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Ethics > Ch 4-6 > Flashcards

Ch 4-6 Flashcards

1
Q

Moral Distress:

A

a type of ethical tension that occurs when a practitioner
knows the right course of action but experiences constraints are barriers that prevent them from acting accordingly and creates discomfort that arises from discord between ethical action and practical limitations.

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2
Q

moral agent

A

a person who can differentiate between right and wrong

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3
Q

3 broad categories of moral distress:

A

 Institutional ethics (e.g., healthcare environment comma reimbursement
pressure)
 Professional practice (e.g., codes of conduct or behavior, professionalism)
 Clinical decision making (e.g. Goal setting, discharge planning)

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4
Q

Implications

A

Negative impact on emotional and physical well-being of the practitioner, the culture of the
workplace, the care of clients, job satisfaction, and staff retention
 Leads to burnout:

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5
Q

Practical applications in OT

A

 2 categories to combat moral distress:
 (1) prevention & (2) intervention
 ALL OTP’s should have moral courage to advocate for what they perceive to be right and
ethical

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6
Q

Moral courage:

A

the courage to overcome the fear of adverse consequences and act in accordance with ethical standards and values

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7
Q

The six strategies occupational therapy manager should implement to prevent and reduce moral distress

A

 (1) recognizing moral distress
 (2) implementing educational strategies
 (3) facilitating interdisciplinary research
 (4) improving communication
 (5) creating healthy organizational work environments
 (6) promoting ethical leadership

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8
Q

(1) Recognizing Moral Distress

A

 Identifying and naming the moral distress is a powerful strategy for mitigating the distress.
 Recognizing feelings of powerlessness in a situation, allows practitioners
to seek the support or resources they need

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9
Q

2 Implementing Educational
Strategies

A

 Continuing education on ethical matters
 By engaging in or creating opportunities for professional growth

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10
Q

3 Facilitating Interdisciplinary
Research

A

 Interdisciplinary moral distress research is essential.
 Further research is required to understand moral distress in OT.
Understanding how team dynamic negatively or positively affect moral distress will lead to more effective interventions and elevation of the team
effectiveness.

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11
Q

(4) Improving Communication

A

 Communication continues to be one of the biggest challenges in health care today.
 Fostering an environment where ALL individuals feel comfortable
 Managers must create a safe space for open dialogue around difficult topics.
 Respectful communication

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12
Q

(5) Creating a Healthy Work
Environment

A

 OT managers must emphasize respect for ALL individuals, both clients and staff.
 OTP’s need to see themselves as moral agents with moral courage to strengthen the healthcare environment

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13
Q

(6) Promoting Ethical Leadership

A

 Ethics & Leadership are intertwined
 A leader cannot be effective without careful consideration of ethics.
 In challenging situations an ethical leader will advocate for optimal solutions
 A strong ethical leader will set the example

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14
Q

(7) Occupational Therapy Ethics
Rounds

A

 forums that bring together OT
practitioners and create an opportunity to discuss emerging ethical issues
 (1) Allow practitioners to practice communication skills
 (2) Demonstrate a commitment to education and ethics
 (3) Strengthen the ability to recognize an ethical issue
 (4) Act as a support system
 Rounds may be initiated by managers practitioners and may be held at a specific frequency or on an as-needed

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15
Q

Codes of ethics

A

along with personal ethics define the range of
appropriate relationships and service delivery within a profession.
 MOST codes of ethics in health care have unifying themes based on the
four principles of biomedical ethics

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16
Q

Bioethics

A

is a multidisciplinary field of study, including research, public health, organizational
and clinical ethics

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17
Q

Biomedical ethics and clinical medical ethics

A

are interchangeable terms referring to the
application of ethical reasoning to specific clinical situations.

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18
Q

The 4 principles of biomedical ethics:

A

 (1) Autonomy
 (2) Nonmaleficence
 (3) Beneficence
 (4) Justice

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19
Q

Clinical Medical Ethics (CME)

A

 Founded in 1972 by Mark Siegler,
 Focus: Ethical decision-making in daily patient care interactions
 Key Concept: Practical ethics for health care professionals, beyond theoretical bioethics.
 Central to CME: The relationship between provider and patient.
 Shared-Decision Making: Evolved through CME, emphasizing patient-provider relationships.
 Daily Practice: Interprofessional huddles improve communication and prevent errors.

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20
Q

Utilitarianism

A

A philosophy that considers the best choice to maximize good for the most people
or minimize harm to the fewest.
 Key Principle: The ends justify the means.
 Application: Cost-benefit or cost-effectiveness analysis for resource allocation

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21
Q

Utilitarianism examples

A
  1. Maximize benefit using cost-effectiveness analysis.
  2. Every life has equal value, no bias toward specific individuals.
  3. No preference for actions addressing inequality unless they maximize overall benefit.
     Healthcare Example: Mailing free COVID-19 test kits to all households to reduce transmission, without regard to individual circumstances.
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22
Q

Deontology

A

Rule-based ethics focusing on duties and obligations,
developed by Immanuel Kant.
 Key Principle: Duty guided by human rights, not outcomes (ends do not justify the means).
 Focus: Respect for the autonomy, dignity, and worth of individuals.

23
Q

Deontology examples

A

 Informed consent.
 Adherence to HIPAA (Health Insurance Portability and Accountability Act)
ensuring privacy and autonomy in healthcare decisions

24
Q

Ethical Approaches: Virtue Ethics

A

 Concept: Virtue ethics focuses on character rather than outcomes or processes.
 Philosophical Roots: Originates from Aristotle’s philosophy, emphasizing the role and character
improvement.
 Aristotle’s Insight (Lyon, 2021): “Virtue is a disposition that enhances the person’s goodness and their
role success.“

25
Q

Introduction to Occupational Therapy Ethics

A

 Central Documents: (OTPF)
and AOTA Code of Ethics.
 Purpose: Guide professional values in clinical and academic settings.
 Presidential Address 2017 (Amy Lamb): Encouraged reflection on personal motivation for choosing OT (“OT Why”) to navigate ethical
tensions.

