LAW AND ETHICS REVIEW

1. LAW AND ETHICS REVIEW Refresher Course on Professional Ethics and Law for Radiologic/Imaging Technologists, especially those working with students. Presented by Martina Harris University of Phoenix

2. Goals and ObjectivesProfessional Ethics and Law Review Goal 1: While working with students, the Radiologic Technologist/Imaging Technologist must uphold standards of behavior and communicate the varying aspects of ethics as defined the American Registry of Radiologic Technologists.

3. OBJECTIVES for Goal 1 By the end of this section, the Technologist will be able to: • List the three parts of the Standard of Ethics • Describe the purpose of the Code of Ethics • Summarize the Code of Ethics • Describe the purpose of the Rules of Ethics

4. ETHICS Ethics – The discipline dealing with what is good and bad and with moral duty and obligation. A set of moral principles or moral values. The principle of conduct governing an individual or a group (professional).

5. ETHICS Philosophers today usually divide ethical theories into three general subject areas Metaethics Normative ethics Applied ethics

6. ETHICS Applied Ethicsinvolves examining specific controversial issues such as capital punishment, abortion, right to live or die, etc. This the theory of ethics involves areas in which the Radiologic/Imaging Technologist would find themselves most effected.

7. PROFESSIONAL ETHICS Applied ethics in medicine is commonly known as Biomedical ethics. This “may be defined as the branch of ethics dealing with dilemmas faced by medical professionals, patients, and their families and friends…described as guidelines for proper activities and attitudes toward patients and peers…suggests a standard of conduct that is expected of members of the profession.” Towsley-Cook, D.M & Young, T.A. (1999()

8. PROFESSIONALISM A profession is defined as an occupation, especially one requiring training and specialized study. It is a body of qualified persons engaged in an occupation. A profession does subscribe to certain behaviors or conduct.

9. Professional Ethics The Radiologic/Imaging Technologist have accrediting and professional societies which have an ethical code of conduct in which the professional is expected to abide by. The following few slides will discuss the accrediting agency called the American Registry of Radiologic Technologists (ARRT) Standard of Ethics.

10. ARRT STANDARDS OF ETHICS Three parts of the ARRT Standard of Ethics: • Code of Ethics • Rules of Ethics • Administrative Procedures

11. CODE OF ETHICS 1. The Code of Ethic is a guide by which Registered Technologists and candidates may evaluate their professional conduct as it relates to patients, healthcare consumers, employers, colleagues and other members of the healthcare team. The Code is termed "aspirational," meaning it sets the level of ethical conduct that provides optional protection, safety and comfort of patients; but it is not specifically enforced.

12. RULES OF ETHICS 2. The Rules of Ethics are mandatory standards of minimally acceptable professional conduct...and they are enforced as such. Technologists and candidates who engage in or permit the occurrence of an infraction are subject to sanctions.

13. ADMINSTRATIVE AREA 3. Administrative Procedures detail the steps that the Ethics Committee and Board of Trustees may take in enforcing the Rules of Ethics.

14. ARRT • ARRT Web Standard of Ethics Let’s take a look at the Standard of Ethics as written in the web pages of the ARRT Website Link to website : http://www.arrt.org/ Go to Ethics, then Standards of Ethics. When finished, hit the back key on the website.

15. CORPORATE/HOSPITAL POLICIES • Also, expected is Professional Conduct within the working environment. All healthcare facilities subscribe to a certain behavioral conduct and is stated in the human resource policy manual. Example: http://techtransfer.massgeneral.org/csrl/investigators/cconduct.asp

16. ASSESSMENT - PART 1 At this point, we have discussed Ethics and the relationship to our professional lives. Before we move on to the Ethics and how it relates to Law. There is a short assessment on what has been discussed. If you would like to go back to the beginning again use this button: Or go tohttp://mhlawethics.tripod.com/id11.html to continue to self-assessment.

17. Law and Ethics Review continued • Welcome to Section 2

18. Goals and ObjectivesProfessional Ethics and Law • Goal 2: All Radiologic/Imaging Technologists must recognize when a breach of the Standards of Ethics occurs.

19. OBJECTIVES for Goal 2 By the end of this section, the Technologist will be able to: • Define Standard of Care • Contrast public and private law • Define professional liability • Given 5 case studies describing unethical behavior, be able to identify the behavior and describe an alternate ethical behavior in at least 4 out of 5 cases.

20. INDIVIDUAL RIGHTS Rights and Health Care: “A right is defined as a claim or an entitlement. Healthcare is a practice, a commodity, an approach, or a collective responsibility to ensure the wellness of a population.” (Towley-cook, D.M. & Young, T.A. 1999)

21. Every New Jersey hospital patient has been given the following Rights: (Listed as a summary) Confidentiality Informed Consent Considerate and respectful care Complete and current information Right to privacy To refuse medication and treatment after possible consequences of this decision have been explained. Treatment/medical services without discrimination based on race, age, religion, national origin, sex, sexual preferences, handicap, diagnosis, ability to pay, or source of payment RIGHTS OF PATIENT

22. NJ Patient Rights continued: Treatment/medical services w/o discrimination based on race, age, religion, national origin, sex, sexual preferences, handicap, diagnosis, ability to pay, or source of payment Free from human experimentation unless consented Continuity of Care Freedom from physical and mental abuse Freedom from restraint, unless authorized by a physician with certain restrictions. To have prompt access to information contained in the medical record Explanation of bill RIGHTS OF PATIENT

23. Example of a Patient Right Confidentiality Information from or about the patient/clients, whether in the record or not, is to be shared only with other licensed professionals and then only for the patient/client benefit.

