ethics of health care

1. EFFICIENT HEALTHCARE IN CANADA
AN ETHICAL APPROACH
PRESENTED BY- TEJASKUMAR
WCC12245

2. PRINCIPLES OF HEALTH CARE ETHICS
• The language of ethics related to healthcare, also commonly called bioethics,
• This applied across all practice settings.
• Four basic principles are commonly accepted.
(1) autonomy,
(2) beneficence
(3) nonmaleficence
(4) justice.
For Case managers, and other health professionals, veracity (truthfulness) and fidelity (trust) are also
spoken of as ethical principles but they are not part of the foundational ethical principles identified by
bioethicists.

3. THE PRINCIPLE OF AUTONOMY
• It is the ability to make decisions for oneself, also known as self-government. We hold great respect for
individual rights and equate freedom with autonomy.
• Patients be told the truth about their condition and be informed about the risks and benefits of
treatment.
• Permitted to refuse treatment.
• Patients heavily armed with internet resources who demand their own choice in any decision-making.
This transition of authority has been slower to evolve in the geriatric population.

4. THE PRINCIPLE OF BENEFICENCE
• Beneficence is the act of being kind.
• Beneficence always raises the question of subjective and objective determinations, of benefit versus
harm.
• Ethical decision-making process and the ultimate decision were the determination of the physician.
• For example, case managers have expertise in quality-of-life issues, and in this capacity can offer much
to the discussions of lifestyle and life-challenging choices, particularly when dealing with terminal
diseases and end-of-life dilemmas.

5. THE PRINCIPLE OF NONMALEFICENCE
• Nonmaleficence means doing no harm.
• Actions or practices of a healthcare provider are “right” as long as they are in the interest of the patient
and avoid negative consequences.
• Omission would be failing to raise the side rails on the patient’s hospital bed, upon which the patient
fell out and was injured.
• Commission is something actually done that resulted in harm.
• For example, discharging a patient to an inappropriate level of care or leaving a patient in a dangerous
living situation. A key role for the case manager is to be an advocate for the patient and neglecting this
role could be maleficent.

6. THE PRINCIPLE OF JUSTICE
• Justice speaks to equity and fairness in treatment.
• providing fairness in treatment to the patient, the institution and staff must also be treated fairly.
• For example, it is not fair if a patient cannot make payments and the institution has to pay for the
treatments already given for the patient’s benefit.
• distributive and comparative. Distributive justice addresses the degree to which healthcare services are
distributed equitably throughout society.
• Comparative justice determines how healthcare is delivered at the individual level. It looks at disparate
treatment of patients on the basis of age, disability, gender, race, ethnicity, and religion.

7. THE PRINCIPLE OF VERACITY
• Veracity (truthfulness) is not a foundational bioethical principle and is granted just a passing mention in
most ethics texts.
• Informed consent is only possible if patients have been well informed of options, which then allows
them to exercise autonomy with full knowledge.

8. THE PRINCIPLE OF FIDELITY
• Fidelity is loyalty.
• It speaks to the special relationship developed between patients and their healthcare professionals.
Each owes the other loyalty; although the greater burden is on the provider to be worthy of the
patient’s trust and loyalty.
• For example, if a physician promises the patient they will always be there to care for them, yet leaves
the organization and joins another healthcare facility, the patient may feel the physician betrayed their
loyalty.

10. REFERENCES
• Aicardi, C., DelSalvio, L. Dove, E., et al. (2016). Emerging ethical issues regarding digital health data. World
Medical Association Draft Declaration of Ethical Considerations Regarding Health Databases and
Biobanks. Croatian Medical Journal:57(2)207-213.
• Airth-Kindree N, Kirkhorn L. (2016). Ethical grand rounds: Teaching ethics at the point of care. Innovations in
Nursing Education: Building the Future of Nursing 37(1):48–50.
• American Nurse Association (ANA). (2015). Code of Ethics. Retrieved August 24, 2018 from
http://nursing.rutgers.edu/civility/ANA-Code-of-Ethics-for-Nurses.pdf.
• American Physical Therapy Association (APTA). (2010). Core Documents: Code of Ethics.
• Badawi, A. (2016). Boundaries in therapeutic practice. Journal of the Australian Traditional Medicine
Society 22(21):90–93.
• https://www.atrainceu.com/content/3-principles-healthcare-ethics
• https://www.canada.ca/en/health-canada/services/publications/health-system-services/ethical-issues-home-
care.html