Patient Care & Ethical Standards in Neurology Flashcards

A surrogate decides for an incapacitated patient based on what the patient would have wanted. What is this standard called?

Answer: Substituted judgment

Substituted judgment reflects the patient's own known values and preferences.

When should the best-interests standard be used instead of substituted judgment?

Answer: When the patient's wishes are unknown or were never expressed

Best interests applies when the patient's own preferences cannot be determined.

An adult patient with multiple sclerosis asks that their diagnosis be kept from their family. What should the clinician do?

Answer: Respect the request and keep the information confidential

Competent adults control who receives their health information, and MS does not trigger a duty-to-warn exception.

Which situation best fits the ethical concept of 'duty to warn'?

Answer: A patient with a neurological condition makes a credible threat to harm a named person

Under Tarasoff, confidentiality can be breached to protect an identifiable third party from serious threatened harm.

A clinician is offered speaking fees by a company that makes a new migraine drug they often prescribe. What is the most appropriate action?

Answer: Disclose the conflict of interest and keep prescribing based on evidence

Financial relationships must be disclosed, and they must not affect clinical decisions.

Which sign of autonomic dysreflexia in a patient with a T4 spinal cord injury calls for immediate action?

Answer: Sudden severe hypertension with a pounding headache

Autonomic dysreflexia causes dangerous hypertension and needs the patient sat upright and the noxious trigger removed right away.

What is the best way to confirm a patient understood education about a new antiepileptic drug?

Answer: Teach-back, where the patient explains it in their own words

Teach-back checks real comprehension rather than assuming it.