HCM 415- Section 3 Flashcards
Define Beneficence
acting with charity and kindness
Define Respect for Persons
implied duties and relationships, including a person’s autonomy
Define Nonmaleficence
refraining from actions that aggravate a problem or cause other negative results.
Define Justice
fairness; equals are treated equally and unequals unequally
Define Virtue Ethics
an internal disposition habitually to seek moral perfection, to live one’s life in accord with moral law, and to attain a balance between noble intention and just action
In the presence of infectious diseases, the organizations have a responsibility to protect staff and patients; this premise is supported by which principle?
Non-maleficence (to cause no additional harm)
Define Reasonable person standard
the “reasonable person” is a composite of a relevant community’s judgment as to how a typical member if said community should behave in situations that might pose a threat of harm (through action or interaction) to the public. The standard also holds that each person owes a duty to behave as a reasonable person would under the…?
Define Veracity
Truth telling. Legal principle that states that a health professional should be honest and give full disclosure to the patient, abstain from misrepresentation or deceit, and report known lapses of the standards of care to the proper agencies (Think Verified!)
Define Distributive justice
that virtue, whose object is to distribute rewards and punishments to every one according to his merits or demerits
Define Utilitarianism
the theory based off of the idea that action should be directed toward doing the “greatest good for the greatest number of people”; “the end justifies the means”; the results of an action are determined by comparing the good brought about by a particular action compared to the good brought about by alternatives, or the amount of evil avoided.
Discuss what John Stuart Mill wrote about utilitarianism.
sought to distinguish pleasures (the good) on qualitative grounds; freedom is requisite to producing happiness.
Balancing Utilitarian and Kantian Ethics.
Utilitarianism is based on the idea that people’s ethical decisions should be based on whatever provides the greatest useful goodness for the greatest number of people. Utilitarianism ethical theory believed that the moral benefit of an action is determined by the outcome of the action no matter what the motive behind the action was. Kantian ethics state that people have an unconditional moral duty to do what is right, not because it will profit us, not because if we don’t do it and get caught we will be punished but because it is the right thing to do. Kant went on to say that the only true moral act is done from a pure sense of duty.
Define Paternalism
the concept that one person knows what is best for another
Discuss why autonomy and paternalism conflict with each other.
The two terms are conflicting because physicians act in what they believe to be the patient’s best interest, however autonomy does not eliminate paternalism, but paternalism should be limited to certain situations
Utilitarian Logic
benefits of procedures balanced against the harm
Kantian Ethics
all people have value and deserve benefits of health care
What two principles are conflicting with the consent to treat?
Paternalism and autonomy
What are the 4 elements of Respect for Persons?
Autonomy
Truth Telling
Confidentiality
Fidelity
Define Autonomy
allows others to govern themselves (viewed as a freedom right)
Define Truth Telling
honesty in all activities
Define Confidentiality
protecting information that is confidential, both employee and patient
Define Fidelity
promise keeping, doing one’s duty
An advance directive is a good example of which ethical principle/ theory?
Autonomy
Discuss why the concept Justice is important in resource allocation
Because the concept is expressed in health services delivery by expanding greater resources on individuals who are sicker and thus in need of more services
Discuss Confidentiality
Act of respecting privileged information
Ethical dilemmas and exceptions of confidentiality
an abused child, certain diseases, gunshot wounds
When is “Consent” actually “Consent”?
consent is actually consent when a physician discloses the known and existing dangers associated with a course of treatment to a patient, and the patient has approved the treatment without coercion
What elements must be present for consent to take place?
consent must be voluntary, competent, and informed
If there is no consent and treatment takes place anyway, what are the liabilities of the physician and the hospital?
physicians and hospitals are liable if no consent is given; the exceptions are emergency rooms where it is presumed that patients want treatment, or when the state allows treatment for a minor of mentally incompetent person when those who speak for them refuse to give consent
What is the proper role of using medical students, interns, and residents in treating patients in an academic medical center?
consent must first be given by the patient before they can participate
What is a Fiduciary Duty?
- Ethical and legal concept.
- Relationship exists when trust and confidence on one side results in a superior position and influence on the other.
