Ethical Foundations & Intro to Law Flashcards

1
Q

Morals refer to = ?

B,P,V

Ethical Foundations, Intro to Law

A

Morals:

  • Refer to beliefs, principles, and values about what is right, what is good.
  • These are personal to each and every individual (moral values).
  • These are often but not always grounded inreligion.
  • Morals (like ethics) are culture based, culture driven, andtime dependent.
  • No one is or should feel compelled to abide by another person’s morality.
  • Individuals are clearly obliged to comply with organized ethical and legal mandates.
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2
Q

Compare morals and ethics:

  • Morals = Primarily __ ?
  • Ethics = Determine __ ?

Ethical Foundations, Intro to Law

A

Morals:

  • Primarily intrapersonal
  • What individuals feel is good/bad

Ethics:

  • Determine what behaviors are right/wrong
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3
Q

Ethics refers to = ?

A

Ethics: Refers to how individuals conduct themselves intheir personal and professional endeavors.

  • Branch of philosophy that focuses on justice, right vs wrong, honesty, and free will.
  • Ethical rules of conduct are firmly grounded in moral theory.
  • ‘Ethics’, derived from Greek: “Ethikos” and “Ethos” = character, custom.
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4
Q

Business Ethics vs. Healthcare Ethics

Ethical Foundations, Intro to Law

A

Business ethics

  • Address standards of conduct for business persons and organizations in general.
  • Meet implied social responsibilities: acts of public interest, volunteerism, civic charity, employment practices.

Healthcare ethics:

  • Many are not-for-profit.
  • Treat patients who are injured, suffer pain, therefore are more vulnerable to exploitation than in business ventures.
  • We have a fiduciary responsibility to our patients.

Healthcare ethics are intentionally set higher than business ethics.

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5
Q

Someone who manages money or property for someone else = ?

Ethical Foundations, Intro to Law

A

Fiduciary:

  • Someone who manages money or property for someone else.
  • Usually involves finances and/or managing assets of another person.
  • Eg. A company has a fiduciary duty to its shareholders.
  • A fiduciary may be responsible for the general well-being of another.
  • Eg: A child’s legal guardian

Example: An attorney has a fiduciary relationship w/ the client.

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6
Q

Fiduciary Relationship in Healthcare:

  • Examples of our fiduciary duty to our patient include = ?

Ethical Foundations, Intro to Law

A

In healthcare, a fiduciary =

  • An individual who has either legal or ethical relationship that they owe another party.
  • Is a classic trust relationship, we are essentially acting as a “trustee” to our patients.

Examples of our fiduciary duty to our patient:

  • Confidentiality
  • Performing the correct treatment for our patients.
  • Having fair financial practices
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7
Q

Biomedical Ethical Principles:

  • The 4 pillars of medical ethics = ?

Ethical Foundations, Intro to Law

A

Biomedical Ethical Principles (Also called “The 4 Pillars of Medical Ethics”):

  1. Beneficence
  2. Nonmaleficence
  3. Justice
  4. Autonomy
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8
Q

Health care professionals’ duty and moral obligation to act for the benefit of others = ?

Ethical Foundations, Intro to Law

A

Beneficence:

  • Health care professionals’ duty and moral obligation to act for the benefit of others.
  • Acting in patients best interest.
  • We act in the best interest for our patientsby preventing harm and promoting the greater good.

Examples:

  • Promoting the patient’s overall well being.
  • Choosing the best treatment available and fostering positive outcomes.
  • Following procedural guidelines.
  • Improving situations surrounding the patient.
  • Effective patient education and open dialogue.
  • Collaborative decision making.
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9
Q

The moral obligation of health care professionals to, above all else: “do no harm; do not hurt people” = ?

Ethical Foundations, Intro to Law

A

Nonmaleficence:

  • The moral obligation of health care professionals to, above all else: “do no harm; do not hurt people”.
  • Health care interventions carried out on patients’behalf, however, may cause them suffering orother injury.
  • The ethical principle states that youwill not intentionally or maliciously cause harmor injury to patients under your care.
  • Eg. Performing ROM on a patient after a total knee replacement; the intervention might be painful, but it isn’t with intent to harm (is nonmaleficent).

Maleficence:

  • Also refers to acts of omission— “the failure to act when one should”.
  • Eg. Following hurricane Katrina, patient were abandoned in hospitals due topower outages, lack of supplies, andlooting, leading to lengthy legal investigations.
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10
Q

Equity or fair treatment / acting in a way to maximize fairness toward all patients and potential patients = ?

Ethical Foundations, Intro to Law

A

Justice:

  • Equity or fair treatment / acting in a way to maximize fairness toward all patients and potential patients.
  • Applies to health care professionals individually, to organizations, and more broadly to health care delivery.
  • It’s crucial for healthcare professionals to uphold the principles of justice by advocating for all patients, particularly those without strong advocates.

Justice can include:

  • In the emergency department, patients with more serious illness/injuries can be treated first.
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11
Q

Justice:

Comparative vs. Distributive justice = ?

