Lecture 4 Flashcards
What does the Code of Ethic define?
Professional Behavior (duty, virtue) Promises to Patients (duty, fidelity, veracity) Reasonable Care (beneficence/non-maleficence) Respect for Patients (autonomy, dignity) Personal/Professional Responsibilities
When was the Code of Ethics created? by who?
What is the purpose of the document?
1847
AMA published the first code of ethics
The document was created for the public to help clarify their expectations
What are a few arguments in favor of the code?
- state a profession’s obligation to society
- explains conventions between professionals
- reflects the collective recognition of the member’s responsibilities
- creates a norm of ethical behavior
- indicates to others the serious concern with responsible and professional conduct
What are a few arguments against a Code of Ethics?
- it is too simplistic/general OR too prescriptive/controversial
- ethics should be open-ended and codes confuse this
- professionals should have no special duties beyond being a moral person
- codes are rarely sought after for guidance/utilized
- a code might compromise an individual’s moral autonomy
What are some major topics covered in the Naturopathic Code of Ethics (2012)?
Honesty (Improper) Relationships Privacy Performance Obligation Competence Discrimination Communication Conflicts of Interest
What types of problems occur within moral dilemmas?
Moral uncertainty
moral dilemma
moral distress
What is moral uncertainty?
act not quite right, don’t know what to do
What is a moral dilemma?
two or more options/actions, don’t know which is right.
What is moral distress?
knowing the correct action, but being constrained by unacceptable consequences
What information gathering considerations are encouraged by the Jonsen Model?
- Medical Indications
- Patient Preferences
- Quality of Life
- Contextual Features
What are common steps to dealing with ethical/moral dilemmas?
- gather the facts
- gain addt’l info from an expert, if needed
- talk to a peer/mentor
- decide
- -> There is often more than one “right” action and the wrong one is usually apparent
- Act and accept responsibility (Kantian)
What is expected from AANP CoE - Honesty:
- conduct in an honest manner
- do not represent self to patients or public in an untruthful, misleading, or deceptive manner
- do not engage in false advertising
AANP - Improper Relationship:
- no sexual relations with patient, unless released from care for at least one year
- termination of physician-patient relationship should be in writing and the patient should understand the termination of care
AANO CoE: Privacy
- maintain patient confidentiality and privacy
EXCEPTION: if patient is a danger to public or him/herself, physician shall contact appropriate officials/agencies
AANP CoE: Performance
- perform tasks/responsibilities to best of your abilities and standards of care
- refrain from engaging in any behavior that detracts from ability to engage in competent care
AANP CoE: Obligation
Fundamental
Fundamental Obligation is to the patient, and to the maintenance and improvement of the patient’s health and well-being
What does obligation look like?
- employ methods/diagnoses true to naturopathy, provide patient with info, and seek informed consent
- facilitate patient’s access to high quality, safe and reliable medicine, devices, tests, etc
- offer alternative sources of the above things
- refrain from recommending medicines or treatments of a secret nature
- all therapies should be monitored by an ND in a timely manner and with assessment
- only provide or recommend services that are medically necessary or beneficial
AANP CoE: Competence
maintain proficiency and competence; be diligent in the provision and administration of patient care
- -> Continuing Edu
- exercise judgments with competency and collaborate when needed
- pursue approp. advanced training when expanding services
- dedicate sufficient time to each patient
AANP CoE: Discrimination
A ND is free to decide whether or not to provide medical care to a particular person
- unless confronted with med emergency
- unless other reasonable options are not available
- may not discriminate on basis of race, ethnicity, creed, religion, disability, gender, age, sexual orientation, or national origin (Protected classes)
- once relationship has begun, care must be provided until it is complete, patient ends relationship or ND has discharged the patient from care
- if ND wishes to end care, provide/document a formal referral
AANP CoE: Communication
Communicate effectively with patient
- educate the patient
- convey relevant info in terms that the patient can understand
- provide adequate opportunity for questions and discussion
- transfer patient records to another HC provider at the request of patient
- maintain confidentiality of all patient records (exceptions: patient request or law)
- treat with respect
AANP CoE: Conflicts of Interest
Conflicts should always be resolved in the best interest of the patient
- disclose any conflicting financial interests to patient (including appropriate medical care, compensation from product sales/statements/endorsements)
AANP CoE: Improper Conduct
A ND shall not prescribe, provide, or seek compensation for medical services that are not specifically indicated for an individual patient
AANP CoE: Influence
ND shall not exert influence over a patient’s decision to undertake any action that is contrary to the patient’s best interest
AANP CoE: Accepting Gifts
ND shall not accept gifts from any individual or entity that are deemed to influence the ND’s clinical judgment
Failure to comply results in what?
reprimand or revocation of membership in AANP
