Ethical Issues Related to Health Promotion

1. ETHICAL ISSUES RELATED TO
HEALTH PROMOTION
JACEY MITCHELL, RDH, MS
FALL 2018
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

2. HEALTH PROMOTION AS A MORAL ENDEAVOR
• WHEN WE PROVIDE SERVICE TO SOCIETY THROUGH HEALTH-PROMOTION INTERVENTIONS, THEIR
CARE FOR INDIVIDUALS CAN BE SEEN AS A MORAL ENDEAVOR.
• IN ORDER TO SET HIGHER STANDARD OF HEALTH FOR ALL PEOPLE, THERE NEEDS TO BE A CHANGE
IN OUR APPROACH TO UNDERSTANDING HEALTH AND THE DEVELOPMENT OF HEALTH-PROMOTION
ETHICS.
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

3. HEALTH CARE ETHICS
• APPLIED ETHICS—USES MORAL PHILOSOPHY TO FORMULATE THEORIES GUIDING ACTIONS IN
PRACTICE THAT MOST CONSISTENTLY RESULT IN GOOD ACTION OR AVOID HARMFUL ACTIONS
• MORAL PHILOSOPHY—CONCERNED WITH WHAT IS RIGHT OR WRONG, GOOD OR BAD, IN
HUMAN ACTION TOWARD OTHER HUMANS, ANIMALS, AND THE ENVIRONMENT
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

4. HEALTH PROFESSIONALS’ MORAL RESPONSIBILITIES
• HEALTH PROFESSIONALS HAVE MORAL RESPONSIBILITIES TOWARD INDIVIDUALS AND SOCIETY WITH
REGARD TO FACILITATING HEALTH AND WELL-BEING, OR THE RELIEF OF SUFFERING
• PROFESSIONAL RESPONSIBILITIES/OBLIGATIONS ARE LAID OUT IN THE PROFESSION’S CODE OF
ETHICS, WHICH SERVES AS A STANDARD
• DENTAL HYGIENE CODE OF ETHICS
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

5. APPLYING ETHICS TO PRACTICE
• ETHICAL THEORIES CAN BE USEFUL IN HIGHLIGHTING SALIENT ASPECTS OF COMPLEX PROBLEMS,
SERVING AS POTENTIAL TOOLS IN PROBLEM-SOLVING.
• HOWEVER, ALL MORAL THEORIES HAVE FLAWS; IT IS NOT PRUDENT TO ADOPT ONE THEORY TO
GUIDE ACTIONS IN EVERY SITUATION.
• COMBINING PRINCIPLES DERIVED FROM A VARIETY OF ETHICAL THEORIES (A PHILOSOPHICAL
FRAMEWORK FOR ACTION) WITH CONTEXTUAL CONSIDERATIONS INCREASES THE LIKELIHOOD OF
EFFECTIVE/BENEFICIAL ACTIONS.
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

6. ETHICAL PROBLEM SOLVING
• ISSUES—ETHICAL PROBLEMS IN WHICH A CHOICE MUST BE MADE
• DILEMMAS—SITUATIONS IN WHICH A CHOICE MUST BE MADE BETWEEN TWO OR MORE EQUALLY
UNDESIRABLE OPTIONS
• TRUE DILEMMAS ARE RARE, BUT NEGLECTED ISSUES CAN BECOME DILEMMAS
• PREVENTATIVE ETHICS- AIMS TO INTERRUPT POTENTIAL ETHICAL PROBLEMS BEFORE THEY
DEVELOP
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

7. ETHICAL PRINCIPLES IN HEALTH PROMOTION
• AUTONOMY
• FREEDOM OF ACTION
• SELF-DETERMINATION
• VERACITY
• DEVOTION TO THE TRUTH
• NONMALEFICENCE
• NOT HARMING OTHERS
• BENEFICENCE
• TO DO GOOD
• CAN CONFLICT WITH AUTONOMY
• JUSTICE
• FAIRNESS
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

8. INFORMED CONSENT
• INFORMED CONSENT TO RESEARCH, TREATMENTS, OR HEALTH-PROMOTION ENDEAVORS INVOLVES
ENSURING THAT A PERSON HAS ALL OF THE INFORMATION NECESSARY TO COME TO A DECISION
THAT FACILITATES AUTONOMOUS ACTION
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

9. CONFIDENTIALITY
• CONFIDENTIALITY—PEOPLE HAVE THE RIGHT TO DECIDE WHO SHALL HAVE ACCESS TO
INFORMATION ABOUT THEM, THUS LIMITING THE NEGATIVE USE OF PERSONAL INFORMATION BY
OTHERS
• HEALTH CARE PROFESSIONALS MUST STRIVE TO KEEP PATIENTS’ PERSONAL INFORMATION CONFIDENTIAL
• DISCLOSE ONLY AS MUCH INFORMATION AS NECESSARY TO PERMIT OPTIMAL CARE AND ONLY INFORMATION
THAT IS PERTINENT TO THE SITUATION
• OVERRIDDEN ONLY IN SITUATIONS IN WHICH EXTREME HARM TO THE PATIENT OR OTHERS IS IMMINENT
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

10. THE PRIVACY RULE
• DEVELOPED AS A RESULT OF THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
(HIPAA)
• ATTEMPTS TO ENSURE THAT INDIVIDUALS’ HEALTH INFORMATION IS PROPERLY PROTECTED, WHILE
ALLOWING FLOW OF INFORMATION NEEDED TO PROVIDE HIGH-QUALITY CARE AND PROTECT
PUBLIC HEALTH
• ENSURES THAT PATIENTS ARE GIVEN A COPY OF THE PRIVACY PRACTICES AT A GIVEN INSTITUTION
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

11. CONFIDENTIALITY ISSUES WITH ADOLESCENTS
• CONFIDENTIALITY ISSUES IN THE TASK OF FACILITATING ADOLESCENTS’ EMERGING AUTONOMY
AND CONFIDENTIALITY NEEDS
• HEALTH CARE PROFESSIONALS POTENTIALLY CAUGHT IN TENSION BETWEEN A TEENAGER WANTING TO
ASSERT INDEPENDENCE AND PARENTAL FIGURE(S) WHO FEEL THEY HAVE A RIGHT TO INFORMATION
• HANDLE SITUATION IN A MANNER THAT PRESERVES TRUST AND SUPPORT; IF NECESSARY, SOLICIT
APPROPRIATE ADVICE FROM A PEER/RESOURCE
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

12. STRATEGIES FOR ETHICAL
DECISION MAKING
• IDENTIFY THE PROBLEM OR ISSUE
• IDENTIFY THE LEVEL OF THE PROBLEM OR ISSUE
• INDIVIDUAL, GROUP, SOCIAL
• IDENTIFY THE ETHICAL PRINCIPLE(S) INVOLVED
• IDENTIFY WHO/WHAT CREATED THE PROBLEM OR ISSUE
• DETERMINE PREVALENT VALUES
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

13. STRATEGIES FOR ETHICAL
DECISION MAKING (CONT.)
• IDENTIFY INFORMATION GAPS
• FORMULATE POSSIBLE COURSE OF ACTION AND PROBABLE CONSEQUENCES
• INITIATE SELECTED COURSE OF ACTION AND EVALUATE THE OUTCOME
• ENGAGE IN SELF- AND PEER-REFLECTION
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.