This document discusses several ethical issues and dilemmas that can arise in healthcare. An ethical issue involves following a specific rule, while an ethical dilemma is a conflict between two morally right actions. Other concepts discussed include conflict of interest, paternalism in healthcare, deception, privacy/confidentiality, and whistleblowing. Paternalism involves making decisions for another's benefit, but can conflict with patient autonomy. Privacy, confidentiality, and trust are intertwined, and confidentiality protects individual privacy. Whistleblowing refers to expressing concerns about improper behavior for the public interest.
Resources for Week 2 HLTH440 from M.U.S.E. My Unique Student Expe.docxronak56
Resources for Week 2 HLTH440 from: M.U.S.E. My Unique Student Experience Registered Trademark CEC 2013. All Rights Reserved.
The Basis for Health Care Ethics
What is Ethics?Ethics is what you believe is right or wrong. It is a moral philosophy that seeks to help the individual distinguish between good and bad as defined by one's culture. Ethics guides individuals and groups in their decisions about health care and other matters. Ethics helps the individual and group set boundaries.
Health care ethics is based on the law, professional codes of ethics, standards of care, and institutional policies and practices (corporate law).
Codes of EthicsCodes of ethics or codes of conduct are lists of standards or guides that provide an ethical framework for practice within a profession. Physicians are bound by the Hippocratic oath, but nursing has its own code of ethics. All health professions have a code of ethics.
It is axiomatic that the practice of health care presents moral and ethical dilemmas, because it deals with human beings and life-altering circumstances.
Health care financing presents broader moral dilemmas in the allocation of scarce resources. The conflict exists between the inherent values, duties, and obligations in caring for patients and the availability of resources to treat them.
The depth or content of a code of ethics is dependent on the type of contact that the health care professional has with a patient.
Ethical Theories
A number of ethical frameworks or theories are used to make decisions in health care and, in general, to set boundaries for expected behavior. The theories are used to determine what is fair or unfair. The following are several ethical frameworks:
Normative ethics: The ethical theory that describes how things ought to be.
Teleological theory: Also known as consequentialist theory, which believes that the best action in any situation is the one that promotes the greatest happiness for the largest number of people. In health care financing, this would fall under the rubric of cost containment by calculating the net benefits verses the consequences.
Utilitarianism: This is Mill’s definition of morality, which is the practical ethics of judgment: What is the greatest good that will benefit the greatest number of people? Medicare falls under this rubric.
Deontological theory: What one should or must do based on the obligations and duties of one’s life. This theory focuses on means, whereas teleological theory focuses on ends.
Virtue ethics: This is the ethics of care as a part of virtue ethics; virtue ethics is a form of normative ethics, which emphasizes the character of the interaction between the health care provider and the patient. This is the opposite of the emphasis on rules or consequences in other moral theories. Health care virtues include compassion, conscientiousness, cooperativeness, discernment, honesty, trustworthiness, truth telling, integrity, kindness, respect, and commitment.
Situational ...
Resources for Week 2 HLTH440 from M.U.S.E. My Unique Student Expe.docxronak56
Resources for Week 2 HLTH440 from: M.U.S.E. My Unique Student Experience Registered Trademark CEC 2013. All Rights Reserved.
The Basis for Health Care Ethics
What is Ethics?Ethics is what you believe is right or wrong. It is a moral philosophy that seeks to help the individual distinguish between good and bad as defined by one's culture. Ethics guides individuals and groups in their decisions about health care and other matters. Ethics helps the individual and group set boundaries.
Health care ethics is based on the law, professional codes of ethics, standards of care, and institutional policies and practices (corporate law).
Codes of EthicsCodes of ethics or codes of conduct are lists of standards or guides that provide an ethical framework for practice within a profession. Physicians are bound by the Hippocratic oath, but nursing has its own code of ethics. All health professions have a code of ethics.
It is axiomatic that the practice of health care presents moral and ethical dilemmas, because it deals with human beings and life-altering circumstances.
Health care financing presents broader moral dilemmas in the allocation of scarce resources. The conflict exists between the inherent values, duties, and obligations in caring for patients and the availability of resources to treat them.
The depth or content of a code of ethics is dependent on the type of contact that the health care professional has with a patient.
Ethical Theories
A number of ethical frameworks or theories are used to make decisions in health care and, in general, to set boundaries for expected behavior. The theories are used to determine what is fair or unfair. The following are several ethical frameworks:
Normative ethics: The ethical theory that describes how things ought to be.
