Chapter Three Basic Principles of  Health Care Ethics
Morality and Ethics  Morality What is believed to be right and good Ethics Generic term for the study of how we make judgm...
Professional Ethics Applied ethics, designed to bring about ethical conduct Differing professions have different views as ...
Hierarchy of Reasoning  by Values Copyright ©2009 Delmar, Cengage Learning. All rights reserved. World View Basic Principl...
Universal Principles Copyright ©2009 Delmar, Cengage Learning. All rights reserved. veracity autonomy confidentiality Role...
Autonomy From the Greek (self-governance) Ability to decide Power to act Respect for the autonomy of others Informed conse...
Veracity Health care provider can be of little assistance if patient lies  Patient cannot be autonomous if health care pro...
Beneficence  Every patient has the right to assume that the health care provider is actively seeking their good  One ought...
Nonmaleficence  One of the first principles of health care is the admonition: “primum non nocere” (first do no harm) What ...
Principle of Double Effect  Guideline Elements The course chosen must be good, or at least morally neutral The good must n...
Principle of Double Effect    Guideline Elements  (continued) The harm must never be intended, but merely tolerated with t...
Confidentiality If patients begin to believe that we do not protect their confidentiality, then they will cease to tell us...
Justice Deals with concepts of fairness, just desserts, entitlements What is most just method for distributing the limited...
Methods Used in the Distribution of Scarce Goods and Services   How to distribute health care? To each an equal share To e...
Role Fidelity Each health care specialty has a particular and designated role to play in health care practice  Role is oft...
Basic Principles Review the now infamous “Tuskegee Study” case. Each basic principle of health care ethics was breached by...
Key Concepts  Morality and ethics defined Basic principles Autonomy Veracity Beneficence Nonmaleficence Justice Role fidel...
Key Concepts  (continued) Paternalism defined Principle of double effect:  Course chosen good, or at least morally neutral...
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Chapter03

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Chapter03

  1. 1. Chapter Three Basic Principles of Health Care Ethics
  2. 2. Morality and Ethics Morality What is believed to be right and good Ethics Generic term for the study of how we make judgments in regard to right and wrong Offers a way of examining the moral life Copyright ©2009 Delmar, Cengage Learning. All rights reserved.
  3. 3. Professional Ethics Applied ethics, designed to bring about ethical conduct Differing professions have different views as to what constitutes the end good or major purpose These views shape the application of the basic ethical principles Copyright ©2009 Delmar, Cengage Learning. All rights reserved.
  4. 4. Hierarchy of Reasoning by Values Copyright ©2009 Delmar, Cengage Learning. All rights reserved. World View Basic Principles Rules Codes Decisions
  5. 5. Universal Principles Copyright ©2009 Delmar, Cengage Learning. All rights reserved. veracity autonomy confidentiality Role Fidelity beneficence justice nonmaleficence
  6. 6. Autonomy From the Greek (self-governance) Ability to decide Power to act Respect for the autonomy of others Informed consent Autonomy vs. paternalism Therapeutic privilege Benevolent deception Copyright ©2009 Delmar, Cengage Learning. All rights reserved.
  7. 7. Veracity Health care provider can be of little assistance if patient lies Patient cannot be autonomous if health care provider lies Lying damages health care process What is to be done about placebos? Can a lie be justified? Copyright ©2009 Delmar, Cengage Learning. All rights reserved.
  8. 8. Beneficence Every patient has the right to assume that the health care provider is actively seeking their good One ought to prevent evil or harm One ought to remove evil or harm One ought to do or promote good Copyright ©2009 Delmar, Cengage Learning. All rights reserved.
  9. 9. Nonmaleficence One of the first principles of health care is the admonition: “primum non nocere” (first do no harm) What to do when seeking to do good, if there is a harmful secondary effect? Principle of double effect Copyright ©2009 Delmar, Cengage Learning. All rights reserved.
  10. 10. Principle of Double Effect Guideline Elements The course chosen must be good, or at least morally neutral The good must not follow as a consequence of the secondary harmful effects Copyright ©2009 Delmar, Cengage Learning. All rights reserved.
  11. 11. Principle of Double Effect Guideline Elements (continued) The harm must never be intended, but merely tolerated with the good intended The good must outweigh the harm Copyright ©2009 Delmar, Cengage Learning. All rights reserved.
  12. 12. Confidentiality If patients begin to believe that we do not protect their confidentiality, then they will cease to tell us what we need to know Confidentiality is a central element of the therapeutic relationship Copyright ©2009 Delmar, Cengage Learning. All rights reserved.
  13. 13. Justice Deals with concepts of fairness, just desserts, entitlements What is most just method for distributing the limited resources of health care? Place of compensatory justice, when a patient is harmed? (Retribution?) Copyright ©2009 Delmar, Cengage Learning. All rights reserved.
  14. 14. Methods Used in the Distribution of Scarce Goods and Services How to distribute health care? To each an equal share To each according to need To each according to effort To each according to contribution To each according to merit To each according to ability to pay Copyright ©2009 Delmar, Cengage Learning. All rights reserved.
  15. 15. Role Fidelity Each health care specialty has a particular and designated role to play in health care practice Role is often outlined by the legislative specialty practice act Obligation to faithfully practice within the constraints of the role Copyright ©2009 Delmar, Cengage Learning. All rights reserved.
  16. 16. Basic Principles Review the now infamous “Tuskegee Study” case. Each basic principle of health care ethics was breached by the health care providers involved. Provide an example from the case that shows the breaking of each principle Copyright ©2009 Delmar, Cengage Learning. All rights reserved.
  17. 17. Key Concepts Morality and ethics defined Basic principles Autonomy Veracity Beneficence Nonmaleficence Justice Role fidelity Confidentiality Copyright ©2009 Delmar, Cengage Learning. All rights reserved.
  18. 18. Key Concepts (continued) Paternalism defined Principle of double effect: Course chosen good, or at least morally neutral Good must not follow as a consequence of secondary harmful effects Harm must never be intended The good must outweigh the harm Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

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