Ethical Boundaries and Practices

Ethical issues and their implications in healthcare.

What is ethics?• Principles of right and wrong.• 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.• Purpose: Set standards of

professional conduct that promote the welfare of patients and assure high quality care.

• Is there a 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.• Sometimes laws are in conflict

with a person’s ethical principles.• 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? What will you do?• As a healthcare professional, will you

be able to disengage your emotions when dealing with ethical conflicts?

Guiding Principles• Ethical principles for healthcare

workers and the corresponding laws that were created to support them.

Guiding Principles1) Preserve life2) Do good3) Respect

autonomy4) Uphold

justice

5) Be honest6) Be discreet7) Keep

promises8) Do no harm

Healthcare Ethics: Euthanasia

• 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.

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: 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?

Incident Reports• To ensure prompt reporting and

documentation of all incidents resulting in injury or having potential adverse affects to patients, employees, or visitors.

• To accurately document threats or actions of violence and environmental emergencies.

• To accurately document incidents of property damage.

Incident Reports• Follow your agency’s policies in filling

out and submitting incident reports.• Focus on the facts.• The purpose of the incident report is

for legal record keeping – NOT punishment.

• Can you think of examples of when an incident report might be completed?

Electronic Incident Reports

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 Practice1. Use the approved methods

when performing procedures.2. Obtain proper authorization

before performing any procedure.

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

Most codes of Ethics that govern the behavior of

healthcare Professional are written by::

A.) Licensing AgenciesB.) State Boards of HealthC.) Professional OrganizationsD.) Health Science Textbook companies

Hippocrates wrote standards for the ethical behavior of

physicians 2500 years ago in:

A.) RomeB.) FlorenceC.) VeniceD.) Greece

What statement about euthanasia and healthcare

professionals is true?A.) The decision to employ methods of euthanasia is exclusively

the physiciansB.) Most HCW feel that euthanasia is contrary to their professional

ethicsC.) HCW shoul always follow their ehtical beliefs, regardless of what

the physician orders or patient requestsD.) Euthanasia is always illegal and unethical

A grief stricken family in an ER have just been notified of the death of their child, who was hit by a car. What should the physician ask

regarding organ transplantation?A.) Do not ask as the family is grief stricken and cannot make an

informed decisionB.) Wait 5 or 6 hours until the family has had time to absorb their

loss, then ask about organ donationC.) Immediately ask the family for permission to donate the childs

organs for transplantationD.) Start the process of removing the organs, and hope that the

family will give permission when asked

A couple wishes to have their own biological child, but the wife had a

hysterectomy for medical reasons when she was 25. What option would give

them the best hope for having a child?A.) Genetic counseling and fertility drugsB.) Artificial insemination with sperm from a sperm bank

C.) Implantation of 5-10 frozen embroysD.) IVF of their own eggs and sperm with implantation in a

surrogate

A nursing assistant refuses a request by the charge nurse to take a pain pill

to a patient. The assistant believes that giving the pain medication would

be a violation of his/her A.) Scope of PracticeB.) Religious BeliefsC.) Reasonable AccomodationD.) Rights under OSHA rules

What MOST LIKELY would be the task of a hospital ethics

committee?A.) Approve discontinuatiuon of life support on a terminally ill

patientB.) Allow the hiring of a physical therapist whose license has been

revokedC.) Termination of an employee with excessive absences

D.) Discipline of a physician who is dating a laboratory technician

Which of the following is an ethical dilemma that an ethics committee would be asked to

consider?A.) Removing a terminally patient from a respirator

B.) Following through on a DNR requestC.) Transplanting an organ into a patient who is first on the

transplant listD.) Patient who is opting for a less invasive treatment when an

invasive procedure is available

Dr. North went to a meeting with other physicians and spoke about a patient he had, Mrs. Kennedy. He was telling jokes about some odd complaints that she had made. One of the physicians was a personal friend of Mrs. Kennedy's,

who informed her about what Dr. North had said.

What ethical principle has Dr. North violated?

A.) Be honestB.) Preserve LifeC.) Be discreteD.) Unhold justice