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Ethics > Ethics > Flashcards

Ethics Flashcards

1
Q

General ethical guidelines for the healthcare professional (HCP) are grounded in core ethical values and standards. List the directives that follow the core values?

A
  • Respect for persons
  • Best interest or well being; Non Maleficence and Beneficence
  • Human Rights
  • Autonomy
  • Integrity
  • Truthfulness
  • Confidentiality
  • Compassion
  • Tolerance
  • Justice
  • Professional Competence
  • Community
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2
Q

Define Respect for Persons

A

HCP should respect patients as persons and acknowledge their intrinsic worth, dignity and sense of value.

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3
Q

Define Non-Maleficence

A

HCP should act in patients best interest i.e. not harm or act against the best interests of patients, even when the interests of the latter conflict with their own self interests.

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4
Q

Define Beneficence

A

HCP should act in the best interests of patients even when the interests of the latter conflict with their own self interest.

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5
Q

Define Human Rights

A

HCP should recognize the human rights of all patients

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6
Q

Define Autonomy

A

HCP should honour the rights of patients to self determination, or to make their own informed choices, and to live their lives according to their own beliefs, values and preferences

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7
Q

Define Integrity

A

HCP should incorporate these core ethical values and standards as the foundation of their character and practice as responsible HCP’s.

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8
Q

Define Truthfulness

A

HCP should regard the truth and truthfulness as the basis of trust in their professional relationship with patients

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9
Q

Define Confidentiality

A

HCP should treat personal or private information as confidential in professional relationships with patients - unless overriding reasons provide a moral or legal right to disclose

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10
Q

Define Compasion

A

HCP should be sensitive to, and empathize with the individual and social needs of their patients and seek to create mechanisms for providing comfort and support where appropriate and possible.

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11
Q

Define Tolerance

A

HCP should respect the rights of people to have different ethical belief, as these may arise from deeply held personal, religious or cultural convictions.

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12
Q

Define Justice

A

HCP should treat all individuals and groups in an impartial, fair and just manner.

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13
Q

Define professional competence and self-improvement

A

HCP should continually endeavor to attain the highest level of knowledge and skills required within their area of practice.

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14
Q

Define Community

A

HCP should strive to contribute to the betterment of society in accordance with their professional abilities and standing in the community.

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15
Q

Core values and standards ground ethical guidelines. Ethical reasoning is used to handle difficult situations around how to use these guidelines. Briefly outline the steps of the process:

A

Step 1. Formulate the problem.
Step 2. Gathering information:
Step 3. Considering options:
Step 4: Making a moral assessment.
Step 5: Discuss your proposed solution with those whom it will effect
Step 6. Act on your decision with sensitivity to those affected
Step 7. Evaluate your decision and be prepared to act differently in the future.

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16
Q

Define step 1 of the ethical decision making model; Formulating the problem

A

Determine whether the issues at hand is an ethical one, once this has been done, it must be decided whether there is better way of understanding it.

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17
Q

Define step 2. Gathering information:

A

All the relevant information must be collected - such as clinical , personal and social data. Consult authoritative sources such as these guidelines, practitioner associations, respected colleagues and see how practitioners generally deal with such matters.

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18
Q

Define Step 3. Considering options

A

Consider alternative solutions in light of the principles and values they uphold.

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19
Q

Define step 4. Making a moral assessment

A

THe ethical content of each option should be weighed by asking the following questions.

  1. What are the likely consequences of each option?
  2. What are the most important values, duties, and rights. Which weigh the heaviest?
  3. What are the weaknesses of the HCP’s individual view concerning the correct option?
  4. HOw would the HCP want to be treated under similar circumstances?
  5. How does the HPS think that the patient would want to be treated in a particular circumstance?
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20
Q

Ethical guidelines express duties, they may be ethical, legal or both; What does it mean to have a duty?

A

A duty is obligation to do or refrain form doing something. A duty to another implies being bound to the person in some respect/for some reason. We owe the person something , while he or she holds a corresponding right or claim against us. To have a duty is to ask, What do I owe others? To have a right is to ask What do other owe me?

