Chapter Ethical Considerations © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Ethics • Defined in terms of what is considered right or wrong Sometimes referred to as morals â 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Ethics • Professional organizations often identify their ethics in “codes” – Principles of Medical Ethics from American Medical Association (AMA) – Medical assistants have AAMA code of ethics and a creed – American Hospital Association (AHA) Hospital Patient Bill of Rights – More than 50 differing codes of ethics for professional organizations – Seven ethical codes that relate to the entire world © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Ethics • Principle-centered leadership – Guidelines to how you might perform ethically in medical setting – Adapted from Stephen R Covey’s The Habits of Highly Effective People and Principle-Centered Leadership © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Ethics • Five Ps of ethical power – – – – – Purpose Pride Patience Persistence Perspective • From The Power of Ethical Management by Kenneth Blanchard and Norman Vincent Peale © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Ethics • Ethics check questions – – – – Is it legal? Is it balanced? Is it the best approach for all concerned? How will it make me feel about myself? © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Keys to the AAMA Code of Ethics • Render service with full respect for the dignity of humanity • Respect confidential information • Uphold honor and high principles of the profession and accept its disciplines © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Keys to the AAMA Code of Ethics • Seek to improve knowledge and skills of medical assistants • Participate in additional service activities to improve health in community © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Ethical Guidelines for Health Care Providers • AMA’s Code of Medical Ethics • American Osteopathic Association Code of Ethics • American Chiropractic Association’s Code of Ethics © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Ethical Guidelines for Health Care Providers • Advertising – Legal and ethical for providers to advertise if claims made truthful and not misleading – May include credentials of providers, description of practice, services rendered, how fees determined – Managed care agencies may advertise services and participating providers © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Ethical Guidelines for Health Care Providers • Professional rights and responsibilities – Only providers should inform families of patient’s death – Should expose incompetent, corrupt, dishonest, and unethical conduct by other providers – May not treat patients if under influence of controlled substances or alcohol – Must take precautions if HIV positive – Must avoid “conflicts of interest” © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Ethical Guidelines for Health Care Providers • Disaster response and emergency preparedness – Care of sick and injured is primary concern – Providers should consider seeking training in emergency preparedness and disaster response © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Ethical Guidelines for Health Care Providers • Treatment for culturally diverse clientele – Same quality of care to all patients regardless of race or ethnicity – Eliminate biased behavior toward any individuals different from themselves – Encourage diversity when hiring © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Ethical Guidelines for Health Care Providers • Care of the poor – Should be regular part of every provider’s practice – Encouraged to take certain number of patients on reduced-cost basis or provide free services – Volunteer their time to lobbying and being advocates for those without medical coverage © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Ethical Guidelines for Health Care Providers • Abuse – Neglect, physical, emotional/psychological/mental injury, sexual – Child, elder, intimate partner violence (IPV) – All 50 states mandate reporting of child abuse – Most states have legislation regarding elder abuse – Reporting abuse of IPV varies by state • Stalking: reportable crime in some states Rape: reportable criminal act â 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Ethical Guidelines for Health Care Providers • Abuse – Protect and care for the abused – Treat abuser as victim also – Provide safe environment for abused seeking treatment – Seek treatment for abuser and abused © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Bioethics • Allocation of scarce medical resources – 2011: 59 million people without health insurance coverage – Health Care Reform Act of 2010 – Hispanic and non-Hispanic black children more likely to have no health care – Elderly have difficulty finding providers who take new Medicare patients – Macroallocation and microallocation © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Bioethics • Health care–right or privilege? – Examples • • • • Available kidney Next available pediatric appointment Artificial insemination Referral to a mental health specialist © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Bioethics • HIV and AIDS – Confidentiality must be safely guarded – Unethical to deny treatment to individuals because they test positive for HIV – If patient refuses to notify person at risk, authorities can be contacted © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Bioethics • Reproductive issues – Female genital mutilation – Contraception – Sterilization • Tubal ligation • Vasectomy – Assisted reproduction • Artificial insemination • In vitro fertilization Surrogacy â 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Bioethics • Abortion and fetal tissue research – Constant court challenge to validity of Roe v Wade – States’ restrictions vary, but abortion in first trimester is legal without interference – Health care professionals cannot be forced to perform or participate in abortions – Many unanswered ethical questions related to abortion © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Bioethics • Abortion and fetal tissue research – Use of fetal tissue to benefit patients with lifethreatening diseases – Some states ban research using aborted fetuses – Federal law prohibits sale of fetal tissue – Fetal tissue research is not to be used to encourage abortion – Stem cells in umbilical cord blood shown to be beneficial © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Bioethics • Genetic engineering/manipulation – Used in diagnosis of disease, production of medicines, forensic documentation, research – May be able to create custom-made organs to replace those that are defective or diseased – Where does cloning stop? © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Bioethics • Dying and death – Patients making more choices – Examples seen in Karen Ann Quinlan and Terri Schiavo cases – Physician-assisted suicide legislation in Oregon – Other states considering similar action – Quality-of-life issue © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Bioethics • Hospice – Make patients comfortable and as free from pain as possible and allow them dignity in their deaths – Death treated as natural end-of-life experience – Death neither hastened nor prevented – Often covered by insurance and less expensive than inpatient hospital care © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part ... organizations often identify their ethics in “codes” – Principles of Medical Ethics from American Medical Association (AMA) – Medical assistants have AAMA code of ethics and a creed – American... reduced-cost basis or provide free services – Volunteer their time to lobbying and being advocates for those without medical coverage © 2014 Cengage Learning All Rights Reserved May not be scanned,... – – – – – Purpose Pride Patience Persistence Perspective • From The Power of Ethical Management by Kenneth Blanchard and Norman Vincent Peale © 2014 Cengage Learning All Rights Reserved May not