Ethics

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This document discusses ethics in quality improvement and healthcare. It outlines common ethical values like autonomy, beneficence, non-maleficence, and justice. It also addresses ethical issues for elderly heart failure patients, such as the costs and ethics of readmitting patients. Components of healthcare costs like direct medical costs, patient costs, and productivity costs are reviewed. The document provides references on ethics in healthcare quality improvement, balancing practice economics with patient needs, and establishing ethical standards to promote quality medical care.

Ethics in quality
improvement
Calle Lindén
Emily Moore
The Dinh Thi

Heart Failure
• Ethics of readmission for elderly patients
• 75-85 years
• heart failure NYHA Class II-IV
• telephone support and discharge education
• The cost-effectiveness in healthcare

To help interveners having
suitable decisions
Respect for
persons

Addressing
conflict of Justice
interest

patients

Beneficence
Diversity & non-
maleficence

Integrity

Values of medical ethics
• Autonomy - the patient has the right to refuse or choose their
treatment.

• Beneficence - a practitioner should act in the best interest of the
patient.

• Non-maleficence - "first, do no harm".

• Justice - concerns the distribution of scarce health resources, and
the decision of who gets what treatment (fairness and equality).

• Dignity - the patient (and the person treating the patient) have the
right to dignity.

• Truthfulness and honesty –

• To meet patient expectations
• To address the health needs of the community
• To enhance the quality care
• To foster professionalism
• To improve the organization s culture and practices

What components make up
cost in healthcare?
• Direct costs

Medical: drugs, staff-time, equipment.
Patient: transport, out-of
pocket expenses.

Cost in
Productivity costs Intangibilities: healthcare
Pain, suffering…

Ethics in healthcare
• Ethical standards promote the aim of medical care to alleviate
suffering.
• Medical care is built on the communication between medical
workers on one side and patients and/or patients’ families on
another side.
• Ethical standards will help to build public support for medical
care.
• Health and medical care typically involve different medical
workers from a variety of disciplines.

Ethical Problems for Heart
Failure Patients
• Costs
• Unnecessary medical services
• Fees for medical services
• Balancing practice economics with patient need
- improving health along with financial realities of running a
hospital or health service

References
• Morgan, L., (2006). Hasting center report on Ethics of Quality
Improvement.
• Anne Mart Oostheizen, Silvia Pera, Dirk van der Wal. (2011).
(3rd ed). Ethics in Healthcare.
• Sheila, M., (2006). First do no harm: Law, Ethics & Healthcare.
• Batter, K. (2001). Ethics issues in advanced nursing practice.
Edinburgh: Elsevier science limited.
• LAO. Providing Constitutional and Cost-Effective Inmate
Medical Care. Taylor, M. Legislative Analyst. April 19, 2012.
• Brent C. James, M.D. (1989). Quality Management for Health
care delivery.
• Aastha , D. (2012). Ethical Issues in Healthcare.
http://www.buzzle.com/articles/the-importance-of-health-
ethics.html

References
• AMA. (1994). Opinion 6.05 - Fees for medical services.
Retrieved from http://www.ama-assn.org/ama/pub/physician-
resources/medical-ethics/code-medical-
ethics/opinion605.page?
• WMA. (2006). WMA international code of medical ethics.
Retrieved from
http://www.wma.net/en/30publications/10policies/c8/
• AMA. (1994).AMA’s code of medical ethics. Retrieved from
http://www.ama-assn.org/ama/pub/physician-
resources/medical-ethics/code-medical-ethics.page?
• Medellin, G. (2011). Balancing practice economics with patient
need. Retrieved from http://virtualmentor.ama-
assn.org/2011/08/ccas1-1108.html

Search Process
• Established the common ethical values and principles in
healthcare
• Applied these values to our problem
• Used academic data bases and government websites to direct
our searches

Collaboration Process
• Divided up ethical problems to research among group
members
• Met up and combined powerpoint slides

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Ethics

1. Ethics in quality improvement Calle Lindén Emily Moore The Dinh Thi

2. Heart Failure • Ethics of readmission for elderly patients • 75-85 years • heart failure NYHA Class II-IV • telephone support and discharge education • The cost-effectiveness in healthcare

3. To help interveners having suitable decisions Respect for persons Addressing conflict of Justice interest patients Beneficence Diversity & non- maleficence Integrity