26
Q

Enforcement and Education by AOTA
Ethics Commission

A

 Role: Provides ethics education, revises the Code, offers advisory opinions
 Enforcement: Handles complaints
 3 Enforcement Pathways for reporting and sanctioning OTP’s:
 1) State Regulatory Boards: Handle illegal actions and serious professional misconduct.2)
 2) AOTA Ethics Commission: Deals with ethical violations by AOTA members.
 3) NBCOT: Addresses ethical concerns for certified practitioners

27
Q

Procedure for Complaints - AOTA

A

 Complaints involve violations of conduct standards.
 initial discussion and corrective steps recommended.

28
Q

Procedure for Complaints
NBCOT

A

 Maintains a list of disciplinary actions.
 Complaints may lead to certification consequences.

29
Q

Procedure for Complaints
State Boards

A

 Handle complaints involving legal violations.
 May result in license removal or legal consequences

30
Q

Procedure for Complaints
General Process

A

 Contact details for filing complaints available through the secretary of state or relevant websites.
 Severe cases may escalate to criminal or civil justice systems for resolution

31
Q

Settings Requiring Collaboration

A

 Examples: Acute care, inpatient rehabilitation, skilled nursing facilities.
 Focus: Collaboration with patients and interprofessional teams for care and discharge planning

32
Q

Sources of Ethical Tensions

A

 Diverse agendas and potential for competing allegiances in practice settings.
 Common issues: Resource allocation, client safety, working with vulnerable clients, interpersonal conflicts,
adherence to professional standards.

33
Q

Consequences of Ethical Tensions

A

 Negative: Decreased care standards, practitioner burnout.
 Positive: Opportunities for change, increased job satisfaction.

34
Q

Management of Tensions

A

 Productive resolution is crucial for mitigating negative impacts and enhancing positive outcomes

35
Q

Ethical Dilemma

A

 Definition: A choice between two or more conflicting ethical principles.
 Example: Deciding between respecting patient autonomy and promoting beneficence or
nonmaleficence in a patient with a history of substance misuse who refuses recommended treatment

36
Q

Ethical Temptation

A

Definition: A scenario where personal or organizational agendas challenge ethical values.
 Example: A clinician faces pressure to reduce time spent with a patient due to lower insurance reimbursement, creating a conflict between ethical practice and financial considerations

37
Q

Ethical Silence

A

Failure to act on or report unethical behavior of a colleague.

38
Q

Ethical Reasoning Process

A

1) Define the Problem
2) Gather Initial Data
3) Formulate a Hypothesis
4) Gather Evidence
5) Take Action
6) Reflect

39
Q

Analytical Tools for Ethical Dilemmas

A
  • CELIBATE Method: A 10-step guide for evaluating factors in dilemmas, such as stakeholder
    involvement, motivations, and legal issues.
  • Realm–Individual Process–Situation Model: Analyzes dilemmas by considering the realm (individual,
    organizational, societal), moral processes (sensitivity, judgment, motivation, ego strength), and
    situation types.
40
Q

Decision-making Triangle

A

Organizes evidence and theory within ethical principles to guide decision-making.

41
Q

Role of Ethics in Practice

A

 Ethics guide good behavior based on moral principles.
 Essential for addressing complex school-based challenges

42
Q

Ethical reasoning

A

Process to recognize, analyze, and clarify ethical problems
 Focuses on what should be done, not just what could be done.

43
Q

Practical Application

A

 Constant adaptation to policy, political contexts, team structures, family, and school demands.
 Creates challenges in maintaining quality services within constraints

44
Q

Role in Schools

A

 Facilitate access to and participation in the IEP.
 Increase engagement and reduce unnecessary special education referrals

45
Q

Standards of Conduct in Occupational Therapy

A

veracity and fidelity
Promoting Equity

46
Q

Third-Party Billing

A

 Ethical responsibility to accurately document services for reimbursement.
 Compliance with laws, guidelines, and regulations for billing

47
Q

Impact of Financial Drivers

A

 Avoid letting third-party funding drive service recommendations.
 Ensure occupational therapy inclusion is based on educational need, not
potential reimbursement

48
Q

Understanding Stakeholders

A

 Identify interests of families, administrators, educators, and community members.
 Stakeholders can be allies or complicate ethical decision-making

49
Q

Resource Allocation

A

 Address shortages in professional time, supplies, space, and equipment.
 Allocate resources based on the ethical principle of justice, considering all stakeholders’ interests

50
Q

Systematic Approach

A

Follow a structured method of ethical reasoning

51
Q

Steps for Resolution:

A

-Follow the Process
-Persistence
-Clarify the problem
initial Steps: Talk directly to the individual involved to
-Educational Approach:
-Administrative Actions:
-Escalation - if needed contact SRB

52
Q

Filing a Formal Complaint:

A

-documentation
-Contact Information: Use the SRB’s online forms or call directly. The contact
info may be on the license itself.
-Additional Steps: Notify professional bodies like AOTA or NBCOT if applicable

53
Q

Gathering Resources for Ethical
Practice
 Accessing Ethical Resources

A

 Availability: Important documents are mostly available online and should be
consulted for ethical reasoning.
 Key Areas: Be knowledgeable about federal, state, and local laws, especially those concerning education, Medicaid billing, and state credentialing
regulations.

Ethics (6 decks)

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