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21
Q

HCP’s fulfill different roles, accordingly they have different kind of duties. Outline your Natural Duties?

A

As Human beings we have natural duties. i.e. unacquired general duties like refraining from doing harm, promoting good, being fair and just. These duties are owed to all other people, regardless of their status as patients or not and independently of the professional qualifications.

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22
Q

As professionals we have moral obligations, explain?

A

These are general duties we acquire by being qualified and licensed as professionals, that is professionals entering into contractual relationships with patients - for example the professional duties to provide medical care, relieve pain, gain informed consent, respect confidentiality, and be truthful.

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23
Q

Explain what is meant by institutional duties?

A

Instituitional duties are imposed upon HCP working in specific institutions. They are specific to the HCP particular institutional role, e.g. the duties of a practitioner employed by a company, government research agency or private practice. These duties are contained in employment contracts, job descriptions, conventional expectations etc. Institutional duties must be consistent with the ethical and legal duties of HCP.

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24
Q

Explain Legal Duties.

A

Legal duties are duties imposed by statute (for example, the national health act (act no 61 of 2003) that require HCP to follow certain procedures and to use particular skill and care when dealing with patients.

25
Q

Describe the ethical hierarchy?

A
  1. Core ethical values. e.g sovereignty of individual.
  2. Ethical Principles e.g profesional codes like autonomy
  3. Ethical Duties i.e. be accessible to patients.
26
Q

Are duties absolute?

A

No, no dury is absolute or holds without exception irrespective of time, place or circumstance. This is not surprising, since different duties may prescribe quite opposite decisions and actions in a specific concrete or real life situation. There may be instance or conflicts of interest or dual loyalties

27
Q

Outline some of the duties that bind any HCP as a professional to her patients and others ?

A

-Duties to patients
- Duties to colleagues and other health professionals
- Duties to patients of other HCP
-Duties to themselves
-Duties to Society
Duties to Health Care Profession
-Duties to the Environment

28
Q

Explain the 12 Duties to patients listed under: Patients best interest or well-being in more detail?

A

HCP should:
1.Always regard concern for the well-being of their client as their primary professional duty
2.Honor the trust of patients
3.Mindful of their position of power and avoid abuse of position
4. Within normal constraints of practice, be accessible to patients when on duty and make arrangements for access when not on duty
5.Do not let personal beliefs prejudice patients health care, i.e. race, culture, ethnicity, social status, lifestyle, age, gender, disability, sexual orientation, communicable disease status, religious or spiritual beliefs, or any condition of vulnerability.
6. If they feel their beliefs might affect treatment, they must explain this to the patient and inform them of their right to see another HCP
7.Not refuse or delay treatment because they believe that patients actions have contributed to their condition, ot because they-the HCP-may be putting their own health at risk.
8.Apply their mind when making diagnosis and considering appropriate treatment.
9.Act quickly to protect patients from risk if they believe they or their colleagues are impaired.
10.Respond to criticism and complaints promptly and constructively
11.Not employ any intern, HCP in community service, or HCP with restricted registration with HPCSA as a locum tenens - or otherwise.
Inform patients if they are in the employ of, in association with, linked to, or have an interest in any organization that could be interpreted as potentially creating a conflict of interest or dual loyalty in respect of their patient care.
12.In emergency situations, provide health care within the limits of their practice, experience and competency. If unable to do so, refer.

29
Q

Explain the 5 duties to patients listed under: Respect for patients?

A
  1. Respect the privacy and dignity of patients
  2. Treat patients politely and with consideration.
  3. Listen to patients and respect their opinions.
  4. Avoid improper relationships with patients, patients friends, or patients family members (e.g. Sexual or exploitive financial relationships)
30
Q

Explain the 5 duties listed under Informed consent.

A
  1. Give the patient the information the ask for or need about their condition, its treatment and prognosis.
  2. Give information on a way patients can best understand it, in a language they understand, and in a manner that takes into consideration their level of literacy, understanding, values and beliefs.
  3. Refrain from withholding any information, investigation, treatment or procedure the HCP knows would be in the patients best interest.
  4. Apply the principle fo informed consent as an on-going process
  5. Allow patients access to their medical records.
31
Q

Explain the 3 duties of patient confidentiality?

