ethics Medical Therapeutics Bioethics or biomedical ethics is a specialized branch of ethics that is concerned with human behavior within the context of modern medicine.

Bell Work Vocabulary: Look up definition and then define in own words: Ethics Morals Laws Nonmaleficence Beneficence Autonomy Distributive justice Paternalism Veracity Fidelity

Learning Objectives Standard 3: Analyze specific laws and ethical issues that impact professional practice such as confidentiality, informed consent, and patient self-determination. Citing specific textual evidence to support analysis, debate these issues in an oral or written format. At the conclusion of class today I CAN: Identify the structure of an ethical dilemma Define key terms related to bioethics and use them in context Describe the importance of understanding ethical issues in health care https://www.youtube.com/watch?v=2D-K2twZwr8

Ethics and Morals Morals—personal beliefs of right and wrong behavior based on religious beliefs, cultural norms, family customs, and past experiences Ethics—human behavior and its effect on society, more concerned with the big picture as well as the immediate situation Morals and ethics are terms that are sometimes used interchangeably because they are based on values regarding human conduct.

Laws and Ethics Laws can be made to designate actions that are right and wrong even though the same action may not be viewed as unethical Another action may be viewed by some as ethical but is considered illegal Although a behavior may be deemed unethical by some individuals, it is not necessarily illegal.

Susan is a respiratory therapist at a large hospital Susan is a respiratory therapist at a large hospital. It was discovered that Susan had an affair with the chief of staff at the hospital. She was later fired by the board of the hospital. Were Susan’s actions illegal or unethical? Illegal: go to the right side of the room by the window Unethical: go to the left side of the room by the door Both: go to the back of the room

Bioethics Specialized branch of ethics concerned with human behavior within the context of modern medicine Medical research develops new technology and advances at a rapid rate Human cloning, stem cell research, and euthanasia are examples The number and variety of situations that confront health care providers are many. Therefore, it is not possible to predict them or to explain what ought to be done in every case.

Ethical Principles Ethical rules regarding people’s behavior Ethical reasoning process Seem simple and straightforward, may be complicated Nonmaleficence Beneficence Autonomy Distributive justice Paternalism Veracity Fidelity Ethical principles are rules about how people ought to behave. An understanding of these principles is necessary to understand the ethical reasoning process.

Nonmaleficence Pertains to health-care workers “Do no harm” Hippocratic Oath, professional codes In medicine there is always a potential to do harm Nonmaleficence refers to the duty of health-care providers to “do no harm.”

Beneficence Health-care workers aim to provide benefit in addition to avoiding harm Medications are proven to be safe before they are released Medications and treatments should have a reasonable likelihood of being helpful Risks should be made known to patients Health care providers must aim to provide benefit for their clients in addition to avoiding doing harm.

Autonomy Right of patients for self-determination Freedom of choice Patient’s right to refuse or accept medical treatment Obtain informed consent before treatment or procedures https://www.youtube.com/watch?v=LSeiur_-0IU Autonomy is the patient’s right to freedom of choice.

Should minors be allowed to make their own medical decisions? Yes: go to the right side of the room by the window No: go to the left side of the room by the door

Distributive Justice Includes concept of fairness Fair allocation of scarce resources People waiting for transplant organs Who decides who receives the organ and who does not Distributive justice is founded on the concept of fairness. Such decisions must be made to maximize the good for the greatest number of people, while minimizing harm to all.

Paternalism “Father” role is taken on by health-care provider, judge, or other person or entity who makes the decision for a person based on his or her best interests Right to autonomy is denied Parent makes decisions for minor child Paternalism is when another person or health care provider makes decisions for the patient.

Veracity Duty to be honest Is there an appropriate time to withhold information from a patient? Is there such a thing as the acceptable “little white lie”? Veracity is the quality of truthfulness.

Fidelity The duty to keep reasonable promises and to meet obligations Clients have a right to expect health-care workers to keep their information private Reasonable expectations and unreasonable expectations Fidelity refers to faithfulness, the duty to keep reasonable promises and meet obligations.

Anatomy of an Ethical Dilemma A decision must be made The outcome will have profound consequences There is a disagreement among involved parties about right course of action What may seem to be an ethical dilemma is really just a situation in which miscommunication has occurred or inadequate information is available. Therefore, the first steps in addressing a potential ethical dilemma are to gather data and seek clarification of all relevant issues.

Ethical Decision Making Bias—response based on previous experience Uses ethical reasoning process Thoughtful decision making based on solid understanding of ethical principles and careful reasoning Ethical decision making may be difficult. How is a reasonable decision made? A person’s response must be based on thoughtful reflection, not on emotions and personal beliefs.

Ethics Committees Serve as resource to health-care organizations Formulate institutional policies Provide education for staff Serve as consultant role between patients and providers Ethics committees formulate institutional policies and provide education for health care staff and, possibly, community members.

Would you want to serve on an ethics committee? Yes: go the right side of the room by the window No: go to the left side of the room by the door

Health care Ethical Behavior Trust and loyalty Confidentiality Respect and dignity Commitment to professional development Medical assistants are obligated to behave professionally and ethically in the medical office. Medical assistants must act in a manner consistent with their own professional code of ethics and with the expectations of their employers.

Differentiate morals and ethics Differentiate unethical and illegal Discussion Differentiate morals and ethics Differentiate unethical and illegal Define bioethics and identify if you have been exposed to a situation when bioethics was an issue

Scenarios An adult Jehovah’s Witness patient because of acute massive bleeding which cannot be rapidly stopped requires life saving blood transfusion but is awake and refuses blood transfusions based on the patient’s religion. The patient is informed that with the transfusion, the patient will live and the underlying bleeding problem can be resolved with no long term medical consequences. Without the transfusion, the patient could most likely die. The patient still refuses but the physician, as the patient is beginning to lose consciousness, violates the patient’s autonomous demand and begins the blood transfusions. Is what the physician did ethical?

Scenario Brain surgery of lesions is often performed on conscious patients to establish safe dissection around motor and sensory areas. A patient with skull opened and brain exposed demanded the surgeon to stop the operation at once despite understanding the consequences of fully terminating the surgery at this point and leaving the skull open. Instead of stopping, the surgeon had the patient anesthetized to allow proper closure of the skull thus was violating the patient's demand. Is what the surgeon did ethical?