These are incredibly helpful. I’ve been in practice for 30 years and am the county medical director, and have mostly administration that I have to deal with. I really appreciate the refresher. Maybe I can teach old admin dogs new tricks.
To all those having doubt: In Non maleficence question, the question is not asking about what ethical principles are being balanced in the informed consent process.. For that Option d would have been right. The question specifically asks about a component of informed consent i.e; risk vs benefits.. risk... nonmaleficence benefits.... beneficence . . No where in the question it is mentioned whether you want to or not want to undergo this procedure ?... This is autonomy. Another way of understanding this: The question is saying risks and benefits come under which ethical principles ? Ans: nonmalef. vs benef. If the question says patient refuses or accepts the procedure comes under which principle.. Ans: autonomy.
@DirtyMedicine please weigh in as this is seemingly creating confusion. This rationale does not justify the removal of choice D as a correct answer. In fact, I do not understand how your answer effectively makes B the correct choice at all. Per your comment: "The question specifically asks about a component of informed **'consent'** i.e; risk vs benefits". So, CONSENT: Autonomy, as in the patient consenting to the procedure of their own choice and will. Risk: Nonmaleficence Benefits: Beneficence. The question asked specifically about the purpose of "EXPLAINING" the risk v.s. Benefits TO THE PATIENT.. You EXPLAIN the associated risks and benefits in order to allow the patient to make THEIR OWN INFORMED DECISION. Again, a patient making their decision is autonomy. On the contrary, THE PHYSICIAN going through the process of weighing the risks and benefits in order to ADVISE THE PATIENT on the best course of action would be Nonmalficience v.s. Beneficience.
Your videos that I have seen so far are great, I just started my class this week and I am a visual learner. With distance learning I've discovered that I need to be able to see and hear new material while I folloe along. Therefore, the way you have formatted the videos is amazingly helpful and I get so much out of them. I will be citing your points of view if need be but since this is common knowledge you left plenty of room for following your format. I will also be sharing your link with all my classmates and I will make sure they follow and hit the notification bell.
JUST PASSED MY COMLEX!!!!!!!!! SCORED AVERAGE IS MOST SECTIONS AND ABOVE AVERAGE IN the communications part. All I needed for boards was dirtymedicine lol
I had thought that when you usually ask anything along the lines of "how did you arrive at this decision," you are not checking for capacity, rather, you are trying to understand the concerns and reservations behind making a certain decision so you can address them. I think A is the correct answer. Anyone else wanna chime in?
The question told you that the patient already was judged to have capacity. Which means you ALREADY asked "tell me how you arrived at this decision? (this phrase is part of the capacity assessment)" Therefore choice A is redundant and incorrect. And yes, it's obviously a good thing to understand their reservations and concerns but by definition you've already done that
@@DirtyMedicine Invasive procedure for a child of 12 years. Father gives consent but child refuses what should the physician do? A) Do the procedure. B) Encourage mother to have discussion with child. Please help with this question.
Awesome explanation and just right amount of examples! You deserve more subscribers! These videos help International Medical Graduates prepping for medical exams. You are truly one of the best🖒
Question : how does judging full capacity imply the patient understands the consequences of his decision ? In which case isn't it better to have an open ended conversation about why the patient feels/thinks this way versus proverbially shutting him up by saying it's not in your best interest.
That was my question too. Based on some practice questions on Combank, your approach is the correct approach. Acknowledge, and then continue convo with an open ended question...
@@kellycarbary9857 Yes, I agree too. In the first example, Option A is more consistent with the principles of motivational interviewing. Choosing option C means you might be ethically "correct" according to a textbook, but you have likely missed an opportunity to establish a situation where a patient can reassess their decision for themselves. And by shutting that possibility down, you are not really acting in the patient's best interests. And also, Option C also pre-supposes you have already told them that their decision may not be in their best interests - because you have already assessed capacity, which means they already have this information. Sorry, but Option C cannot be other than unethical in practice. Option A is the choice that is more in the interests of the patient.
1st Q`s answer doesn`t make sense to me! the patient has capacity he already knows it is not the best course of action, but he still choose it anyway and clearly said I don`t want to hear about treatment options + in other resources when a patient declines a beneficial treatment always ask WHY to clear any misunderstanding which makes choice A more reasonable or just go for D.
Explanation of the best course of treatment is also part of the informed consent process (while judging for capacity they have to be informed about and understand the medical treatment that you are judging capacity against) so the same way that you eliminated answer choice A would also eliminate answer choice C. This is why ethics questions are so frustrating! The logic is not internally consistent, there is either no right answer to that question or two right answers.
Not technically. I can counsel you on the best course of treatment for heart failure but nowhere in that process need I assess your ability to understand the information and make a decision consistent with your values (part of the process for determining capacity). See the nuance here?
