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Introduction to Ethics in End of Life Care

Introduction to Ethics in End of Life Care. September 2005. Objectives. Define Ethics and related topics Discuss ethical theories & principles Examine the elements of Value-based ethics Identify applied ethics. Overview of Ethics. Definitions Theories and Frameworks Primary Principles.

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Introduction to Ethics in End of Life Care

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  1. Introduction to Ethics in End of Life Care September 2005

  2. Objectives • Define Ethics and related topics • Discuss ethical theories & principles • Examine the elements of Value-based ethics • Identify applied ethics

  3. Overview of Ethics • Definitions • Theories and Frameworks • Primary Principles

  4. Definitions • Ethics: critical, rational, systematic and intellectual approach to right and wrong • Ethics as Discipline: deals with concepts of morality, moral duty, obligations and values • Ethical Dilemma: Conflict of obligation, loyalties, or values

  5. Types of Ethical Issues • Clinical Ethics • Professional Ethics • Organizational Ethics • Business Ethics

  6. Ethical Theories and Frameworks • Teleological Theories • Related to final causes or purpose • An action or practice is right if it leads to balance of good (or bad) consequences. • Result determines rightness or wrongness • Benefits/burdens—greatest good for greatest number.

  7. More on theories • Deontological Theories • Based on duty or moral obligation • An act is right or wrong if it conforms to an overriding moral duty • Rightness/Wrongness determined by looking at certain aspects of of the act itself. • Religious beliefs guide actions

  8. Primary Ethical Principles • Beneficence---to do good • Non-Malevolence---do not harm • Autonomy • Veracity • Justice • Fidelity • Professional Integrity

  9. Value-based Ethics • A commitment to clients that goes beyond our own personal feelings & moral standards • Know & Respect values and beliefs of clients • Know our own values, beliefs, attitudes and judgments

  10. Principles of Applied Ethics • Applied Ethics refers to using ethical principles in real life situations

  11. Ethics Committee The basic role is education, policy development, and consultation.

  12. Responsibilities POLICY DEVELOPMENT Code of Ethics JCAHO Ethics Standards Ethics Policy/Procedure EDUCATION Self Education of Committee Members Education of Staff • General • Department Specific Education of Community • Patient Self-Determination Act (PSDA) Program Development CONSULTATION Consultation on Individual Cases • Current & Retrospective Creating a Forum for Interdisciplinary Dialogue Maintaining Vitality of the Religious and Ethical Traditions of the Institution

  13. Ethical Decision Making • Gather facts & Information • Medical Indications and Interventions • Patient/Client preferences • Quality of Life Issues • Contextual Considerations

  14. JONSENIAN PARADIGM

  15. Ethical Decision Making process • Identify issues • Values • Duties • Beliefs • Emotions • Loyalties

  16. Ethical Decision Making - more • List Options • Determine Best interest of each stakeholder • Consider previous wishes • Consider consequences of each resolution • Make a decision & act

  17. Other Considerations • Conflicting values • Recognize asymmetrical influences • “Can do” does not equal “must do” • Family may have internal conflict and disagreements • Outside consultant may be needed • Who has authority in this arena?

  18. QUESTIONS? You can find this presentation and receive more information on Hospice care by contacting the Franciscan Hospice Website www.hospice.FHShealth.org

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