Teleological theory: Also known as consequentialist theory, which believes that the best action in any situation is the one that promotes the greatest happiness for the largest number of people. In health care financing, this would fall under the rubric of cost containment by calculating the net benefits verses the consequences.
Utilitarianism: This is Mill’s definition of morality, which is the practical ethics of judgment: What is the greatest good that will benefit the greatest number of people? Medicare falls under this rubric.
Deontological theory: What one should or must do based on the obligations and duties of one’s life. This theory focuses on means, whereas teleological theory focuses on ends.
Virtue ethics: This is the ethics of care as a part of virtue ethics; virtue ethics is a form of normative ethics, which emphasizes the character of the interaction between the health care provider and the patient. This is the opposite of the emphasis on rules or consequences in other moral theories. Health care virtues include compassion, conscientiousness, cooperativeness, discernment, honesty, trustworthiness, truth telling, integrity, kindness, respect, and commitment.
Situational ...
CHAPTER 2Principles of Healthcare EthicsJim Summers.docxchristinemaritza
CHAPTER 2
Principles of Healthcare Ethics
Jim Summers
INTRODUCTION
Chapter 1 of Health Care Ethics: Critical Issues for the 21st Century
presented the major ethical theories and their application in health care
as part of a foundation for the study of ethics. This chapter extends that
foundation by showing how those theories inform the principles used in health
care and apply to the issues in that field. The principles commonly used in
healthcare ethics—justice, autonomy, nonmaleficence, and beneficence—
provide you with an additional foundation and tools to use in making ethical
decisions. Each of these principles is reviewed here. The concept of justice
is presented last because it is the most complex. In addition, this chapter
presents a model for decision making that uses your knowledge of the theory
and principles of ethics.
NONMALEFICENCE
If we go back to the basic understanding of the Hippocratic ethical teaching,
we arrive at the dictum of “first do no harm, benefit only.” The principle of
nonmaleficence relates to the first part of this teaching and means “to do no
harm.” In healthcare ethics, there is no debate over whether we want to avoid
doing bad or harm. However, the debate occurs when we consider the meaning
of the word harm. The following ethical theories come into play here:
leads to less good or utility than other choices.
rational natures, that which circumscribes or limits our potential.
carrying out our duty or that which is opposed to the formal conditions of
the moral law.
eudaimonia, a person of practical
wisdom—would find that harm is that which is immoderate, that which
leads us away from manifesting our proper ends as humans.
her self-interest.
What Is “Harm” in the Clinical Setting?
In the clinical setting, harm is that which worsens the condition of the patient.
However, deciding what harm or worsen means is no simple matter. Much of
health care involves pain, discomfort, inconvenience, expense, and perhaps
47
even disfigurement and disability. Using the natural law theory of double
would say that the greater good, the greater utility, occurs from accepting the
pain or dismemberment as part of the cost to get the benefit the healthcare
procedures promise. The due care standard to provide the most appropriate
treatment with the least pain and suffering sounds almost like a deontological
principle.1
Most healthcare workers consider harm to mean physical harm, because the
long history of healing has focused primarily on overcoming bodily disorders.
However, harm can occur in other ways. For example, healthcare managers can
these can lead to adverse patient outcomes. Harm also comes from strategic
decisions that lead to major financial losses and ...
A training powerpoint presentation for employees in patient confidentiality as a follow up on multiple breaches of confidentiality and privacy of protected health information of celebrities in a hospital setting.
Medical Research: conflicts between autonomy and beneficence/non maleficence, euthanasia, informed consent, confidentiality, criticisms of orthodox medical ethics
CHAPTER 2
ETHICAL THEORY
*
ETHICS AND NURSINGIt is through the intimacy and trust of the nurse-patient relationship that nurses become critical participants in the process of ethical decision making.By developing a working knowledge of ethical theory, nurses can make clear and consistent decisions.
*
PHILOSOPHYThe intense and critical examination of beliefs and assumptions.It gives coherence to the whole realm of thought and experience and offers principles for deciding what actions and qualities are most worthwhile.It gives shape to what would otherwise be a chaos of thoughts, beliefs, assumptions, values, contradictions, and superstitions.
*
MORAL THEORYProvides a framework for cohesive and consistent ethical reasoning and decision making. The best moral theories are part of larger integrated philosophies. Two moral theories having the greatest influence on contemporary bioethics and nursing: utilitarianism and deontology.