24. STANDARD OF CARE • Patients have these rights and physicians/healthcare providers have an obligation to provide Standard of Care.

25. STANDARD OF CARE • Standard of Care “is the level at which the average , prudent provider in a given community would practice. If treatment for which a recognized specialty exists is in question, then the standard of care is defined by the level at which an average, prudent specialist would practice, even if the treating doctor is a generalist.” (Rynne, T.J. 1995)

26. STANDARD OF CARE • How would you describe standard of care in your professional opinion. What would keep you from being held negligent in your practice of Imaging?

27. LAW • Difference between Public and Private Law PUBLIC:The body of law which concerns the government of its relations with individuals and business organizations. PRIVATE:Refers to the rules and principles which define and regulate rights and duties between or among persons and private business.

28. LAW • Private Law encompasses: • contracts • property • and Tort - Malpractice

29. LAW • According to Hall, J.K. (2002) “Torts, a French word for wrong maybe done accidentally (negligently), or intentionally, or with degrees of intent in between. “ Negligence (Malpractice) = Less Intent Intentional Torts (Battery, Assault, etc.) = More Intent

30. LAW • TORT LAW Black’s law dictionary defines a Tort as a private or civil wrong or injury from which a court will provide a remedy in the form of an action for damages.

31. LAWMALPRACTICE • Malpractice: Simple definition is the “Improper or negligent services provided by a professional, such as a doctor or a lawyer. • This definition can be expanded to include any healthcare professional providing services to a patient.

32. PROFESSIONALNEGLIGENCEand LIABILITY “negligence" is often a bit ambiguous, but can be loosely defined as the failure to provide the degree of knowledge, care or skill of the average professional peer, in good standing, under similar circumstances. Essentially, anyone or any firm that holds themselves out as experts in a particular field can be held responsible for their work; their advice; their counsel.http://www.professional-liability.com/

33. PROFESSIONALNEGLIGENCEand LIABILITY • professional liability insurance is also often referred to as "errors & omissions" or "E&O" or "malpractice" insurance.” http://www.professional-liability.com/

34. ETHICAL DILEMMAS and TORTS There are various ways in which a healthcare professional may be taken to court: • Intentional Torts: • Battery: Touching a patient without their permission • Assault: Threat of touching in an injurious way. • Libel (written) & Slander (verbal): malicious spreading of information that results in Defamation of Character or Loss of Reputation • False Imprisonment: Unjustifiable detention of a person against his/her will.

35. ETHICAL DILEMMAS and TORTS • Unintentional Torts: Acts not intended to do harm but still result in damage to person or property. Malpractice and negligence are usually unintentional torts.

36. Radiologic/Imagining Technologists7 “C’s” of Malpractice Prevention

37. ETHICAL DILEMMAS & CRITICAL THINKING SKILLS

38. CRITICAL THINKING SKILLSEthical Dilemmas According to Wilson, B.G. (1997) “Ethical dilemmas are created when one is faced with a situation in which there is actually more then one ethical course of action. However, in taking one course, you are precluded from taking the other. In other words, a choice must be made between two ethical actions.

39. CRITICAL THINKING SKILLSEthical Dilemmas Scenarios related to patient and workplace: • You just completed a procedure on your patient. As you walk out the door the husband, standing in the hallway, asks about the results. What would you say to him? Why? • What would you do if you saw written in a medical chart the initials “FLK”?

40. CRITICAL THINKING SKILLSEthical Dilemmas • Patient comes to the Imaging Department in restraints. What would you do? • You performed an abdominal radiograph on a patient. Scissors were identified on the film. What would you say if the patient asks why you are taking more radiographs?

41. CRITICAL THINKING SKILLSEthical Dilemmas • You are aware that the radiologist did not give the patient all the information needed to make an informed decision about a procedure. What would you do? • Adult hit by an automobile. Comes to Trauma Department for radiographs. You notice a fracture of T-7. Wife wants to know why he cannot move his legs. What do you say?

42. CRITICAL THINKING SKILLSEthical Dilemmas • 4-year old comes to Radiology Department for possible fracture of tibia/fibula. You notice bruising on his legs and arms. Parent states child fell. What do you do?

43. CRITICAL THINKING SKILLSEthical Dilemmas Links to websites: http://www.cariboo.bc.ca/ae/php/phil/mclaughl/courses/ethics/bioeth/lectures.htm http://bmj.bmjjournals.com/cgi/content/full/322/7288/709 http://www.essayedge.com/contentpartners/business/lesson8.html#article

44. ASSESSMENT - PART 2 You have completed the Ethics and how it relates to Law Section 2. There is an additional short assessment. If you would like to go back to the beginning of this section, again, use this button Or go tohttp://mhlawethics.tripod.com/id12.html to continue to assessment. Reminder: ECE credits are assigned to this review. Both these assessments must be completed within 6 weeks and we will send you a certificate of completion.

45. REFERENCES • American Society of Radiologic Technologists website: http://asrt.org • American Registry of Radiologic Technologists website: http://www.arrt.org • Hall, J.K. (2002). Law and Ethics for Clinicians. Jackhal Books: Texas • Runne, T.J. (1995). Healthcare Marketing in Transition. (rwin Professional Publishing, 1995, 1-800-634-3966 • Towsley-Cook, D.M. & Young, T.A. (1999). Ethical and Legal Issues for Imaging Professionals. Mosby: Missouri • Wilson, B.G. (1997). Ethics and Basic Law. For Medical Imaging Professionals. F.A. Davis Company: Philadelphia

46. LAW AND ETHICS REVIEW THE END