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Competency 1: Cognitive
Start with factual info and recall:
-knowledge
-info management
-application of information to real life situations
-ability to recog. gaps in own knowledge
-ability to learn from experience
-use of tacit knowledge and personal experience
-self directed acquisition of new knowledge
-ability to generate useful questions
-awareness of biases
,Competency 2: Integrative
Seeing the whole as well as the parts:
-incorporation of scientific, clinical, and ethics
-appropriate use of reasoning strategies
-linking of interdisciplinary and clinical knowledge
-managing uncertainty
-examining and refining one's own reasoning strategies
Competency 3: Relational Competencies
Communication and the image one projects of oneself:
-communication skills
-handling conflict
-teamwork
-teaching
-professional image
Competency 4: Moral
Ability to see what is morally relevant
-attentiveness
-critical curiosity
-awareness of thought and emotion
-recognition of cognitive and emotional biases
-willingness to acknowledge and correct errors
-ability to respond with others
Technical vs. Moral Error
Technical error is cognitive
Moral is Moral competency; denying responsibility for a technical error
,5 Principles
1. Respect for persons
2. Beneficence
3. Nonmaleficence
4. Utility
5. Justice
Principle 1: respect for persons
-Autonomy
-believing the patient
-Veracity (habitual truthfulness)
-Dignity (privacy and confidentiality)
-Fidelity (loyal to their interests)
-Avoiding killing
-Communication
--> Does not mean simply giving the person what they want
Democratic societies = (right to self unless harming others)
Human rights
respect for individual dignity and rights
-relies on respect for persons
-any form of discrimination violates sense of personal dignity
, Autonomy
autos= self nomos= rule
-the capacity humans have to make decisions with regard to their best
interests
-informed consent, privacy
-democratic right to self
Diminished Autonomy
under 12 or Alzheimers
Advanced Directives
Extensions of autonomy
-one is 'living will' another is '5 wishes' tells who you want to make
decisions for you etc.
Limits of Respect for Persons
Harm Principle:
-the only purpose for which power can rightfully be exercised over any
member of a civilized community is prevent of harm
ie. with diminished autonomy
Paternalism
The view that the doctor knows best
-used in attempts to justify violating autonomy