Ethical and Legal Flashcards
Ethics Acronym
● E - Evaluate the Facts
● T - Think about the conflict presented
● H - How many principles apply?
● I - Identify applicable codes and code sections
● C - Compare different options
● S - Select the best option under the circumstances
Ethics: The philosophical inquiry of the _________
dimensions of human conduct.
moral
Ethics is often used synonymously with the term _________ to
describe an action or decision as good or right.
moral
Ethical deliberations may be differentiated from
other endeavors by 3 characteristics:
ultimate or fundamental, The issue is universal, deliberation considers the welfare of all
involved
a process in which everyone
is concerned by that decision.
Deliberation
obliged to give
reasons for the point of view of our patients.
Ethical Deliberation
LEVELS OF ETHICAL JUDGMENT IN THE
HEALTHCARE SETTING
Micro, Meso, Macro
level of ethical judgement: Decisions made in an individual
professional-patient level of healthcare
Micro level
level of ethical judgement: institutional/organizational level or at
community/regional levels
Meso level
level of ethical judgement: sets policy for the health system, as a
standard established for an entire profession,
or through government as law/regulation for
the society as a whole.
Macro level
rules of conduct imposed by society on its
members
Law
rules of conduct or standards by which a
particular group in society regulates its actions
and sets standards for its members
Professional ethics
During ethical dilemmas, the heatlh professional should be able to:
(1) identify, (2) interpret, (3) specify, and (4)
balance
determine and justify what a professional
should consider as the right decision or the
best course of action for each specific ethical
situation.
ethical deliberation
used to justify a particular judgment
Action guides
Action guides can be
Ethical Theory,
Principles, Rules, Particular set of rules
Breaks down the complex problem into
manageable steps. Instead of focusing on the
problem we are focusing on the action (plans,
procedures) that is needed to be done to help
resolve the conflict or dilemma
Action guides
Action Guides
Ethical theory -> Principles -> Rules -> Particular judgement
4 principles of healthcare ethics
Autonomy, Beneficence, Non-maleficence, Justice
Respect a person’s freedom to choose what’s right for them
autonomy
All choices. for a patient are made with intent to do good
beneficence
Do no harm
non maleficence
Treat and provide care fairly to all patients
Justice
aims to improve patient
welfare by allowing our patient to be in full
command in their treatment and care
autonomy
You need to show kindness and mercy to your
patients
Beneficence
Most commonly prioritized principle
Non-maleficence
We need to be fair, in all medical decisions
Justice
To justify judgment as to not tell others about a
patient’s condition. covered by the rule of ______ and guided by the princple of
confidentiality; respect for autonomy
ETHICAL THEORIES
Consequentialist theory, Deontological theory
This theory determines if actions or decisions
are morally right or wrong based on their
consequences.
Consequentialist theory
cardinal principles of consequentialist theory:
beneficence and
nonmaleficence
if telling a lie would help save
a person’s life, this theory would say its
the right thing to do
Consequentialist theory
END JUSTIFIES THE MEANS.
Consequentialist theory
This theory looks more to the intrinsic quality
of an act or decision to assert its moral
rightness or wrongness.
Deontological theory
Based on action
Deontological theory
This theory follow set of rules,
Deontological theory
When an ethical dilemma arises, do the
following:
Understand the facts of the case
Identify, analyze, and present reasons for
judgment
Deliberation must be made based on moral
intuition and application of ethical theories,
rules, principles
Deliberation must be made based on _____________ and application of __________,
rules, principles
moral
intuition; ethical theories
this is a moral rule related to principle of
autonomy
Consent; Confidentiality
this is a rule within the principle of
autonomy. Every individual has the right to control
his or her own affairs without interference from or
knowledge of outside parties
Privacy
this is the principle or duty
to the welfare of the individual
Respect for persons
it is an ethical principle within
deontological theory
Veracity
= this is the principle of having responsibility
to be trustworthy and keep promises
Fidelity
refers to fairness and tendering what is
due
Justice
is an implicit contract between the client and
the health care provider that broadly describes
the relationship involved whenever a
pharmacist provides drug information.
