Ethics and Healthcare

Question 1

Values

Answer 1

concepts

goals

ideals

behaviors

Question 2

value effectors

Answer 2

produced and instilled in people by

firends

family

culture

environment

education

life experiences

Question 3

value changes

Answer 3

lifelong process

may change as you age

Question 4

Basic ethical concepts

Answer 4

“Do no harm”

respect patients rights to make decision

aware and sensitive to ethical dilemmas

Question 5

Ethical dilemmas creation

Answer 5

religious

social

cultural influences

Question 6

Abortion/Selective Termination

Answer 6

may have moral objection

respect decision of patient and physician

sonographers beliefs shoul dbe respected as well

Question 7

sonographer duties/obligations

abortion and selective termination

Answer 7

do not try to dissuade, encourage or punish the patient

communicate with supervisor

once accepting responsibility to patient never refuse to carry out procedure

Question 8

video taping obstetric exam

Answer 8

pros and cons

policy established for providing patients with hard copy images

nothing on patient images that was not seen in study

Question 9

Nondiagnostic uses of ultrasound

Answer 9

mid 1990’s many imaging depts abandoned the practive of giving pictures to patients

patients demanded a return to this practice

enterprising physicians and sonographers created a niche for nondiagnostic fetal imaging

patients returned to trendy ultrasound portrait studios

“Womb with a view”

“Body and Sole”

Question 10

Belly and Sole

Answer 10

fetal packages in 2D, 3D, 4D tapes and CD’s complete with music

machines produced higher TI and MI

operators with limited training

SDMS, AIUM issued warnings against this practice

awaiting FDA guidelines or regulations

ethical dilemma, support closure of all or no opposition to these practices

Question 11

Patient Confidentiality

Answer 11

right to privacy

HIPPA

Sonographer, Physician and patient

take history in private

must report a disclosure that would prevent harm to others

Question 12

Competency

Answer 12

ethical obligatoin to perform competent complete exam and provide accurate and reliable information

obtained through continuing education and thorough training to ensure level is matintained

registry by AART, ARDMS

Question 13

Professional disclosure

Answer 13

duty to bring attention to radiologist if an error in the interpretation of study, technique or faulty equipment

suspent of drug/alcohol impairment of coworker

Question 14

Professionalism

Answer 14

being involved in and worthy of high standards of prefession

integrity, honesty and compassion

aware of patients behaviors, interactions and standards of conduct as well as developing technical knowledge and skill

Question 15

patient interactions

Answer 15

unique opportunity due to amout of time spent with patient

patients bring some degree of anxiety to exam

off reassurance and explanation of procedure and reporting process

maintain patients modesty during exam

SDMS code of ethics

Question 16

Things to DO

Answer 16

thoroughly explain procedure and what is expected of patient

work with extreme care

questino abnormal instructions

maintain records and documents for later referal

use common sense and judgment and always practice with limits of abilites and teachings

Question 17

DO NOT do

Answer 17

perform procedures you were not taught

fail to meet established standards for safe patient care

fail to prevent injury to coworkers, other employees or visitors

Question 18

Midico-Legal aspects of

Sonography

Answer 18

2 forms

Battery

Negligence

Question 19

Battery

Answer 19

patient is injured during exam by assault or inadequate care

failure to stop exam if patient changes their mind

failure to obtain patients informed consent

Question 20

Negligence

Answer 20

exam performed below the standard of care

Question 21

Standard of Care

Answer 21

way in which a reasonable and prudent physician or sonographer would act in same circumstances

Question 22

Stan dard of Care

establishment

Answer 22

`expert witnesses testify as to guidelines such as the AIUM pracice gidelinesfor the performance of antepartum obstetric exams of the ACR national standards

Local hospital, radiology or obstetric policy statements aslo set standard of care

Question 23

Physician or Sonographer responsibilites

Answer 23

physician reporting study is responsible for the accuracy and quality of report even is they have never actually seen the patient

Accurately describe the findings including pertinent negative finsing with a clinical conclusion about presence or absence of abnormality

suggestions about additional procedures

problems in performance of study (obesity or suboptimal patient position)

Question 24

Sonographer responsibilities in reporting

Answer 24

not condisered legally hazardous as long as sonographer does not make diagnoses

if working with radiologist not responible for errors in study, providing tge study is performed according to standards set by radiologist

no liable if technique creates images that look like a pathology but is not

Question 25

Examples of misleading findings

Answer 25

pseudohydronephrosis=result of full bladder

sludge filled GB=result of overgained image

not following up on pathologic finding,

missint pancreatic mass by not trying different scanning techniques such as erect scanning or patient drinking water

missing gall or kidney stones due to failure to use high Freq transducer

although not legally responsible, moral/ethical issue

Question 26

Malpractice insurance

Answer 26

any sonographer performing freelance work

hospital empoloyed generally do not need to purchase as they are covered by employer

Question 27

Legal Jeopardy

Answer 27

best protectoin is to practice sonography in safe, ethical and competent manner