@@DirtyMedicine But you've already assessed my ability to understand that this is the best course of treatment option when you judged my capacity. So, why do you want to ask this again ?
For question 2 - "The explanation of risk vs benefits, in this situation, is carefully balancing which ethical principles?" Would D - "Nonmaleficience vs Beneficience AND autonomy" not be a better answer than B - Nonmaleficience vs Beneficience? I ask because, the very act of explaining the risk vs benefits, is giving the patient information to make an informed decision, ergo => Autonomy as well? Or is it B; because it's "balancing" and you're not trying to balance their autonomy, you want to give them all that shit they can take?
@4.16 By option C, wouldn't it be the same as judging the patient's decision? In terms of beneficence it definitely makes sense but doesn't autonomy supersede beneficence? If we come across similar situations would it be ok to tell the patient with capacity they are not making a decision in their best interest? Please correct me if my thought process is wrong. I am really confused.
Same question. Why not D considering autonomy requires informed consent, and part of informed consent includes an explanation of risks, benefits and alternatives?
I guess the only explanation I can think of is that you're not carefully 'balancing' autonomy in this situation. You're making sure to meet that standard of ethical practice, but the conflict lies in balancing non-malificence and beneficence. I guess I answered my own question 😅
I have No words to describe how much this lecture series provided by @Dirty Medicine in ethics and communications are very helpful, very accurate and to the point,i spend a significant amount of time reviewing it and the content is just incredible ! it brought to my attention some people trying to arguing about the best answer for the question presented in the lecture ! but it's very straight forward ! i don't believe from my observation there is a room for argument in the presented question and the answer because simply the physician in the question stem already judged that's his patient has a capacity? why i would check capacity again ? there is no reason to double check capacity when it's already defined and the patient at capacity so very obvious choice A is incorrect by all means ! @DirtyMedicine thank you for making this lectures free and accessible for all at no cost ! we do appreciate your help, gearing toward helping us passing this exam!
In question 2 about which ethics principles we are balancing isn't non-maleficence vs beneficence and autonomy a better option? Since by informing the patient about the biopsy (and in doing so providing them with a choice) honouring their autonomy as well?
To all those having doubt: In Non maleficence question, the question is not asking about what ethical principles are being balanced in the informed consent process.. For that Option d would have been right. The question specifically asks about a component of informed consent i.e; risk vs benefits.. risk... nonmaleficence benefits.... beneficence . . No where in the question it is mentioned whether you want to or not want to undergo this procedure ?... This is autonomy. Another way of understanding this: The question is saying risks and benefits come under which ethical principles ? Ans: nonmalef. vs benef. If the question says patient refuses or accepts the procedure comes under which principle.. Ans: autonomy.
@@Rockk-on3tt This rationale does not justify the removal of choice D as a correct answer. In fact, I do not understand how your answer effectively makes B the correct choice at all. Per your comment: "The question specifically asks about a component of informed **'consent'** i.e; risk vs benefits". So, CONSENT: Autonomy, as in the patient consenting to the procedure of their own choice and will. Risk: Nonmaleficence Benefits: Beneficence. The question asked specifically about the purpose of "EXPLAINING" the risk v.s. Benefits TO THE PATIENT.. You EXPLAIN the associated risks and benefits in order to allow the patient to make THEIR OWN INFORMED DECISION. Again, a patient making their decision is autonomy. On the contrary, THE PHYSICIAN going through the process of weighing the risks and benefits in order to ADVISE THE PATIENT on the best course of action would be Nonmalficience v.s. Beneficience.
For EDUCATIONAL purposes only. Not to be used as medical, legal, or other advice!
when is the very unique case you mentioned at 6:20 that you refer to ethics committee?
yep@@morningchoe
These are incredibly helpful. I’ve been in practice for 30 years and am the county medical director, and have mostly administration that I have to deal with. I really appreciate the refresher. Maybe I can teach old admin dogs new tricks.
Díky!
To all those having doubt:
In Non maleficence question, the question is not asking about what ethical principles are being balanced in the informed consent process.. For that Option d would have been right.
The question specifically asks about a component of informed consent i.e; risk vs benefits..
risk... nonmaleficence
benefits.... beneficence
.
.
No where in the question it is mentioned whether you want to or not want to undergo this procedure ?... This is autonomy.
Another way of understanding this:
The question is saying risks and benefits come under which ethical principles ? Ans: nonmalef. vs benef.
If the question says patient refuses or accepts the procedure comes under which principle.. Ans: autonomy.
@DirtyMedicine please weigh in as this is seemingly creating confusion.
This rationale does not justify the removal of choice D as a correct answer. In fact, I do not understand how your answer effectively makes B the correct choice at all. Per your comment:
"The question specifically asks about a component of informed **'consent'** i.e; risk vs benefits".
