B.SC. Nursing II Computer Unit XI

1. Ethical and Legal Issues in Healthcare
 Unit-IX

2. Ethical Issues in Healthcare
 High ethical standards are necessary for healthcare.
These standards fall under the umbrella of health or
medical ethics, the field of applied ethics that is
concerned with moral decision-making applied to
medical practices and policies.

4. Four basic principles
 Autonomy: Determine the wishes of the patient to
protect their autonomy.
 Justice: Follow the due process to determine limits
on healthcare and treat patients alike.
 Beneficence: Seek the patient’s best interest and
assess what counts as goods to be pursued
 Non-maleficence: Determine what counts as harms
to avoid.

7. Ethical Issues in Healthcare
 1. Do-Not-Resuscitate Orders- A Do-Not-
Resuscitate (DNR) order is written by a doctor and it
instructs healthcare providers not to perform
cardiopulmonary resuscitation (CPR) if a patient
stops breathing or if their heart stops beating. The
DNR doesn’t have instructions for any other
treatment and can only be permitted after a
physician speaks with the patient.

8. Ethical Issues in Healthcare
 2- Doctor and Patient Confidentiality- Violating a
patient’s confidentiality can have legal and ethical
consequences for healthcare providers, according
to the Health Insurance Portability and Accountability
Act (HIPPA), The act requires physicians to protect
the privacy and security of a patient’s medical
records.

9.  HIPPA also sets forth who can see the confidential
information and who cannot. Despite the law’s
straightforwardness, there are some gray areas.
 For example, withholding information about a
patient’s condition could be unethical because it
could harm the patient or someone else. The
opposite can be harmful too.

10. Ethical Issues in Healthcare
 Malpractice and Negligence- Medical errors are
the third leading cause of death in the U.S.,
according to a study published in the BMJ
journal. Despite the decreasing rate of malpractice
suits, patients who are affected by it may never
recover. For others, it may take years.

11. Ethical Issues in Healthcare
 Physician-Assisted Suicide- Physician-assisted
suicide is the act of intentionally killing oneself with
the aid of someone who has the knowledge to do so.
In the most basic sense, the only person fully
qualified to participate in the process is a physician.
PAS is subject to criminalization by the state
only. According to federal law, legalizing PAS is a
matter of states’ rights.

12. Ethical Issues in Healthcare
 Informed Consent- The ethical code of health care
professionals states that patients have the right to
know the truth about their medical condition, and that
they can choose treatment options.
 Ethical and legal dilemmas arise when the health
care provider and the patient, or the patient’s family,
have differing opinions on appropriate care.
 A health care professional may be torn between the
ethics of beneficence (doing good) and autonomy
(respecting patient’s wishes). If resolution cannot be
reached, a judge may need to rule on the matter.

13. For Example
 A patient’s family asks the doctor not to tell their
elderly mother that her tumor is malignant.
 The doctor disagrees with the patient’s request to
forgo treatment.

14. Ethical Issues in Healthcare
 Professional Boundaries- Health care
professionals must maintain appropriate boundaries.
Patients are vulnerable, and that vulnerability needs
to be acknowledged and respected at all times.

15. For Example
 Successful treatment outcomes can give rise to deep
feelings of gratitude that may possibly mistaken for
physical attraction. Professional ethics and sexual
exploitation laws prohibit inappropriate involvement
with clients such as dating or accepting gifts that
exceed nominal value.

16.  Data Privacy- Protecting patient privacy is essential,
in accordance with the Health Insurance Portability
and Accountability Act. Health care professionals
must know and follow HIPPA laws, and cannot
disclose patient information.
 Legally and ethically, health care professionals
cannot violate patient trust, which is an essential
component of treatment.

17. For Example
 When a patient dies, privacy rights still apply.
Accidental or intentional disclosure of private patient
information can result in litigation, huge fines and jail
time for the violator.
 The medical secretary thinks she may have
mistakenly mailed Patient A’s medical records to
Patient B.

18.  Access to Care
 Access to care poses difficult ethical and legal
dilemmas for health care professionals, who sign an
oath not to harm their patient. Striking a balance
between quality care and efficiency can be
challenging. Health care professionals struggle to
help patients who lack the resources to cover the
treatment they need.

19. For Example
 Pressure from hospital administrations, insurance
companies and managed care organizations further
constrain the choices for treatment and
prescriptions. A malpractice suit is more likely to
happen if a patient claims that his condition was
misdiagnosed by a harried medical practitioner.

20.  Digital technologies are getting priorities in all areas
of the patient dealings, both within research area
and the clinical sectors, throughout healthcare
systems across the world

22.  Patients’ rights in digital
health care included patient security in digital
health care and freedom of informed choice in digital
health care.

23.  Patient security in digital health care was described
as patients being concerned about their
confidentiality in digital communication and their
privacy being a key element of trustworthy artificial
intelligence.
 Health care professionals should consider about
patient safety and should prevent any kind of
unintentional harm to them.

24.  Freedom of informed choice in digital health
care meant preservation of dignity
and support of human autonomy in digital health care
services.
 In case of video visit clinician need to trust on
patient’s judgment to avoid negative
disturbances. Valid informed consent, an
important value and part of ethics, should be
taken from the patient considering long time data use
and storing as well as technological and language
difficulties, because it plays an important role to find
out truthful information.

25.  Responsible behavior of health care professionals in digital
health care included Accountability in digital
health care, Transparency in digital health care, Relation of trust in
digital health care.
 Accountability is important in procedural value for digital health which
maintain trustworthiness of artificial intelligence. In case of video
visit sensibility of clinician is required to avoid negative disturbances.
 Human agency and oversight also have importance for
trustworthiness of artificial intelligence.
 Transparency in digital health care is another key element of
trustworthy artificial intelligence which has important procedural
value for digital health.
 Relation of trust in digital health care is important in between service
receiver and service provider to mitigate ethical risk. By working
together in relationships of trust patient safety can be maintain also.

26.  Governance of health care data includes Safe accessibility
of Digital health care data and Responsible Management of
health care data
 Most of the patients want to keep their data private and
confidential.
 Important value in digital health is safety of
information. So, data should be stored in a safe way to protect
from unauthorized access. Exploitation of data should be
prevented carefully.
 Responsible Management of health care data implies that
trustworthy artificial intelligence should be robust, lawful and
ethical, so governance to be considered in rollout of digital
access between patient and clinicians.
 Data should not be used without any purpose. Awareness of
data use and data ownership has important value in digital
health care.

27.  Equity in digital
heath care includes Individual equity in digital
health care and Societal equity in digital health care
 Individual Equity in digital health care means equity
in empowerment, access, exclusion, inclusion and
getting equal treatment in health care access.
 All kind of fairness and ethical issues to be
considered in rollout of digital access between
patient and clinicians.
 Societal equity in digital health care Non-
discrimination, non-stigmatization, environmental
and societal well-being are also the key element of
digital health care.

29. AI is going to be increasingly used in healthcare and
hence needs to be morally accountable.
Data bias needs to be avoided by using appropriate
algorithms based on un-biased real time data.
Diverse and inclusive programming groups and
frequent audits of the algorithm, including its
implementation in a system, need to be carried out.
While AI may not be able to completely replace clinical
judgment, it can help clinicians make better decisions.
Summary

30. Thank You