4. Values of medical ethics • Autonomy - the patient has the right to refuse or choose their treatment. • Beneficence - a practitioner should act in the best interest of the patient. • Non-maleficence - "first, do no harm". • Justice - concerns the distribution of scarce health resources, and the decision of who gets what treatment (fairness and equality). • Dignity - the patient (and the person treating the patient) have the right to dignity. • Truthfulness and honesty –

5. • To meet patient expectations • To address the health needs of the community • To enhance the quality care • To foster professionalism • To improve the organization s culture and practices

6. What components make up cost in healthcare? • Direct costs Medical: drugs, staff-time, equipment. Patient: transport, out-of pocket expenses. Cost in Productivity costs Intangibilities: healthcare Pain, suffering…

7. Ethics in healthcare • Ethical standards promote the aim of medical care to alleviate suffering. • Medical care is built on the communication between medical workers on one side and patients and/or patients’ families on another side. • Ethical standards will help to build public support for medical care. • Health and medical care typically involve different medical workers from a variety of disciplines.

8. Ethical Problems for Heart Failure Patients • Costs • Unnecessary medical services • Fees for medical services • Balancing practice economics with patient need - improving health along with financial realities of running a hospital or health service

9. References • Morgan, L., (2006). Hasting center report on Ethics of Quality Improvement. • Anne Mart Oostheizen, Silvia Pera, Dirk van der Wal. (2011). (3rd ed). Ethics in Healthcare. • Sheila, M., (2006). First do no harm: Law, Ethics & Healthcare. • Batter, K. (2001). Ethics issues in advanced nursing practice. Edinburgh: Elsevier science limited. • LAO. Providing Constitutional and Cost-Effective Inmate Medical Care. Taylor, M. Legislative Analyst. April 19, 2012. • Brent C. James, M.D. (1989). Quality Management for Health care delivery. • Aastha , D. (2012). Ethical Issues in Healthcare. http://www.buzzle.com/articles/the-importance-of-health- ethics.html

10. References • AMA. (1994). Opinion 6.05 - Fees for medical services. Retrieved from http://www.ama-assn.org/ama/pub/physician- resources/medical-ethics/code-medical- ethics/opinion605.page? • WMA. (2006). WMA international code of medical ethics. Retrieved from http://www.wma.net/en/30publications/10policies/c8/ • AMA. (1994).AMA’s code of medical ethics. Retrieved from http://www.ama-assn.org/ama/pub/physician- resources/medical-ethics/code-medical-ethics.page? • Medellin, G. (2011). Balancing practice economics with patient need. Retrieved from http://virtualmentor.ama- assn.org/2011/08/ccas1-1108.html

11. Search Process • Established the common ethical values and principles in healthcare • Applied these values to our problem • Used academic data bases and government websites to direct our searches

12. Collaboration Process • Divided up ethical problems to research among group members • Met up and combined powerpoint slides

Editor's Notes

https://docs.google.com/viewer?a=v&q=cache:vVVR2R6RkD8J:www.neac.health.govt.nz/moh.nsf/pagescm/7654/%24File/ethical-guidelines-intervention-studies-nov09.pdf+ethics+in+the+invervention+in+taking+care+patients&hl=vi&gl=vn&pid=bl&srcid=ADGEEShZ4_M-3TOAmYfl_Xd-m25z3wUboSJGNBcK7n8TQbAPVDfUpqiSchsvTM3gVQwqkJfHikDDwcrMdl4Yx0XWC8kHUegS9UiSEazy4ezFbcwQHtXqLndEQPbeX_bfmp9ezwl6A5wD&sig=AHIEtbSK17In_9ECLSC7KLRWAtyDo6cISA
Principles that when followed, promote values such as trust, good behavior, fairness, and/or kindness.There is not one consistent set of standards that all companies follow, but each company has the right to develop the standards that are meaningful for their organization. Ethical standards are not always easily enforceable, as they are frequently vaguely defined and somewhat open to interpretation ("Men and women should be treated equally, " or "Treat the customer with respect and kindness."). Others can be more specific, such as "Do not share the customer's private information with anyone outside of the company."Read more: http://www.businessdictionary.com/definition/ethical-standards.html#ixzz1tgTjPe55

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