Unit #4 – Medical Ethics

1. Unit #4 – Medical Ethics Cecile M. Sanders, M.Ed., MT(ASCP), CLS(NCA)

2. Unit #4Medical Ethics • What is “ethics”? • According to the American College Dictionary, “ethics” means: 1. The principles of morality, including both the science of the good and the nature of the right 2. The rules of conduct recognized in respect to a particular class of human actions, as in “medical ethics” 3. Moral principles, as of an individual 4. The science of the human character in its ideal state

3. Unit #4Medical Ethics • In a nutshell, “ethics” means doing what is right. • So, what is “right”? • “Right” depends on your values • “Values”, in terms of societal interaction, refer to the ideals and customs toward which a person or group of person has a positive regard.

4. Unit #4Medical Ethics • “Values” can be a positive thing, like cleanliness, freedom, education, etc. or a negative thing, like cruelty, crime, or blasphemy. • What are YOUR values? • One can hardly argue with things like cleanliness, freedom or education, but we all know there are people who don’t value these things.

5. Unit #4Medical Ethics • In some cultures, freedom is not important. • In some cultures, it is OK to send suicide bombers into a crowd of innocent people just because they are trying to make a point or disagree with others’ values. • So, again, what are YOUR values?

6. Unit #4Medical Ethics • Here are things that many people value: • Honesty • Integrity • Freedom • Loyalty • Life • Friendship • Family • Timeliness • Hard-work • Truthfulness • Religion • Etc., etc., etc.

7. Unit #4Medical Ethics • All of us have values even though we may not know it or admit it to ourselves. • Sometimes our values don’t make themselves apparent until we are confronted with a tough issue or decision.

8. Unit #4Medical Ethics • For instance: • If you value honesty, • Is it OK to keep extra money that a store clerk has returned to you accidentally? • Is it OK to call in sick when you are not? • Is it OK to “fudge” laboratory results when you need to leave work to pick up your children at day care?

9. Unit #4Medical Ethics • If you value life, • Is it OK to have an abortion? • Is it OK to disconnect a feeding tube from a comatose patient? • Is it OK to bomb innocent people? • Is it OK to have capital punishment?

10. Unit #4Medical Ethics • If you value friendship, • Is it OK to tell a friend a lie? • Is it OK to turn a friend in to the police if he has committed a crime? • I think you get the idea that although one may say they hold a certain value doesn’t mean that they would always act to hold that value.

11. Unit #4Medical Ethics • Most professions have established a Code of Conduct or a Code of Ethics for people in the field • Example: Doctors take the Hippocratic Oath, Nurses take the Florence Nightingale Oath • The American Society for Clinical Laboratory Sciences has established a Code of Ethics for clinical laboratory professionals. It can be found at http://www.ascls.org/?page=Code

12. Unit #4Medical Ethics • The ASCLS Code of Ethics basically states that all laboratory professionals have: • I. Duty to the Patient • II. Duty to Colleagues and the Profession • III. Duty to Society

13. Unit #4Medical Ethics • ASCLS Pledge to the ProfessionAs a clinical laboratory professional, I strive to: • Maintain and promote standards of excellence in performing and advancing the art and science of my profession • Preserve the dignity and privacy of others • Uphold and maintain the dignity and respect of our profession • Seek to establish cooperative and respectful working relationships with other health professionals • Contribute to the general well being of the community. I will actively demonstrate my commitment to these responsibilities throughout my professional life.

14. Unit #4Medical Ethics • The ASCLS Code of Ethics and Pledge to the Profession can serve as a “moral compass” to guide clinical laboratory professionals in their jobs and even in their interactions with friends and family. • Decision-making can be tough in any situation, but particularly tough when you are a recent graduate or when you are the only person working in the lab when a decision is needed.

15. Unit #4Medical Ethics • Here is one of many decision-making models, based on personal and/or professional values: • 1. State the problem • 2. Determine personal or professional values regarding the problem • 3. List the possible alternative solutions to the problem • 4. Frame a choice from the possible alternative solutions and compare it with personal or professional values • 5. List the short and long term consequences of the choice

16. Unit #4Medical Ethics • Example of using the Value-Based Decision-Making Model • The Lead MLT is the only staff person left in the lab on a Saturday evening. Two technicians arrive for the midnight shift. One of the technicians seems to be under the influence of something; her gait is unsteady and her speech is slurred. • What to do?

17. Unit #4Medical Ethics • Example of using the Value-Based Decision-Making Model (cont’d) • Using the Decision-Making Model outlined on slide #15, this is what the Lead MLT decided: • 1. The problem is that this midnight tech might be drunk or under the influence of some drug and her ability to function may be impaired. • 2. The Lead MLT values excellent patient care and accurate laboratory testing. He also values maintaining a good working relationship with the midnight tech and her friendship. Too, he values his free time and a good night’s sleep.

18. Unit #4Medical Ethics • Example of using the Value-Based Decision-Making Model (cont’d) • 3. The Lead MLT could: • A. Stay for a double shift, assigning the midnight MLT to harmless tasks • B. He could warn the other midnight tech about this possibly impaired MLT, leave, and hope for the best • C. He could call his supervisor for a decision • D. He could ignore the situation and hope for the best

19. Unit #4Medical Ethics • Example of using the Value-Based Decision-Making Model (cont’d) • 4. This Lead MLT chose alternative D (ignored the situation and hoped for the best). He decided that his friendship with this person and maintaining a good working relationship with her, along with wanting his free time and a good night’s sleep, was priority.

20. Unit #4Medical Ethics • Example of using the Value-Based Decision-Making Model (cont’d) • 5. Short-term consequences of his decision include: • A. The Lead MLT could go home and not work a double shift. • B. His supervisor would not have to be disturbed. • C. The impaired employee could work with no reprimands. • 6. Long- term consequences are that laboratory errors could affect patient care.

21. Unit #4Medical Ethics • Example of using the Value-Based Decision-Making Model (cont’d) • Is this the decision you would have made? Maybe, maybe not. It is difficult to know until you are actually in that situation.

22. Unit #4Medical Ethics • In the Assignment for this Unit, go to http://virtualmentor.ama-assn.org/ • On the home page for this website, click the “Ethics Poll” tab at the top of the page. • Then click on “all polls”; it is a tiny link beneath the “Ethics Poll” heading and next to the “print” link. • Click on the April 2008 poll on “Immigrants and Medical Care”. • Take the Poll, as directed. Click the “Vote” button at the bottom to view the results. • Copy and paste the results in a Word document AND, using the 5 step decision-making model in this PowerPoint, outline the steps you used to arrive at your voting results. • Send the Assignment to the instructor by the scheduled deadline.