Ethical Covenant
Patients have the:
Right to receive competently-provided
information and respectful treatment
Obligation to provide background
information needed by the pharmacist
Right to request for adequate
background information
Obligation to deliver competent,
trustworthy, and caring service
SUPPORT FOR ETHICAL DECISION- MAKING
Ethics committees
Policies and procedures
Organizational policies
Foundational ethics education
Legal standards are enforced by
government entity
Ethical standards are enforced by
human
principles
A body of rights, obligations, and remedies that is
applied by courts in civil proceedings to provide
relief for persons who have suffered harm from the
wrongful acts of others
TORT LAW
The person who sustains injury or suffers pecuniary
damage as the result of tortious conduct is known as
the
plaintiff.
The person who is responsible for inflicting the injury
and incurs liability for the damage is known as the
defendant or tortfeasor.
negligence refers to
failure to exercise the degree of care that a
reasonable person would exercise under the same
circumstances.
Malpractice liability based on negligence
Elements of negligence:
duty breached
damages were evident
direct causation
defenses absent
once the duty of care is established, the plaintiff
would need a set of quality evidence to prove
that:
○ the information provided was materially
deficient
○ the deficient information was a proximate
cause of injury suffered
○ the recipient reasonably relied on the
information provided
○ the information deficiency was due to failure to
exercise reasonable care
○ the pharmacist knew or should have known
that the safety or health of another may have
depended on the accuracy of the information
provided.
WAYS IN WHICH TORT LIABILITY CAN RELATE TO
THE PROVISION OF DRUG INFORMATION:
● Incomplete information
● Inappropriate quality information
● Outdated information
● Inappropriate analysis/dissemination of information
T/F: Under informed consent, the defendant
could assert that the patient knowingly
assumed the risk for a new or
experimental therapy or regimen
T
the
allocation of responsibility for
damages incurred between the
plaintiff and the defendant,
based on the relative negligence
of the two
Comparative negligence
the wrongful acts or omissions of two or more persons acting independently, but causing the same injury.
Concurrent negligence
the attribution of liability on one person for the actions of another.
Vicarious liability
refers to the proposition that the
employer is responsible for the
negligent acts of its agents or
employees.
Respondeat superior
Methods to protect against lawsuits
○ Contracts covering financial arrangements
○ Adequate documentation
○ Disclaimers
○ Insurance
T/F: Best way to avoid omission negligence is to learn
from experience, anticipate mistakes that may
appear in databases, and keep abreast of changes
in DI sources.
T
Three Key Areas of Liability:
-learned intermediary rule,
-doctrine of over-promotion,
-Promotion of off-label use
assumption
that consumer’s already has prior
knowledge
Learned intermediary
Involves magazine, television, website,
cellphone, and text advertisements,
suggesting the use of various prescription
drugs for medical conditions the viewer might
experience and also suggesting the viewer
ask their physician if the medication would be
appropriate for them.
Direct-To-Consumer Advertising (DTCA)
specifies that prescription drug
advertisements cannot omit material
facts, and must present a fair balance
between effectiveness and risk
information.
Direct-To-Consumer Advertising (DTCA)
specifies that every risk addressed in
the product’s approved labeling must
also be disclosed in the advertisements
Direct-To-Consumer Advertising (DTCA)
requires that the advertisement
contain a summary of “all necessary
information related to adverse effects
and contraindications.”
Direct-To-Consumer Advertising (DTCA)
involves use for indications not
specifically approved by the FDA.
Off-label use
T/F: Once FDA approves a drug for marketing, a
physician’s discretionary use of that product is
not restricted to the uses indicated on
FDA-regulated labeling.
T
Particularly important in the areas of oncology
and acquired immunodeficiency syndrome
(AIDS),
Off-Label Use and Informed Consent
DTCA on the internet is considered ________,
rather than advertising and, as such, the FDA
has principal authority to regulate it.
labeling
use of
telecommunications and interactive video
technology to provide health care services to
patients who are at a distance.
Telemedicine
broader concept that
includes marketing, relationship creation,
advice, prescribing, and selling
pharmaceuticals and devices in cyberspace.
Cybermedicine
pharmacist provide or use
telecommunication in providing pharmacy
services or in providing patient counseling or
medication information.
Telepharmacy
T/F: patient information must never
be disclosed on such sites.
‘t
This principle is considered of intrinsic value
JUSTICE
