Unit 8 Lesson 4: Technology & Ethics Flashcards
There are many more situations that healthcare workers face each day where ethical codes can help them think things through. Give examples
When a patient refuses treatment that a doctor has ordered, there is conflict between the autonomy of the patient and the requirement to do what is in the best interest of the patient. You don’t want to give fatty food to a patient with a heart condition, in an effort to do no harm, but that might be in conflict with the wishes of the patient, who enjoys rich foods. Every job will have some everyday situations that require ethical thought to work out.
When a situation offers a choice of two ethically unacceptable options, we call this an
ethical dilemma
What happens in an ethical dilemma
In an ethical dilemma, there is some sort of ethical problem with several possible actions.
Example of ethical dilemma in personal life
Ethical dilemmas come up in personal life too, such as when a kid that has been mean to you in the past is being bullied. Should you speak up to protect him, say mean things along with the others, or do nothing? All of these options have pitfalls. You don’t like this kid, and he has said mean things to you in the past, so you don’t want to defend him against the other kids, yet it would normally be the right thing to do. You may be tempted to pile it on and add to the insults being hurled at this kid, which will make your friends who are taunting him happy—you’d be supporting your friends—but you would also be bullying someone, which is wrong. If you do nothing, you are tacitly approving of the bullying when you have the power to lessen the negative impact on the person being bullied.
In healthcare, the ethics and laws around confidentiality are important, but there are many ethical dilemmas that workers can face regarding information.
What if an elderly man is in very poor health, and his daughter would like to see his records, but the man cannot give permission because he is unconscious? Or a patient calls to get her records which she needs urgently; she is too sick to come in and pick them up but does not have a fax machine, and a worker may be tempted to email the records, which would be a HIPAA violation. Imagine a situation where there is an online social media group for social workers; one member of the group is having a really hard time dealing with a situation at work and wants to ask the group for advice, but this might mean she would need to talk about some of the patients in her posts. There are going to be ethical conundrums that will need to be worked out in many situations around confidentiality.
Electronic communications have increased the number of ethical questions healthcare workers face. Even with very clear guidelines from HIPAA, our communications technology moves so quickly that mistakes and unintentional breaches can easily happen. Example
Perhaps a worker is composing an email to a doctor within the hospital system, only typing in the first few letters and letting the computer autofill the name, but the communication goes to the wrong person who has no need to know it. Just the requirement to keep people from seeing a computer screen can be difficult in a busy office setting, but no one should look at a patient record who does not have a need to work with the information. Providing efficient care and work is difficult when so many precautions are required to keep patient data safe; however, this is the ethical imperative in working with medical data.
Do Not Resuscitate Tattoo stroy
A 70-year-old man was rushed to the ER, unconscious and without any friends or relatives with him. On his chest was a tattoo that read “Do Not Resuscitate” which the doctors wanted to abide by. However, they could not be sure this was his actual wish without a signed document. The man died the next day, but it raised a serious dilemma for the hospital staff. Advance directives need to be clearly written, but does a tattoo count?
Brain-Dead Mother Gives Birth to Twins stroy
A 21-year-old Brazilian woman lost consciousness before reaching the hospital and was found to have severe bleeding in her brain. The hospital declared her brain dead but kept her on life support because she was nine-weeks pregnant with twins. They expected the fetuses’ hearts to stop beating within 3 days, but the twins continued to develop normally for 123 days, finally being born at 3 pounds each. Is it ethical to keep a pregnant woman alive, whether she would want it or not, to save the life of a fetus she is carrying? This is just one of many cases where modern medicine has intervened in the pregnancy of a woman who was declared brain-dead.
Altering the Genes of Embryos stroy
Can you imagine genetically-engineered babies with exactly the qualities that the parents ordered? This is the fear of many who don’t want to see science alter the genetic makeup of embryos. However, doctors in Portland, Oregon, have been experimenting with performing “surgery” to edit the DNA in embryos to correct a mutation that can cause a potentially fatal heart condition. It may seem like a good idea to be able to prevent severe genetic conditions by “editing” out a part of the DNA, but where do we draw the line? What traits are “undesirable?” Nearsightedness? Being short? What are the risks of this new technology?
Right to Die stroy
What happens when a patient is near death and suffering? Is it okay for the person to choose to die rather than suffer? What if a patient with a very disabling condition wants to die? Is it acceptable for physicians to assist in the person’s death? In 2016, California passed an Aid-In-Dying law, laying out how a physician could go about assisting terminally ill patients to have a more peaceful death if they wish. However, the courts suspended the law in 2018, leaving many patients in the middle of the process. Around the world, the debate about physician assisted dying has been raging for years. Some European countries allow it, as do some US states, but the ethics involved in these laws put healthcare workers right in the middle of the continuing controversy.
