Chapter 6 Flashcards
How are medical ethics and medical law the same?
-Share the goal of creating and maintaining social good.
-Both are dynamic and are in a constant state of change due to new laws being created.
Ethics
A system of moral principles or standards governing a person.
Morals
-basis for ethical conduct.
-an individuals own belief of what is right and wrong
-culture-based and time dependent
Medical ethics
-A system of principles governing medical conduct.
-how healthcare providers conduct themselves in their professional undertakings.
Where are physical therapy ethics derived from?
-APTA
Medical Law
-Establishment of social rules for conduct.
-A violation in the medical law may create criminal and civil liability.
Can healthcare providers influence legal standards?
-yes because most laws are created by looking at policy statements of professional organizations.
What would be a violation of this law by a PTA?
If a PTA were to represent themselves as a PT.
What are the 6 fundamental biomedical ethical principles healthcare providers are guided by?
1) Beneficence
2) Nonmaleficence
3) Justice
4) Veracity
5) Confidentiality
6) Autonomy
Beneficence
- Ethical principles that emphasizes doing best for the patient.
-Duty is to promote the health and welfare of the patient above anything else
EX of beneficence in PT
-showing concern for the physical and psychological welfare of their patients and clients.
Nonmaleficence
-Ethical principle that exhorts practitioners to not do anything that causes harm to a patient.
Who was the first to express ethical principles of beneficence and nonmaleficence?
-Hippocrates in his Hippocratic Oath.
EX of a breach of nonmaleficence in PT
-Exploiting patients financially by selling the patient an unnecessary assistive device or one at an inflated price.
Justice
Ethical principle that mandates that a healthcare provider distribute fair and equal treatment to every patient.
EX of justice in PT
Advocating to legislators and insurance companies the need to provide and improve access to healthcare services for all individuals.
Veracity
Ethical principle that binds the healthcare provider and the patient in a relationship to tell the truth.
EX of breach of veracity in PT
A PTA identifying themselves as a PT
Confidentiality
-Ethical principle that requires a healthcare provider to maintain privacy by not sharing information about the patient.
-Considered a fundamental ethical principle in healthcare.
Confidentiality can be breached only if…
-there is a clear threat to the well-being of the patient
or another person,
or the health of the public may be compromised.
A patients written authorization for release of information is required for the following:
-patients attorney or insurance company
-patients employer
-member of patients family
Health Insurance Portability and Accountability Act (HIPPA)
-created in 1996
-created additional patient confidentiality considerations
-training every year
Health of information technology for economic and clinical health act
-passed in 2009
-law describes how electronic data must be safeguarded under the HIPPA regulations
HIPPA’s privacy rule
-applied to health plans, healthcare clearinghouses, and healthcare providers
-Created rules to protect individuals medical records and other personal health information.
-also gives rights to patients to ask for a copy of their health information.
This rule does not what?
Replace federal, state, or even other laws that provide individuals with even greater privacy protection.
Covered entities
Healthcare providers, health plans, and healthcare clearinghouses
If the covered agrees to add more private protection for its patient it is bounded by what?
HIPPA
Protected health insurance
-individuals health information in any form
Notice of privacy practices
- states that an individual has a right to adequate notice of how a covered entity may use and disclose the individuals PHI.
-notice of privacy must be given to patient on first date of service delivery, involving face-to face exchange.
EX;s of reasonable safeguards that a covered entity needs to implement:
-avoid using the patients name in public hallways
-speaking quietly when discussing patients condition in waiting room to patient
-when making private phone calls, verify identity of person you are speaking to.
-leaving limited voice mail information
-locking file cabinets
-requiring additional passwords
A sign in sheet should not include?
reason for visit
Personal representatives of patients/clinets
-in situations where the patient/client is not capable of exercising his or her privacy rights.,
-the patient/client designates another individual to act on their behalf
EX of marketing of PHI
-the OT selling the patients name to a company that sells therapeutic gel
Who administers password protection during security of electronic PHI?
-computer engineers
who oversees and enforces HIPPAs privacy rule?
-DHHS office for civil rights
what happens if HIPPAs privacy rule is broken?
-civil sanction (fines, no personal gain)
-criminal sanction (monetary penalties and jail time).
Who receives a complaint about a covered entity?
Centers for Medicare and Medicad Services (CMS)
-they notify the entity and give them the chance to fix the problem, if not then they are fined
Autonomy
ethical principle that in healthcare means a form of personal liberty or self-governance
-A PATIENT HAS CONTROL OVER HIS OR HER OWN LIFE
EX of autonomy in PT
PT’s obligation not to restrict the patients freedom to select their provider of pt services
Patients Bill of Rights
-first adopted by American Hospital Association in 1973.
what is the first guideline in the patients bill or rights?
patients right to considerate and respectful care
Cultural competence
Means that patients who are racially, ethically, culturally diverse have the same right as other patients to receive effective, and respectful care.
The development of cultural competence depends more on what then specific knowledge of culture?
attitude
How many national standards for culturally and linguistically appropriate services are there from the DHHS office of minority health?
14
In PT, who supports the standards, promoting the incorporation of cultural and linguistic competence in school curriculum?
CAPTE
What are the steps in becoming culturally competence for PT/PTAs?
-identifying personal cultural basis
-understanding cultural differences
-accepting and respecting cultural differences
-applying cultural understanding
Ethnocentrisim
act of judging another culture based upon ones own cultural customs
3rd principle of the patients bill of rights
-informed consent.
elements of informed consent to be discussed with patient
-nature of procedure
-reasonable alternatives
-risks, benefits
-assessment of patient understanding
-patients acceptance
Presumed or implied consent
-used in emergency situations where the healthcare provider is to act on the patients behalf and use the principle of beneficence
how many principles are there in the guide for professional conduct for PTs?
11
how many standards are there for PTAs developed by APTA?
8
RIPS (realm individual process-situation model of ethical decision making
a four step process on not just what to do , but why when confronting ethical dilemmas
1)investigate the situation
2)reflect
3)make a decision
4)implement, evaluate, and reassess
APTAs definition of professionlism
a systemic and integrated set of core values
8 value based behaviors for the PTA
1)altruism
2)caring and compassion
3)continuing competence
4)duty
5)integrity
6)PT/PTA collaboration
7)responsibility
8)social responsibilty
Altruism
placing patients needs ahead of PTs/PTAs self interest
EX of altruism
-providing pro-bono services
-providing services to underrepresented populations
Ex of continuing competence
-personal self assessment
-creating personal goal
-plan for future career advancement
duty
the commitment to provide effective physical therapy services to patients
Integrity
steadfast adherence to high ethical principles or professional standards
responsibility
active acceptance of the roles
EX of responsibility
-understanding personal strengths and weaknesses
-communicating clearly
Fraud
obtaining something that one is not entitled to through deception or misrepresentation, IT IS INTENTIONAL
Waste
defined as unnecessary costs or treatment
abuse
payment for services that a provider is not entitled to but is done unintentionally
What did the APTA create the Center for Integrity in Practice as part of their integrity?
Grew out of recognition of fraud, waste, and abuse.