Ethical Foundations, Intro to Law

A

Comparative justice:

  • How health care isdelivered at the micro or individual level.
  • E.g. Based on age, disability, gender, race, ethnicity,or religion.
  • E.g. Patient denied health care coverage due to pre-existing condition.

Distributive justice:

  • Concerned with how equitable health care services are distributed atthe macro or societal level.
  • E.g. Care of uninsured patients.
  • E.g. How should scare health care resources be distributed?
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12
Q

Autonomy = ?

Ethical Foundations, Intro to Law

A

Autonomy:

  • Self-governance or self-determination.
  • Competent individuals have the right to made decisions regarding their care, and the right to refuse all treatment after options/consequences of refusal have been explained to them.
  • Applies to patients and to providers.
  • Health care professionals have autonomy over their support personnel and their scope of practice.

This is not absolute, for example:

  • A patient who wants a c-section for no medical reason.
  • A patient who has active TB, has to take the medical treatment to protect the community from outbreak.
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13
Q

Refers to when someone fails to recognize another person’s autonomy and rights = ?

Is NOT an ethical principal, but is tied to them

Ethical Foundations, Intro to Law

A

Paternalism:

  • Refers to when someone fails to recognize another person’s autonomy and rights.
  • Occurs when a healthcare provider disregards a patient’s autonomy and substitutes their own beliefs or judgments for those of the patient.
  • Health care worker rationalizes their actions by asserting that they acted in the patient’s best interest.
  • Recognizing and addressing paternalism is crucial in promoting patient-centered care and upholding autonomy.

Examples:

  • Acting without informed consent.
  • Going against a patient’s wishes.
  • In long term care settings, can include involving the family in decision-making instead of the patient.
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14
Q

More Ethical Principles and Terminology:

  • Veracity = ?

Ethical Foundations, Intro to Law

A

Veracity:

  • The duty to tell the truth.
  • Principle of truthfulness,honesty.
  • Important in all of our patient communications.
  • Is tied in with Informed Consent.
  • Providing patients with full information, with tact and sensitivity.
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15
Q

More Ethical Principles and Terminology:

  • Duty = ?

Ethical Foundations, Intro to Law

A

Duty:

  • The obligations that we hold toward others within society

With our patients duty can include:

  • Standard of care
  • Maintaining confidentiality
  • Patient safety and security
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16
Q

More Ethical Principles and Terminology:

  • Rights = ?

Ethical Foundations, Intro to Law

A

Rights:

No definition in the powerpoint

17
Q

More Ethical Principles and Terminology:

  • Confidentiality = ?

Ethical Foundations, Intro to Law

A

Confidentiality: We have a duty to maintain confidentiality.

  • The duty to maintain the privacy of information concerning patients by not disclosing it to unauthorized persons.
  • Divulging medical information on a “need-to-know” basis.
  • Includes health related information, financial information, and other potentially sensitive information.

Taken from the Hippocratic Oath:

  • “That whatever you shall see or hear of the life of men or women, whether in a professional capacity or otherwise, which shall not be passed on to others, I will hold as professional secrets and not divulge them”

Exceptions:

  • Breaching confidentiality to protect citizens (grounded in justice and beneficence).
  • E.g. Reporting child abuse, elder abuse…
18
Q

More Ethical Principles and Terminology:

  • Fidelity = ?

Ethical Foundations, Intro to Law

A

Fidelity:

  • Our moral duty to uphold promises and fulfill commitments made to patients.
  • Can be explicit promises/commitments or implicit promises;
  • E.g. “I’ll reach out to your doctor for clarification before tomorrow’s appt”
  • E.g. regulations like HIPAA and confidentiality
19
Q

Situational ethics =?

Ethical Foundations, Intro to Law

A

Situational Ethics:

  • Selective noncompliance with ethics rules and standards for special circumstances.
  • May occur out of sense of caring for a colleague or patient.
  • Occasional breach of professional ethics may be acceptable.
20
Q

Legal and Ethical Four-Quadrant Clinical Practice Grid = ?

Ethical Foundations, Intro to Law

A

Legal and Ethical Four-Quadrant Clinical Practice Grid:

  • Illustrates acceptable and unacceptable health care practices, based on one’s compliance with or violations of legal and ethical practice rules and standards.
21
Q

Legal and Ethical Four-Quadrant Clinical Practice Grid:

  • Quadrant #1 = ?

purple

Ethical Foundations & Intro to Law

A

Quadrant #1:

  • (+) Legal / (+) Ethical
  • Abiding by the laws and ethical guidelines; is our goal and standard.
22
Q

Legal and Ethical Four-Quadrant Clinical Practice Grid:

  • Quadrant #2 = ?

purple

Ethical Foundations, Intro to Law

A

Quadrant #2:

  • (-) Legal / (+) Ethical
  • Violating the law but upholding ethical standards.
23
Q

Legal and Ethical Four-Quadrant Clinical Practice Grid:

  • Quadrant #3 = ?

purple

Ethical Foundations, Intro to Law

A

Quadrant #3:

  • (+) Legal / (-) Ethical
  • Not violating the law, but violating standards of practice.
24
Q

Legal and Ethical Four-Quadrant Clinical Practice Grid:

  • Quadrant #4 = ?

purple

Ethical Foundations, Intro to Law

A

Quadrant #4:

    • Legal / - Ethical
  • Breaking the law and not following standards of practice.
25
Q

American legal system has two basic subsystems:

  1. = ?
  2. = ?