MORALS AND ETHICSMoral philosophy is the philosophical discussion of what is considered good or bad, right or wrong, in terms of moral issues.Moral issues are those which are essential, basic, or important and deal with important moral issues.Ethics is a formal process making logical and consistent decisions, based upon moral philosophy.
*
ETHICAL THEORIESEthical theories explain values and behavior related to cultural and moral norms.As a morally central health care profession, nursing requires astuteness concerning moral and ethical issues.Professional codes of ethics provide a formal process for applying moral philosophy and ethics.
*
NATURALISMRegards ethics as dependent upon nature and psychology.Proposes that nearly all people have a tendency to make similar ethical decisions despite differences in culture.Sympathy is a motivating factor in moral decision making.
*
RATIONALISMRationalists believe feelings or perceptions, though they may seem similar in many people, may not actually be similar in all people.Believe there exist universal truths, independent from humans, that can be known through the process of reasoning.
*
UTILITARIANISMSometimes called consequentialism, holds that an action is judged as good or bad in relation to the consequence, outcome, or end result that is derived from it.Holds that no action is in itself either good or bad.Mill believed it to be in the spirit of the golden rule, “Do unto others as you would have them do unto you.”
*
TYPES OF UTILITARIANISMAct-utilitarianism: people choose actions that will, in a given circumstance, increase the overall good. Allows for different, sometimes opposing, action in different situations.Rule-utilitarianism: people choose rules in all situations that increase the overall good. Rules that maximize happiness and reduce unhappiness.Rules are easy to learn and should be strictly followed.
*
DEONTOLOGYDeontology is based upon the idea that rightness or wrongness of an act depends upon the nature of ...
CHAPTER 2Principles of Healthcare EthicsJim Summers.docxchristinemaritza
CHAPTER 2
Principles of Healthcare Ethics
Jim Summers
INTRODUCTION
Chapter 1 of Health Care Ethics: Critical Issues for the 21st Century
presented the major ethical theories and their application in health care
as part of a foundation for the study of ethics. This chapter extends that
foundation by showing how those theories inform the principles used in health
care and apply to the issues in that field. The principles commonly used in
healthcare ethics—justice, autonomy, nonmaleficence, and beneficence—
provide you with an additional foundation and tools to use in making ethical
decisions. Each of these principles is reviewed here. The concept of justice
is presented last because it is the most complex. In addition, this chapter
presents a model for decision making that uses your knowledge of the theory
and principles of ethics.
NONMALEFICENCE
If we go back to the basic understanding of the Hippocratic ethical teaching,
we arrive at the dictum of “first do no harm, benefit only.” The principle of
nonmaleficence relates to the first part of this teaching and means “to do no
harm.” In healthcare ethics, there is no debate over whether we want to avoid
doing bad or harm. However, the debate occurs when we consider the meaning
of the word harm. The following ethical theories come into play here:
leads to less good or utility than other choices.
rational natures, that which circumscribes or limits our potential.
carrying out our duty or that which is opposed to the formal conditions of
the moral law.
eudaimonia, a person of practical
wisdom—would find that harm is that which is immoderate, that which
leads us away from manifesting our proper ends as humans.
her self-interest.
What Is “Harm” in the Clinical Setting?
In the clinical setting, harm is that which worsens the condition of the patient.
However, deciding what harm or worsen means is no simple matter. Much of
health care involves pain, discomfort, inconvenience, expense, and perhaps
47
even disfigurement and disability. Using the natural law theory of double
would say that the greater good, the greater utility, occurs from accepting the
pain or dismemberment as part of the cost to get the benefit the healthcare
procedures promise. The due care standard to provide the most appropriate
treatment with the least pain and suffering sounds almost like a deontological
principle.1
Most healthcare workers consider harm to mean physical harm, because the
long history of healing has focused primarily on overcoming bodily disorders.
However, harm can occur in other ways. For example, healthcare managers can
these can lead to adverse patient outcomes. Harm also comes from strategic
decisions that lead to major financial losses and ...
A training powerpoint presentation for employees in patient confidentiality as a follow up on multiple breaches of confidentiality and privacy of protected health information of celebrities in a hospital setting.
Medical Research: conflicts between autonomy and beneficence/non maleficence, euthanasia, informed consent, confidentiality, criticisms of orthodox medical ethics
CHAPTER 2
ETHICAL THEORY
*
ETHICS AND NURSINGIt is through the intimacy and trust of the nurse-patient relationship that nurses become critical participants in the process of ethical decision making.By developing a working knowledge of ethical theory, nurses can make clear and consistent decisions.