- The superiority in a fiduciary relationship raises duties of loyalty and influence.
A relationship in which trusts and confidence on one side results in a superior position and influence on the other is which type of relationship?
Fiduciary
How to balance Mission and Margin?
Health care must make money. Balancing the yin of quality with the yang of profit needed to survive. Mission needs to consider quality, community, and have a foundation in resources. Need to live beyond the doors of the facility.
Discuss the role of HIPAA in accessibility to medical records.
The federal Health Insurance Portability and Accountability Act places substantial restrictions on how health information is obtained, managed, stored, transferred, and used. Health services organizations have a duty to ensure the confidential and appropriate use of patient information
Discuss the personnel who should have access to medical records.
The only personnel who should have access to patient‘s medical records are those individual involved in treatment or care of the individual. (i.e. physician and nurses treating the patient.) The patient also has a right to view their medical records.
Discuss whether or not healthcare organizations should admit their mistakes
Patients have a right to know if any harm or potential harm inflicted on them by healthcare organizations.
When is Consent, Informed Consent?
Informed consent means that there must be full disclosure regarding condition, treatment, alternatives, consequences of treatment and non-treatment.
Discuss the rights of the patient to refuse treatment.
Competent patients have the right to refuse treatment.
Discuss the rights of a parent to refuse treatment for a minor child.
Parents have the right to refuse treatment for the minor child. In June 1986 the Supreme Court agreed that DHHS did not have the right to force hospitals to treat infants over parental objections.
What is the role of the organization in determining that patients have consented in a way that meets ethical criteria?
The organization must ensure that consent is voluntary, the individual is competent, and they are informed.
Discuss why advance directives are important.
AMD inform the providers of their wishes regarding treatment.
Discuss why patient autonomy may be violated is there is no advance directive.
If the provider is not aware of what the patient’s wishes are they can very easily violate them.
What are Living Wills?
allows individuals unable to communicate with caregivers to express their wishes about treatment. Without legislation or case law the living has no legal support.
What is a DNR and what must be the healthcare organization’s response
to the presence of the DNR?
- The do-not-resuscitate order is a type of AMD that is used at the point of service delivery.
- DNR policy should identify the chemical and mechanical technologies included and the specific instances in which they will be applied
- patients with DNR may required surgery and anesthesia management for palliative care, pain relief/distress, or to improve patient quality of life
- Non-hospital DNRs recognized in 27 states in 1996
- Problems with DNRs- inadequate hydration and nutrition, staff confused about type of care DNR represented, different perception from Docs of orders equitable writing for differ patients with the same diagnosis other concerns–may encourage systematic rationing of HC to older adults, right to die may become duty to die (slippery slope)
Discuss Euthanasia
Euthanasia “good death” is care that makes death less painful.
Define Ordinary Care
all medicines, treatments, and operations which offer reasonable hope of benefit and which can be obtained and used without excessive expense, pain, or other inconvenience.
Define Extraordinary Care.
all medicines, treatments, and operations which cannot be obtained or used without excessive expense, pain, or inconvenience, or which, if used, would not offer a reasonable hope of benefit
Discuss the concept of Nonmaleficence in the presence of infectious disease
Nonmaleficence: “do no harm”except where some degree of harm is necessary to prevent a greater degree of harm. The organization has a duty to protect patients, staff, and the community in the presence of infectious disease.
What is the healthcare organization’s duty to patients, staff, and the community in the presence of infectious disease?
The organization has a duty to protect patients, staff, and the community in the presence of infectious disease.
Importance of staff competency
look up
How to assure competency?
Education, Background checks, etc..
Discuss the role of ethics committees
Ethics committees play two roles of general importance: to assist in developing or reconsidering the organizational philosophy[hy (to move the organization towards a more desired culture) and the derivative vision and mission statements. The experience and range of its interdisciplinary membership are likely to produce better reasoned and more thorough results. Education is the second role. It adds a level of sophistication to the organization and improves the quality of clinical and administrative decision making.
Discuss the role of Institutional Review Boards
The IRB is responsible for providing guidance and oversight for the human participant protection program (experimenting, clinical lab, etc.) and for helping to maintain compliance with applicable laws, regulations, and policies.