A
  1. Recognize the right of patients to expect that HCP will not disclose any personal or confidential information they acquire in the course of their professional duties, unless they agree to such disclosure, or unless HCP have good and overriding reason for doing so.(e.g if disclosure is not made their is a likelihood of serious harm to an identifiable third party, or there is a public health emergency, or an overriding and ethically justified requirement.
  2. Not breach confidentiality without sound reason or without knowledge of their patients.
  3. When claiming from medical schemes explain to patients the significance of ICD-10 coding and get permission of patients to breach confidentiality when making a medical scheme claim
32
Q

Explain the three duties of patient participation in their own health care.

A
  1. Respect the right of patients to be fully involved in decisions about their treatment and care even if they are not legally competent to give the necessary consent.
  2. Respect the right of patients to refuse treatment or take part in teaching or research
  3. Inform the patient that they have a right to seek a second opinion without prejudicing their future treatment.
33
Q

Explain the duties under impartiality and justice

A

HCP should be aware of the rights and laws concerning und=fair discrimination in the management of their patients on the basis of race, culture, ethnicity, social status, lifestyle, perceived economic worth, age , gender, disability, communicable decease status, sexual orientation, religious or spiritual beliefs, or any condition of vulnerability such as contained in health rights legislation

34
Q

Explain duties under access to care?

A

HCP should promote access to health care. If they are unable to provide a service, they should refer the patient to a practitioner or facility where the required service can be obtained., provided that in a emergency situation practitioners shall be obliged to provide care to stabilize a patient and then arrange for an appropriate referral.

35
Q

Explain the four duties under potential conflict of interest.

A
  1. Always give priority to the treatment of patient solely on the basis of clinical need.
  2. Avoid over servicing:They should recommend and refer patients for necessary investigations and treatment only, and should prescribe only treatment, drugs or appliances that serve the needs of the patients
  3. Decare to their patients-verbally and by displayed notice- any financial interest they may have in other institutions to which they make referral, if the holding of such interest is permitted by the HPCSA.
  4. Refrain from coercing patients or their families to provide them with gifts or any other undue benefit.
36
Q

Scope of Practice (SOP). Define Counseling

A

Counseling is a reflective, disciplined, relationship between Counsellor and clients. demanding, equal, receptive, supportive, helpful, genuine, based on trust relationship with a view to uphold the rationale and purpose of the registered counsellor context.

37
Q

Scope of Practice: Define Crisis.

A

a state of psychological turmoil in which the person concerned feels unable to cope.

38
Q

Scope of Practice: Define Crisis intervention.

A

Counseling that focuses on acute or stressful situations (e.g.victims or witnesses of crime or violence, accident victims, emergency emotional containment)

39
Q

Scope of Practice: Define community context: -

A

Police, military, schools, early child development centres, FET colleges, prisons, employee assistance programs, primary health care centres, hospitals, faith based organizations.

40
Q

Scope of Practice: Define currative

A

Counseling that helps to alleviate distress

41
Q

Scope of Practice: Define Prevention

A

a planned proactive activity designed to prevent or reduce future harm.

42
Q

SOP: What does primary prevention include?

A
  • Basic mental health
  • Identifying and addressing the basic causes of problems, or containment so that it doesn not get worse
  • Activities designed to reduce stressors and help develop peoples coping abilities
43
Q

SOP. Define psychological counselling intervention?

A

Screen, assess, psychological education and training and referral

44
Q

SOP: Defining screening?

A
  • the investigation of a possible disruption to a client’s psychological wellbeing and early identification of mental health challengers.
45
Q

SOP: Define supportive

A

-counseling that assists by alleviating traumatic responses and/or assists clients to adjust to altered circumstances.

46
Q

SOP: Define Systems level

A

-the dynamic , interaction between individuals, couples, families, groups, communities and society.

47
Q

SOP: Define the role of a registered counsellor?