*
PHILOSOPHYThe intense and critical examination of beliefs and assumptions.It gives coherence to the whole realm of thought and experience and offers principles for deciding what actions and qualities are most worthwhile.It gives shape to what would otherwise be a chaos of thoughts, beliefs, assumptions, values, contradictions, and superstitions.
*
MORAL THEORYProvides a framework for cohesive and consistent ethical reasoning and decision making. The best moral theories are part of larger integrated philosophies. Two moral theories having the greatest influence on contemporary bioethics and nursing: utilitarianism and deontology.
MORALS AND ETHICSMoral philosophy is the philosophical discussion of what is considered good or bad, right or wrong, in terms of moral issues.Moral issues are those which are essential, basic, or important and deal with important moral issues.Ethics is a formal process making logical and consistent decisions, based upon moral philosophy.
*
ETHICAL THEORIESEthical theories explain values and behavior related to cultural and moral norms.As a morally central health care profession, nursing requires astuteness concerning moral and ethical issues.Professional codes of ethics provide a formal process for applying moral philosophy and ethics.
*
NATURALISMRegards ethics as dependent upon nature and psychology.Proposes that nearly all people have a tendency to make similar ethical decisions despite differences in culture.Sympathy is a motivating factor in moral decision making.
*
RATIONALISMRationalists believe feelings or perceptions, though they may seem similar in many people, may not actually be similar in all people.Believe there exist universal truths, independent from humans, that can be known through the process of reasoning.
*
UTILITARIANISMSometimes called consequentialism, holds that an action is judged as good or bad in relation to the consequence, outcome, or end result that is derived from it.Holds that no action is in itself either good or bad.Mill believed it to be in the spirit of the golden rule, “Do unto others as you would have them do unto you.”
*
TYPES OF UTILITARIANISMAct-utilitarianism: people choose actions that will, in a given circumstance, increase the overall good. Allows for different, sometimes opposing, action in different situations.Rule-utilitarianism: people choose rules in all situations that increase the overall good. Rules that maximize happiness and reduce unhappiness.Rules are easy to learn and should be strictly followed.
*
DEONTOLOGYDeontology is based upon the idea that rightness or wrongness of an act depends upon the nature of ...
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2. ETHICAL ISSUES
An ethical issue is considered to be
simple because the solution can be
found by merely following a specific rule
outlined in the code of ethics.
3. ETHICAL DILEMMA
It is an opposition between two
morally righteous actions. A
disagreement exist between two
values or principles.
4. Conflict of interest
A conflict of interest arises when what is in a
person’s interest is not in the best interest of
another person or organization to which that
individual owes loyalty.
5. PATERNALISM
It is taking activities or making decisions on
behalf of another person with the goal of
helping that person.
6. PATERNALISM IN HEALTH CARE
The problem of paternalism in nursing is
clear while trying to do good and promote
the patient’s health. Sometimes nurses must
decide to give treatment against their will
even when it is in the patient’s best interest.
7. Deception
It is the intentional hiding or distortion of the
truth through lying, misleading or other means.
Not all forms of deception include lying. It can
take the form of lying, withholding information,
or more complicated cover-ups. Deception is the
act of purposefully misleading another person.
8. Privacy and confidentiality
Privacy is defined in term of a person having control
over the extent, timing, and circumstances of
sharing oneself with others. It was used to describe
a person’s right to restrict access by other to
certain aspects of their person, such as their
thoughts, personal information.
9. Confidentiality
It is process of protecting an individual’s privacy. All health care
professionals are expected to abide by this significant legal and
medical need. At all cost, patient information should not be
shared with anyone. Three fundamental concepts
Confidentiality
Trust
Privacy
Are interwoven, without privacy and trust, confidentiality is
impossible.
10. WHISTEBLOWING
When a worker, including a student nurse or student
midwife, expresses concern about misbehavior that
is in the public interest, this is referred to as
whistleblowing. It can take place within
organization or if the worker feels they are unable
to do this, to a third person known as a ‘prescribed
person’.
11. Requirements before determining
whistleblower’s concern
Person should be officially employed
Not just done for personal advantage
Confident in the truth of fact they provide
Obeying the laws themselves
Concern must fall under our regulatory
jurisdiction
