Ethical Boundaries and Practices

Ethical issues and their implications in healthcare.

What is ethics?

• Principles of right and wrong.• Questions to consider:–Who should practice ethical behavior?– Is there such a thing as ethical behavior

among friends?

• When was the importance of ethics in health care first recognized?

Hippocrates

• What do you know about Hippocrates?–Greek–Physician–Lived 2500 years ago–Wrote Hippocratic Oath, which is

still taken by physicians today.

Codes of Ethics

• Professional associations write codes of ethics.– American Medical Association (Physicians)– American Nurses Association (Nursing)

• Purpose: Set standards of professional conduct that promote the welfare of patients and assure high quality care.

• Check the web to see the professional code of ethics for your future health profession

AAMA Code of Ethics

• Render service with full respect for the dignity of humanity.

• Respect confidential information obtained through employment.

• Uphold the honor and high principles of the profession.

• Seek to continually improve the knowledge and skills of medical assistants for the benefit of patients and colleagues.

Ethics and the Law

• Laws are based on ethical principles.• Most laws enforce ethical standards.

– Confidentiality of Patient Information • Ethical standard that has become a legal standard

• Sometimes laws are in conflict with a person’s ethical principles.– Abortion

• Your ethical code may prohibit; law support woman’s right to choose

• Healthcare workers should act in the best interest of patients and support legal standards for patient care.

Ethics and the Law

• As a future healthcare professional, do you think you will ever be put in a position where your personal ethics are in conflict with the requirements of your profession? – If so, how will you manage it?

• As a healthcare professional, will you be able to disengage your emotions when dealing with ethical conflicts?– Universal concerns

• Infectious Diseases such as HIV/AIDS• Unable to separate yourself from their care as a healthcare provider

• Legally and ethically, they must act professionally when dealing with all patients.

Guiding Principles

• The upcoming slides provide examples of ethical principles for healthcare workers and the corresponding laws that were created to support them.

Guiding Principles

1) Preserve life

2) Do good3) Respect

autonomy4) Uphold

justice

5) Be honest6) Be discreet7) Keep

promises8) Do no

harm

Healthcare Ethics: Euthanasia

• What is it?– Results in death to alleviate suffering

or when there is no hope for recovery.

• Many healthcare professionals feel euthanasia is contrary to their professional ethics.

• Regardless of their beliefs, healthcare workers should follow state laws.

• Oregon only state to legalize

Healthcare Ethics: Organ Transplants

• Organ donations come at a time of crisis when somebody dies.

• Healthcare workers should ask about donation.

• Illegal to transplant organs without patient or family permission.

Healthcare Ethics: Organ Transplants

• Who gets the organ?– Handout “You be the Judge”• Mr.N• Ms. L• Mr. Z• Mrs. P

Healthcare Ethics: Organ Transplants

• Who gets the donated organ?

– Criteria• Likelihood of benefit• Urgency of need• Change in quality of life

(improved?)• Duration of benefit

Healthcare Ethics: Conception

• IVF – In vitro fertilization• Egg and sperm donation• Surrogates• Fertility drugs•What are the ethical considerations?

Should there be limits to IVF?

• Should obese people be allowed to have IVF?

• Should a couple be approved for IVF if they both smoke?

• Should a single person who is unemployed be a candidate for IVF?

Codes of Conduct

• Ethical responsibilities include respecting the cultural, social and ethnic differences of patients and other healthcare workers.

• “Scope of practice” helps define the code of conduct for healthcare workers.

• Performing skills outside the scope of practice is illegal and unethical.

• Ethical codes of conduct are based on moral standards and society’s expectations.

Ethical Dilemmas

• Advances in health care have created ethical dilemmas for healthcare providers.

• There are no easy answers when addressing ethical dilemmas.

• The question is – what is the responsibility of healthcare providers when addressing ethical dilemmas?

Ethical Dilemmas• Should family members be allowed to

discontinue life support?• Do parents have a religious right to

refuse life-saving blood transfusions for their child?

• Should people be allowed to sell organs for use in transplant?

• Should human beings be cloned?• What should be done with fertilized

frozen embryos when the parents no longer want them?

Ethics Committee

• Most hospitals have ethics committees that examine ethical issues related to patient care.

• They can advise patients, families and healthcare providers.

• A hospital ethics committee might decide the best action to take for a terminally ill patient on a respirator.

• An ethics committee might also be asked to pass judgment on the actions of a healthcare provider.

Professional Practice

1. Use the approved methods when performing procedures.

2. Obtain proper authorization before performing any procedure.

3. Identify the patient.4. Observe all safety precautions.

Professional Practice

5. Think before you speak and carefully consider everything you say.

6. Accept no tips or personal gifts.7. Immediately tell your supervisor

if you make a mistake.8. Act professionally in everything

you say and do.