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Chapter 3: Ethical and Legal Responsibilities in Healthcare

Explore the complex and diverse nature of ethics in healthcare, including the relationship between ethics and the law, ethical dilemmas, professional codes of ethics, personal values, and guiding principles in healthcare ethics. Discover the importance of preserving life, doing good, respecting autonomy, and upholding justice.

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Chapter 3: Ethical and Legal Responsibilities in Healthcare

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  1. Chapter 3 Ethical and Legal Responsibilities

  2. Ethics • Ethics • System of principles for determining right and wrong • Guides decision making • Helps with difficult and complex problems • Varies among cultural groups • Influenced by religion, history, and collective experiences

  3. Ethics • Ethical dilemmas • Situations that have no clear answers or correct courses of action • E.g., gun control, capital punishment, freedom of speech

  4. Ethics and the Law • Ethics provide general principles on which laws are based • Sometimes laws conflict with individual ethics • Laws can have negative, unintended consequences

  5. Question • True or False: • Some laws have harmful results.

  6. Answer • True • Some laws, though meant to be fair, have unintended consequences that harm rather than help

  7. Ethics and Health Care • Many health care issues involve ethical decisions • Hippocrates was concerned with medical ethics • Hippocratic Oath • Some topics relevant today

  8. Ethics and Health Care • Impact of technological advances • Definition of life • Expense of care • Birth control • Vaccinations

  9. Question • True or False: • A good system of ethics will provide answers to most health care decisions.

  10. Answer • False • Many health care issues have no easy answers and present serious ethical dilemmas

  11. Professional Codes of Ethics • Standards of professional conduct • Ensure high quality of care • Many professional organizations have codes • Codes provide guidelines for handling difficult issues

  12. Personal Values • Foundation for making decisions and guiding behavior • Influenced by family, religion, education, and personal experience • Establish priorities • Values not necessarily right or wrong

  13. Question • Which of the following is an example of a value? • Law that protects the welfare of patients • Professional code for behavior • Personal belief that education is necessary for a satisfying life

  14. Answer • C. Personal belief that education is necessary for a satisfying life • Value • Belief on which decisions are based • Tends to be personal

  15. Guiding Principles of Health Care Ethics • Preserve life • Do good • Respect autonomy • Uphold justice

  16. Guiding Principles of Health Care Ethics • Be honest • Be discreet • Keep promises • Do no harm

  17. 1. Preserve Life • Life is precious • Take all possible means to preserve it • No agreement on definition of life • Artificial means of supporting life • Euthanasia to relieve suffering • Illegal in most states

  18. Question • True or False: • It is illegal in most states to withdraw artificial means of supporting life.

  19. Answer • False • Not illegal to withdraw life support under certain conditions

  20. 1. Preserve Life • Dilemmas: • Organ transplantation • Euthanasia • Rationing care and resources

  21. Question • Which of the following patients would most likely receive a liver that becomes available from a donor? • A. Patient who has never abused alcohol • B. Patient who will likely die within weeks without a transplant • C. Patient who can best afford the surgery

  22. Answer • B. Although many factors are taken into account when determining who will receive an organ, medical urgency is a common consideration.

  23. 2. Do Good • Promote welfare of others • Basic duty of health care professional • Work in best interest of patients • Perform one’s job without expectation of receiving anything extra

  24. 3. Respect Autonomy • Self-determination • Patients have right to make own decisions • May choose type of treatment • May refuse treatment

  25. Consent • Permission • Patient must give for treatment • Can be given by the following: • Mentally competent adults • Emancipated minors

  26. Consent • Battery = crime • Touching or treating patients without consent • Assault = crime • Threatening to touch or treat without permission • False imprisonment • Holding mentally competent patients against their will

  27. Consent • Informed consent • Procedure explained including possible consequences • Implied consent • Indicated by patient’s actions • Express consent • Given in writing

  28. Question • If a patient schedules a root canal and shows up at the appointed time for the procedure, this is an example of _____ . • Express consent • Implied consent • Informed consent

  29. Answer • B. Implied consent • Implied consent • Given by patient’s actions • In this case, patient makes and keeps appointment for procedure

  30. Advance Directives • Written instructions containing patient’s desires regarding health care • Designation of health care surrogate • Also known as health care power of attorney • Gives specific people authority to make health care decisions • Living will • Contains written instructions regarding health care

  31. Advance Directives • Patient Self-Determination Act of 1991 • Health care facilities must provide adult patients with information about advance directives • Without instructions, care of incompetent patients can be difficult

  32. Question • True or False: • A patient admitted to a hospital is legally required to sign a living will.

  33. Answer • False • Patients are not legally required to prepare advance directives • However, health care facilities must advise patients of their right to do so

  34. 4. Uphold Justice • Justice refers to fairness • All patients must receive same level of care • Dilemmas: • Equitable distribution of health care resources • Ranking and rationing of health care services

  35. Reporting Abuse • Protect others from harm • Laws require reporting of abuse • Federal Child Abuse Prevention and Treatment Act • States have laws and reporting systems for elder abuse

  36. Reporting Abuse • Laws require reporting of abuse • Report suspected abuse to supervisor • Patient confidentiality does not apply

  37. Laws that Protect • Occupational Safety and Health Act • Requires employers to be responsible for safety and health of employees • Controlled Substances Act • Helps prevent abuse of addictive drugs • Provides guidelines for prescribing and handling

  38. 5. Be Honest • Good health care relies on honesty • Patient’s trust important • Dilemma: • How much to tell patients about their condition • Honesty essential among coworkers and with supervisor

  39. Fraud • Dishonesty involving cheating or trickery • Health care examples: • Insurance claims for services not performed • Selling ineffective treatments • Claiming education or credentials one does not have

  40. 6. Be Discreet • Preserve confidence and respect privacy • Confidentiality • Patients’ information cannot be released without their written consent

  41. 6. Be Discreet • Health Insurance Portability and Accountability Act (HIPAA) • National standards to protect patient privacy • Follow facility policies

  42. Question • True or False: • Individual health care facilities must develop policies for protecting patient confidentiality.

  43. Answer • True • Following federal guidelines, health care facilities must develop policies and procedures for maintaining patient confidentiality

  44. 6. Be Discreet • Defamation of character • Disclosing unauthorized information that can harm reputation of another person • Libel • Disclosing information in writing • Slander • Disclosing information orally

  45. 6. Be Discreet • Maintaining patient privacy • Close doors and curtains • Drape patients appropriately • Do not discuss patients in public areas • Discuss patients only with other authorized personnel

  46. 6. Be Discreet • Dilemmas: • Public safety • Patient has contagious disease • Patient desire to harm self

  47. 7. Keep Promises • Promises are important part of relationships with others • Contracts • Formal promises enforceable by law

  48. 7. Keep Promises • Contracts • Contain three components: • Offer • Acceptance • Consideration

  49. 7. Keep Promises • Types of contracts: • Express • Discussion and agreement on specific terms and conditions • Implied • Actions of parties create and carry out contract

  50. 7. Keep Promises • Breach of contract • One party fails to carry out part of agreement • Damages • Money to compensate for injury or loss • Agent • Someone who represents another person when making contract

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