings multiple meanings for illness; heredity, stress, over-work, punishment, along with possible outcomes. Social and economic context contributes. Age, gender, stage of life cycle.
Q. Patients perspective is subjective. T/F?
Q. Practitioners perspective is objective. T/F?
Q. Name strategies in which the practitioner can use to improve pt-practitioner relationships.
- A. understanding the illness perspective (meaning of illness to patient)
- - improving communication (understanding and accepting the language of distress)
- - increasing reflexivity
- - treating illness and disease; recognising illness has social, psychological and physical dimensions
- - respecting diversity
- - asserting the role of the context (internal and external context of illness in PTs life)
Q. Name the kinds of interpersonal communication in a clinical context:
A. Authoritative. Facilitative.
Q. Authoritative communication is ____ centred?
A. Authoritative communication is practitioner centred.
Q. Describe practitioner centred communication.
A. Authoritative communication. Direct and controls patients behaviour. Booth & Manning: Controlling patient, adaptive child.
Q. What is Booth & Mannings description of Authoritative communication?
A. Controlling parent, adaptive child.
Q. What is Booth & Mannings description of Facilitative communication?
A. Nurturing parent, free child.
Q. Describe patient centred communication.
A. Facilitative. Establish therapeutic relationship which empowers patient.
Q. Name three things that patients see practitioners as:
A. Informant. Caregiver. Advisor.
Q. Name four things that facilitate communication:
- A. The communication style; patient vs task centred.
- Attending: physical demonstration (non-verbal, body language) of accessibility and readiness to listen to patient.
- Empathy: recognition and understanding of the patients situation.
- Friendliness/humour: establish rapport and trust. Reduce anxiety and tension.
Q. Name four challenges to communication in the clinical context.
- A. Intensive care.
- Communication impairment.
- Terminal illness.
- Augmentative and alternative communication (e.g. interpreter, computer, pen & paper)
Q. What is the four principle approach in health ethics?
- 1) Autonomy
- 2) Nonmaleficence
- 3) Benificence
- 4) Justice
Q. What are the four elements of Negligence?
- A. 1. Duty of care/standard of care.
- 2. Breach of duty.
- 3. Damages (compensable injury)
- 4. Causation relationship between injury and breach of duty.
Q. What are the three tactics of medical dominance?
- 1) Subordination - autonomy
- 2) Limitation patient management
- 3) Exclusion prestige
Q. What are the categories of notifiable conduct by registered health practitioners?
- 1) Practising while intoxicated
- 2) Sexual misconduct in practice of profession
- 3) Placing the public at risk because of impairment
- 4) Placing public at risk because of departure from accepted professional standards
Q. What are the four value statements of the 2003 Code of Ethics for DR/RT?
- 1. Respect individuals needs, values, culture
- 2. Right of individuals to make informed choices and quality of service
- 3. Confidence of information of patients
- 4. Accountability of professional role
Q. Negligence falls under what kind of law?
A. Tort Law
Q. Define Tort Law
A. aka Civil Law. A wrong that involves a breach of a civil duty owed to someone else.
Q. Define criminal law
A. Whatever the law proscribes as subject to criminal sanction i.e. Crimes Act
Q. What is the standard of proof for Civil Law?
A. On the balance of probabilities
Q. What is the standard of proof for Criminal Law?
A. Beyond reasonable doubt
Q. Define Assault or Battery
A. Touching without consent
Q. Is assault/battery a criminal or civil wrong?
- A. Can be either
- Assault and indecent assault: criminal. Tort of battery (civil)
Q. What are the four elements of contracts:
- Intention (to create a legal relationship)
- Agreement (must be reached between the parties; Offer and Acceptance)
- Consideration (the price paid for the contract)
- Capacity (infants, those of unsound mind unable to manage affairs)
Q. Duty of confidentiality and privacy falls under what kind of law?
A. Contract law, but loss of privacy can be a breach of duty (i.e. Tort Law)
Q. What is equity?
An equitable duty of confidence. You may not be contractually obliged to behave in a certain way but the right and proper way is equitable duty.
Q. Negligence falls under what kind of law?
A. Tort Law
Q. What is the purpose of Negligence?
- To compensate the person who has suffered a wrong.
- To state the standards of the community in respect of wrongs.
Q. What is a breach of Contract law?
Failure to perform a term of the contract
Q. What happens if you breach Contract Law?
Pay damages by putting person in position they would have been but for the breach
Q. What is the hardest to prove in a negligence case?
Q. Name three ways you provide a defence against Negligence?
- On the balance of probabilities
- Contributory negligence
- Civil Liability Act 2002 NSW Section 5(O)
Q. What is the Civil Liability 2002 NSW Section Act 5(O)?
- Not negligent if at the time of service the professional acted in a manner that was widely accepted in Australia by peer professional opinion as competent professional practice
- Peer professional opinion cannot be relied on for the purposes of this section if the court considers that the opinion is irrational
- Peer professional opinion does not have to be universally accepted to be considered widely accepted.
Q. MRPBA provides the Code of
Q. AIR provides the Code of ...?
Q. AIR provides what?
- Code of Ethics
- Guidelines for Practice
Q. MRPBA provides Code of Conduct and Guidelines for Practice. T/F?
False. Only the code of Conduct.
Q. Does Vicarious liability absolve the practitioner of personal liability?
No. Neither ethically or legally.
Q. What is the effect of the duty of care principle?
Provide a limit and define in what circumstances a legal obligation is owed to another person
Q. What is the common law test of duty of care called?
neighbour principle persons who are so closely and directly affected by my act that I ought reasonably to have them in contemplation as being so affected when I am directing my mind to the acts or omissions which are called in question
Q. What is the Bolam principle?
Standard of care judged by medical men skilled in particular area
Q. Australia accepts the Bolam principle. T/F?
False. Rejected. Courts must decide the standard of care. It must have a logical basis.