So,
CONSENT: Autonomy, as in the patient consenting to the procedure of their own choice and will.
Risk: Nonmaleficence
Benefits: Beneficence.
The question asked specifically about the purpose of "EXPLAINING" the risk v.s. Benefits TO THE PATIENT.. You EXPLAIN the associated risks and benefits in order to allow the patient to make THEIR OWN INFORMED DECISION. Again, a patient making their decision is autonomy. On the contrary, THE PHYSICIAN going through the process of weighing the risks and benefits in order to ADVISE THE PATIENT on the best course of action would be Nonmalficience v.s. Beneficience.
Your videos that I have seen so far are great, I just started my class this week and I am a visual learner. With distance learning I've discovered that I need to be able to see and hear new material while I folloe along. Therefore, the way you have formatted the videos is amazingly helpful and I get so much out of them. I will be citing your points of view if need be but since this is common knowledge you left plenty of room for following your format. I will also be sharing your link with all my classmates and I will make sure they follow and hit the notification bell.
JUST PASSED MY COMLEX!!!!!!!!! SCORED AVERAGE IS MOST SECTIONS AND ABOVE AVERAGE IN the communications part. All I needed for boards was dirtymedicine lol
This has been super high yield for my Level 2 and Step 2! Your vids continue to be relevant and informative!
Nice!!!!!!!!!!! More of the Ethics please!
Finally a clear explanation and review of the four core principles of ethics. Thank you
I had thought that when you usually ask anything along the lines of "how did you arrive at this decision," you are not checking for capacity, rather, you are trying to understand the concerns and reservations behind making a certain decision so you can address them. I think A is the correct answer. Anyone else wanna chime in?
The question told you that the patient already was judged to have capacity. Which means you ALREADY asked "tell me how you arrived at this decision? (this phrase is part of the capacity assessment)" Therefore choice A is redundant and incorrect. And yes, it's obviously a good thing to understand their reservations and concerns but by definition you've already done that
@@DirtyMedicine Invasive procedure for a child of 12 years. Father gives consent but child refuses what should the physician do?
A) Do the procedure.
B) Encourage mother to have discussion with child.
Please help with this question.
Yash Ashara you should watch the consent and assent video
I think so too. Choice A is most likely the correct answer. I have seen similar questions to this in U world.
@@yashashara3106 A. You only need one parent to consent to a procedure for the child
Thank you so much. This explains way better than my ethic professor! It's concise!
Awesome explanation and just right amount of examples! You deserve more subscribers! These videos help International Medical Graduates prepping for medical exams. You are truly one of the best🖒
Wow, I thought I knew ethics!!! Thank you for explaining it this way.
those Ethics Qs are killing me. Thanks for teaching us how to tackle them.
Earlier ethics and communication skills were too difficult for me,thank u so much for these wonderful videos....kudos to ur hardwork...!
thank you for this lecture , it really helps simply the concepts and its application
You are doing god's work here!
This was so helpful! Thanks bro, you are an absolute legend !!
Thank you so much I literally just tweeted you, I really appreciate the work and effort!
Question : how does judging full capacity imply the patient understands the consequences of his decision ? In which case isn't it better to have an open ended conversation about why the patient feels/thinks this way versus proverbially shutting him up by saying it's not in your best interest.
That was my question too. Based on some practice questions on Combank, your approach is the correct approach. Acknowledge, and then continue convo with an open ended question...
@@kellycarbary9857 Yes, I agree too. In the first example, Option A is more consistent with the principles of motivational interviewing. Choosing option C means you might be ethically "correct" according to a textbook, but you have likely missed an opportunity to establish a situation where a patient can reassess their decision for themselves. And by shutting that possibility down, you are not really acting in the patient's best interests. And also, Option C also pre-supposes you have already told them that their decision may not be in their best interests - because you have already assessed capacity, which means they already have this information. Sorry, but Option C cannot be other than unethical in practice. Option A is the choice that is more in the interests of the patient.
That was an excellent first example. Definitely would have gotten it wrong on USMLE so thank you
1st Q`s answer doesn`t make sense to me!
the patient has capacity he already knows it is not the best course of action, but he still choose it anyway and clearly said I don`t want to hear about treatment options
+ in other resources when a patient declines a beneficial treatment always ask WHY to clear any misunderstanding which makes choice A more reasonable
or just go for D.
Thank you so much its very helpful,can you provide more case study .I really appreciate the effort.
So when do you consult the ethics committee? I watched the rest of the ethics playlist and you never circled back to that
Great 👍
Thanks for the quick post up. Hoping you put up another before my exam tomorrow
Explanation of the best course of treatment is also part of the informed consent process (while judging for capacity they have to be informed about and understand the medical treatment that you are judging capacity against) so the same way that you eliminated answer choice A would also eliminate answer choice C. This is why ethics questions are so frustrating! The logic is not internally consistent, there is either no right answer to that question or two right answers.
