Ethical Foundations & Intro to Law Flashcards
Morals refer to = ?
B,P,V
Ethical Foundations, Intro to Law
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.
Compare morals and ethics:
- Morals = Primarily __ ?
- Ethics = Determine __ ?
Ethical Foundations, Intro to Law
Morals:
- Primarily intrapersonal
- What individuals feel is good/bad
Ethics:
- Determine what behaviors are right/wrong
Ethics refers to = ?
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.
Business Ethics vs. Healthcare Ethics
Ethical Foundations, Intro to Law
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.
Someone who manages money or property for someone else = ?
Ethical Foundations, Intro to Law
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.
Fiduciary Relationship in Healthcare:
- Examples of our fiduciary duty to our patient include = ?
Ethical Foundations, Intro to Law
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
Biomedical Ethical Principles:
- The 4 pillars of medical ethics = ?
Ethical Foundations, Intro to Law
Biomedical Ethical Principles (Also called “The 4 Pillars of Medical Ethics”):
- Beneficence
- Nonmaleficence
- Justice
- Autonomy
Health care professionals’ duty and moral obligation to act for the benefit of others = ?
Ethical Foundations, Intro to Law
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.
The moral obligation of health care professionals to, above all else: “do no harm; do not hurt people” = ?
Ethical Foundations, Intro to Law
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.
Equity or fair treatment / acting in a way to maximize fairness toward all patients and potential patients = ?
Ethical Foundations, Intro to Law
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.
Justice:
Comparative vs. Distributive justice = ?
Ethical Foundations, Intro to Law
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?
Autonomy = ?
Ethical Foundations, Intro to Law
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.
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
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.
More Ethical Principles and Terminology:
- Veracity = ?
Ethical Foundations, Intro to Law
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.
More Ethical Principles and Terminology:
- Duty = ?
Ethical Foundations, Intro to Law
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
More Ethical Principles and Terminology:
- Rights = ?
Ethical Foundations, Intro to Law
Rights:
No definition in the powerpoint
More Ethical Principles and Terminology:
- Confidentiality = ?
Ethical Foundations, Intro to Law
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…
More Ethical Principles and Terminology:
- Fidelity = ?
Ethical Foundations, Intro to Law
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
Situational ethics =?
Ethical Foundations, Intro to Law
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.
Legal and Ethical Four-Quadrant Clinical Practice Grid = ?
Ethical Foundations, Intro to Law
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.
Legal and Ethical Four-Quadrant Clinical Practice Grid:
- Quadrant #1 = ?
purple
Ethical Foundations & Intro to Law
Quadrant #1:
- (+) Legal / (+) Ethical
- Abiding by the laws and ethical guidelines; is our goal and standard.
Legal and Ethical Four-Quadrant Clinical Practice Grid:
- Quadrant #2 = ?
purple
Ethical Foundations, Intro to Law
Quadrant #2:
- (-) Legal / (+) Ethical
- Violating the law but upholding ethical standards.
Legal and Ethical Four-Quadrant Clinical Practice Grid:
- Quadrant #3 = ?
purple
Ethical Foundations, Intro to Law
Quadrant #3:
- (+) Legal / (-) Ethical
- Not violating the law, but violating standards of practice.
Legal and Ethical Four-Quadrant Clinical Practice Grid:
- Quadrant #4 = ?
purple
Ethical Foundations, Intro to Law
Quadrant #4:
- Legal / - Ethical
- Breaking the law and not following standards of practice.
American legal system has two basic subsystems:
- = ?
- = ?
Ethical Foundations, Intro to Law: Legal Foundations
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.
Differences Between Criminal and Civil Law = ?
Give two bullet points for each
Ethical Foundations, Intro to Law: Legal Foundations
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.
Primary Sources of Law = ?
there are 4 in the powerpoint
Ethical Foundations, Intro to Law: Legal Foundations
Primary Sources of Law:
- Constitutional Law: Law derived from the federal constitution.
- Statutory Law: Statutes established within the scope of authority by Congress and individual state legislatures.
- Common Law: Court decisions in the absence of statutory law that often creates legal precedent.
- Administrative Law: Administrative agencies at the federal and state levels develop rules and regulations.
Examples of secondary sources of legal authority = ?
Ethical Foundations, Intro to Law: Legal Foundations
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
A private or civil wrong/injury; may involve commission and/or omission = ?
Ethical Foundations, Intro to Law: Legal Foundations
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.
3 types of monetary damages in Tort cases = ?
Ethical Foundations, Intro to Law: Legal Foundations
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.
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
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.
