Sonographic Ethics and Healthcare Flashcards
values
concepts, goals, ideals, and behaviors
Produced and instilled in people by our family, friends, culture, environment, education, and their life experiences
This is a lifelong process, what people believe in when they are younger, may change over time
basic ethical concepts
Healthcare professionals have been taught to “do no harm” to their patients
Sonographers must respect a patient’s right to make his/her own decisions
Sonographers must be aware of and sensitive to ethical dilemmas
Religious, social, and cultural influences can create dilemmas as well
abortion/selective termination
May have a moral objection
Sonographers must respect the decision of the patient and physician
Regardless of belief, trying to dissuade, encourage, or punish the patient is operating out of our scope of practice
Sonographer’s beliefs must also be respected, and should not fear professional or economic reprisals
Must communicate with supervisor
Once a sonographer accepts responsibility toward a patient, however, he/she must never refuse to carry out or complete a procedure
videotaping obstetric exams
pros and cons
A written policy should be established for providing patients with hard copy images
Nothing should appear on the patient’s images that was not seen on the diagnostic study or survey
Nondiagnostic use of ultrasound
Mid 1990s, many imaging departments abandoned the practice of giving pictures to patients fearing potential lawsuits
Expectant parents demanded a return to this practice
Some enterprising physicians and sonographers recognized that this controversy had created a niche for nondiagnostic fetal imaging
Denied their previous fetal keepsakes, patients turned to trendy ultrasound portrait studios
Catchy names, “Womb with a View”, “Body and Sole”
Fetal packages available that provide 2D, 3D, 4D, tapes, and CDs coplete with background music
Machines capable of producing higher TI, MI
Operated by people with limited training
SDMS, AIUM issued position papers warning against this practice
Awaiting FDA to develop and consistently enforce guidelines or regulations
Another ethical dilemma-support the closure of all these practices, or not oppose them at all
confidentiality
Patients have a right to their privacy
HIPAA
Sonographers, physicians, and patients comprise the three personal elements of medical sonography exams, therefore can only be disclosed to outside parties only with the patients permission
Exam history should be taken in private
If a disclosure is made to the sonographer during the exam that would prevent injury to the patient or others (child abuse, or knowledge of a contagious disease) the sonographer has a duty to report it
competency
Sonographers have an ethical obligation to perform a competent complete examination and provide the interpreting physician with accurate, reliable info
Obtained through continuing education and through training to ensure that a level of competence in sonography is maintained
Registry by AART, ARDMS
professional disclosure
Sonographers have a duty to bring attention to the interpreting physician if there is an error in the interpretation of the study, technique, or faulty equipment
Or if there is suspect of drug/alcohol impairment of a coworker
professionalism
Being involved in and worthy of high standards of a profession
Based on integrity, honesty, and compassion
Must be aware of patient behaviors, patient interactions, and the standards of conduct as well as developing technical knowledge and skills
interactions with patients
We have a unique opportunity in sonography due to the amount of time we spend with our patients
Each patient brings some degree of anxiety to his/her ultrasound exam
Must be able to offer reassurance and explanation of the procedure and reporting process
Must maintain pateint’s modesty during exams
SDMS code of ethics
DO: (interactions with patients)
Thoroughly explain the procedure to the patient and what is expected of the patient
Work with extreme care to avoid causing patient injury
Question any abnormal instructions
Maintain records and documents of the procedures performed in the event the info is requested later Documentation is key
Use common sense and judgement and always practice within the limits of the sonographer’s abilities and as taught
DO NOT: (interactions with patients)
Perform sonography procedures that the sonographer has not been taught
Fail to meet the established standards for the safe care of patients
Fail to prevent injury to coworkers, other hospital employees, or visitors as this may result in a lawsuit
Medico-Legal Aspects of Sonography
There are 2 forms: “Battery”- the patient is injured during the exam by assault or inadequate care, for example, falls off the table
Failure to stop the exam, if the patient changes their mind, or failure to obtain informed consent
“Negligence”- the exam is performed in a fashion that is “below the standard of care”
standard of care
Defined as the way in which a reasonable and prudent physician or sonographer would act under the same circumstances
Established in several different ways-Expert witnesses testify as to the standard of care-Guidelines such as the AIUM practice guidelines for the performance of antepartum obstetric examination or the ACR national standards-Local hospital, radiology, or obstetric department policy statements also set the standard of care
responsibilities of the physician or sonographer reporting the study
In the US, the physician reporting the study is responsible for the accuracy and quality of the report even though he/she may not actually see the patient
Must accurately describe the findings including pertinent negative findings with a clinical conclusion about the presence or absensce of an abnormality
Suggestions about additional procedures or follow uo studies may be required
Problems in the performance of the study such as obesity or suboptimal patient position