Not technically. I can counsel you on the best course of treatment for heart failure but nowhere in that process need I assess your ability to understand the information and make a decision consistent with your values (part of the process for determining capacity). See the nuance here?
@@DirtyMedicine Tricky but I see, makes sense. Thank you for taking the time to clarify!
@@DirtyMedicine But you've already assessed my ability to understand that this is the best course of treatment option when you judged my capacity.
So, why do you want to ask this again ?
@@DirtyMedicine Also, nowhere in your videos you mentioned where ethics committee approval is required ?
For question 2 - "The explanation of risk vs benefits, in this situation, is carefully balancing which ethical principles?"
Would D - "Nonmaleficience vs Beneficience AND autonomy" not be a better answer than B - Nonmaleficience vs Beneficience?
I ask because, the very act of explaining the risk vs benefits, is giving the patient information to make an informed decision, ergo => Autonomy as well? Or is it B; because it's "balancing" and you're not trying to balance their autonomy, you want to give them all that shit they can take?
Thank you for your videos. It has truly helped me.
This really helped me alot .. thank you for those examples also.. keep going 👍👍
@4.16 By option C, wouldn't it be the same as judging the patient's decision? In terms of beneficence it definitely makes sense but doesn't autonomy supersede beneficence? If we come across similar situations would it be ok to tell the patient with capacity they are not making a decision in their best interest? Please correct me if my thought process is wrong. I am really confused.
Awesome! Thank you so much!!!
Great video! Thank you, bro!!!
Thanks,,very informative
@09:08 why is the answer not D
Same question. Why not D considering autonomy requires informed consent, and part of informed consent includes an explanation of risks, benefits and alternatives?
I guess the only explanation I can think of is that you're not carefully 'balancing' autonomy in this situation. You're making sure to meet that standard of ethical practice, but the conflict lies in balancing non-malificence and beneficence.
I guess I answered my own question 😅
I have No words to describe how much this lecture series provided by @Dirty Medicine in ethics and communications are very helpful, very accurate and to the point,i spend a significant amount of time reviewing it and the content is just incredible ! it brought to my attention some people trying to arguing about the best answer for the question presented in the lecture ! but it's very straight forward ! i don't believe from my observation there is a room for argument in the presented question and the answer because simply the physician in the question stem already judged that's his patient has a capacity? why i would check capacity again ? there is no reason to double check capacity when it's already defined and the patient at capacity so very obvious choice A is incorrect by all means ! @DirtyMedicine thank you for making this lectures free and accessible for all at no cost ! we do appreciate your help, gearing toward helping us passing this exam!
Man, I love you.. perfect timing!!
In question 2 about which ethics principles we are balancing isn't non-maleficence vs beneficence and autonomy a better option? Since by informing the patient about the biopsy (and in doing so providing them with a choice) honouring their autonomy as well?
To all those having doubt:
In Non maleficence question, the question is not asking about what ethical principles are being balanced in the informed consent process.. For that Option d would have been right.
The question specifically asks about a component of informed consent i.e; risk vs benefits..
risk... nonmaleficence
benefits.... beneficence
.
.
No where in the question it is mentioned whether you want to or not want to undergo this procedure ?... This is autonomy.
Another way of understanding this:
The question is saying risks and benefits come under which ethical principles ? Ans: nonmalef. vs benef.
If the question says patient refuses or accepts the procedure comes under which principle.. Ans: autonomy.
@@Rockk-on3tt
This rationale does not justify the removal of choice D as a correct answer. In fact, I do not understand how your answer effectively makes B the correct choice at all. Per your comment:
"The question specifically asks about a component of informed **'consent'** i.e; risk vs benefits".
So,
CONSENT: Autonomy, as in the patient consenting to the procedure of their own choice and will.
Risk: Nonmaleficence
Benefits: Beneficence.
The question asked specifically about the purpose of "EXPLAINING" the risk v.s. Benefits TO THE PATIENT.. You EXPLAIN the associated risks and benefits in order to allow the patient to make THEIR OWN INFORMED DECISION. Again, a patient making their decision is autonomy. On the contrary, THE PHYSICIAN going through the process of weighing the risks and benefits in order to ADVISE THE PATIENT on the best course of action would be Nonmalficience v.s. Beneficience.
Somebody please explain beneficence question @5:11
u dumb?
❤
Thank you!
this topic turns out to be harder than i thought
Watched this series before Step 1 a year ago, back for round 2
Did it help for step1?
Thanks!
excellent!
Thank you so much
Why the name change from dirtyusmle to dirtymedicine?
Cough... copyright... cough
@@DuckODuckProductions he owns both
Thank you so much ❤️
**New update/Part 2:** ua-cam.com/video/-xVdLbD4NZY/v-deo.html
Thanks!