Ethical Foundations, Intro to Law: Legal Foundations

A

American Legal System Subsystems:

(1) Criminal Law:

  • Pursued by the State due to violation of a statute.
  • Regarding healthcare, typically limited to intentionalmisconduct with injury or death.
  • E.g. Practicing without a proper license.

(2) Civil Law:

  • Individual/ private citizens pursue case.
  • Wrongdoing, negligence, malpractice
  • E.g. A patient suing a physical therapist because of injury.

Each state has its own criminal and civil trial and appellate courts, as does the federalgovernment.

26
Q

Differences Between Criminal and Civil Law = ?

Give two bullet points for each

Ethical Foundations, Intro to Law: Legal Foundations

A

Differences Between Criminal and Civil Law:

Criminal Law:

  • Public legal action taken by society for violations of law against a defendant.
  • Cases initiated by a prosecutor: People v. defendant; State v. defendant, US v. defendant
  • Standard of proof = “beyond a reasonable doubt”
  • Judgment = “Guilty” or ”not guilty”
  • Remedies more severe sentences, incarceration, permanent public record, death.

Civil Law:

  • Private legal actions brought by a private plaintiff against a private defendant.
  • Cases initiated by the plaintiff: healthcare malpractice, personal injury, domestic relations.
  • Burden of proof = “clear and convincing evidence”.
  • Judgment = “Liable” or “not liable”
  • Remedies are designed to make an injured plaintiff “whole” by awards of monetary damages; or to punish by awarding punitive damages.
27
Q

Primary Sources of Law = ?

there are 4 in the powerpoint

Ethical Foundations, Intro to Law: Legal Foundations

A

Primary Sources of Law:

  1. Constitutional Law: Law derived from the federal constitution.
  2. Statutory Law: Statutes established within the scope of authority by Congress and individual state legislatures.
  3. Common Law: Court decisions in the absence of statutory law that often creates legal precedent.
  4. Administrative Law: Administrative agencies at the federal and state levels develop rules and regulations.
28
Q

Examples of secondary sources of legal authority = ?

Ethical Foundations, Intro to Law: Legal Foundations

A

Secondary Sources of Legal Authority:

  • Viewed as “authority” on procedures, protocols and guidelines.
  • Includes professional associations and accreditation agencies.

Examples:

  • The Joint Commission
  • Commission on the Accreditation of Rehabilitation Facilities (CARF)
  • National Committee for Quality Assurance
  • APTA Standards of Practice
29
Q

A private or civil wrong/injury; may involve commission and/or omission = ?

Ethical Foundations, Intro to Law: Legal Foundations

A

Tort:

  • A private or civil wrong/injury; may involve commission and/or omission.
  • Tort”: in French = “wrong
  • Tort Law - Fair and reasonable compensation for those injured atthe hands of others.
  • Tort system strives to make victims “whole” again (or as as close as possible) through the award of monetary damages.
30
Q

3 types of monetary damages in Tort cases = ?

Ethical Foundations, Intro to Law: Legal Foundations

A

Monetary Damages in Tort Cases:

(1) Special Damages:

  • Replace past, present and future out of pocket monetary losses.
  • E.g. lost wages, medical bills and lost future earnings capacity

(2) General Damages:

  • Monetary awards for pain and suffering and the loss ofenjoyment of life.

(3) Punitive (punishment) Damages:

  • Punishment of a monetary fine to the defendant (health careprovider).
  • Punitive damages infrequently awarded by courts.
31
Q

The following are examples of = ?

  • American Physical Therapy Association (APTA)
  • Federation of State Boards of Physical Therapy (FSBPT)
  • State Licensing Boards: (Kansas State Board of Healing Arts)
  • Commision on Accreditation of Rehabilitation Facilities (CARF)
  • The Joint Commission

Ethical Foundations, Intro to Law: Legal Foundations

A

Physical Therapy Regulatory Groups:

American Physical TherapyAssociation (APTA):

  • Professional organization that represents PT’s, PTA’s and SPT.
  • Responsible for creating and promoting standards of conduct and ethical standards.
  • Each state has its own chapter (KPTA).

Federation of State Boards of Physical Therapy (FSBPT):

  • Goal is to protect the public by ensuring PT’s and PTAs provide safe and competent services
  • Create the National PT exam (NPTE) for licensure

State Licensing Boards - (Kansas State Board of Healing Arts):

  • Responsible for providing PT and PTA licenses.
  • Eligibility can vary widely from state to state.
  • Create and maintain the rules surrounding license renewel in their state.

Commision on Accreditation of Rehabilitation Facilities (CARF)

  • Nonprofit organization that provides accreditation for institutions that provide health and human services.
  • Eg. Medical rehab facilities, opioid treatment facilities, aging services…

The Joint Commission:

  • Nonprofit organization that provides accreditation to a variety of health care organizations, including hospitals, doctor offices, nursing homes, behavioral health facilities.