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Ethics, Psychosocial,
and Psychiatric Pearls
Chapter 42
Alison B. McGrorty, MD
❍ What are the principles of medical ethics?
Autonomy, beneficence, nonmaleficence, justice/fairness, and confidentiality.
❍ What is an ethical dilemma?
When two or more ethical principles are in conflict with each other.
❍ What is mental competency/capacity?
Sufficient understanding and memory to generally comprehend the situation in which the patient is currently in,
including the nature, purpose, and consequence of any act or transaction that the patient may enter.
❍ What condition should always be evaluated before declaring competency?
Depression.
❍ What is an advance directive?
An advance directive is the formal mechanism by which a patient may express her values regarding her future
health status. It may take the form of a proxy directive and/or an instructional directive.
❍ What is power of attorney?
The durable power of attorney for health-care designates a surrogate to make medical decisions on behalf of the
patient who is no longer competent to express his/her choices. The terms durable power of attorney, health-care
proxy, health-care agent, and surrogate are all interchangeable.
❍ What is a living will?
A living will is an instructional directive that focuses on the types of life-sustaining treatments that a patient would
or would not choose in various clinical circumstances (ie, CPR and intubation).