A

Make psychological services accessible to population
Provide psychological and preventive interventions that focus on support and promote the enhancement of wellbeing in community contexts (includes individuals, families, groups, communities and excludes psychotherapeutic intervention.

48
Q

SOP: How does the role of RC differ from other categories of psychology.

A

It differs in that the primary function of RC is to prevent, promote, intervene, and appropriately refer. Their primary role at a preventative and promotional level involves screening and engaging early and appropriate levels of intervention.

49
Q

R/C differ from other psychological categories in that their primary function is to prevent, promote and intervene, Explain what is meant by prevent, promote and intervene

A
  • Screening and identification of mental health challenges
  • Containment of presenting difficulties.
  • Provide preventative, developmental counseling services and interventions.
  • Psychoeducation and training
  • Promotion of primary psychosocial well being
  • Referral to appropriate professionals or other appropriate resources (know when to refer to a psychiatrist or psychologist)
  • Working in a appropriate , multi professional team.
  • Assessments (intellectual assessment, BASIC functioning, kinetic-figure drawing)
50
Q

Describe the scope of practice of a RC

A

RC are psychological practitioners who perform various functions aimed at enhancing personal functioning, incl:

  • Psychological screening
  • Basic assessment
  • Technically limited psychological interventions with individuals and groups
51
Q

More specifically outline the scope of practise of RC

A
  • Manage complete sub elements of interventions programmes with associated interventions.
  • Design sub elements of intervention programmes and processes.
  • Execute less advanced , more structured interventions
52
Q

Which acts fall within the scope of practice of RC

A
  • Being the first line of community based psychological support
  • provide preventative and developmental counseling services
  • performing supportive psychological interventions to enhance emotional functioning and mental well-being.
53
Q

List the General duties a HCP has towards patients

A 
1 - Patients best interest or well being
2 - Respect for Patients
3 - Informed Consent
4 - Patient Confidentiality
5 - Patient Participation in their own health care
6 - Impartiality and justice
54
Q

List your duties to colleagues and other health care practitioners

A

Referrals to colleagues and potential conflicts of interest

Working with colleagues

55
Q

List your duties yourself

A

Knowledge and skills

56
Q

Detail your duties under knowledge and skills

A

HCP maintain and improve the standard of their performance by keeping there professional knowledge and skills up to date throughout their working life. THey should regularly take part in educational activities that enhance their provision of health services.
Acknowledge the limits of their professional knowledge and competence. THey should not pretend to know everything.
Observe and keep up to date with laws that regulate HCP

57
Q

Define the general role of a registered counsellor

A

Psychological and preventative interventions that focus on support and promote the enhancement of wellbeing in a community context. (Individual, family, group, communities. Excludes psychotherapeutic inteventions

58
Q

Explain RC relationship to mental illness

A

The RC training precludes the diagnosis of ‘‘mental illness’’, (Psychotherapeutic intervention) like the equivalent biokineticist who in the course of her efforts to promote and support physical health screen can identify a possible ‘‘disease’’ but not diagnose or treat the disease. Likewise the RC in the course of promoting and supporting mental health can identify a possible ‘‘mental illness’’ but cannot then make a diagnosis. Of course this has a number of implications. LIke the bio the RC is not subject to many of the ethical codes that a ‘‘doctor’’ is subject to. Because the RC cannot diagnose illness but only promote health S/he for instance is not in the same position of power over a ‘‘patient’’ because they do not assume the skills and knowledge to make a diagnosis of any ‘‘disease’’ likewise in the absence of mental illness (any illness that might present is referred) there can be no ‘‘prognosis’’ or ‘‘treatment’’ or ‘’ disease intervention’’. In fact they are prohibited from ‘‘psychotherapeutic intervention of any nature. Again the R/C is relieved of the obligation to give ‘‘patients’’ information about their ‘‘condition’’ or ‘‘treatment’’ because the R/C is not qualified to make any diagnosis. THey likewise do not and cannot offer ‘‘medical care’’ because they cannot offer a ‘‘intervention’’

Ethics (2 decks)

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