Medical Law and Ethics Lesson 4: Medical Ethics 3 Medical Law and Ethics Lesson 4: Medical Ethics

Lesson Objectives Lesson Objectives Upon completion of this lesson, students should be able to … Explain the importance of the Hippocratic Oath today. List the seven main points of the AMA Principles of Medical Ethics. List and discuss the main points of the AAMA Principles of Medical Ethics. Discuss what is meant by the medical assistant’s standard of care. 2

Lesson Objectives Lesson Objectives Upon completion of this lesson, students should be able to … Describe the Patient’s Bill of Rights. Explain the HIPAA guidelines concerning the patient’s right to privacy and confidentiality in the medical office. © 2009 Pearson Education 3

Critical Thinking Question What is the difference between ethics and laws? 4

Ethics Branch of philosophy related to morals or moral principles Involves: The examination of human character and conduct The distinction between right and wrong A person’s moral duty and obligation to the community 5

Medical Ethics Refers to the moral conduct of people in medical professions The members of the profession set principles and standards for themselves They willingly choose to follow through on these behaviors 6

Critical Thinking Question What do you think some of the behaviors are in the medical code of ethics? 7

Hippocratic Oath Earliest code of ethics to govern conduct in medicine Statement of principles written in 400 BC by a Green physician, Hippocrates Recited at medical school graduation ceremonies Notes the importance of the physician to teach others and the obligation to act in such a way as to never knowingly harm a patient or divulge a confidence 8

The Hippocratic Oath Click here or go to www.pbs.org to read the Classical Version or the Modern Version of the Hippocratic Oath 9

Critical Thinking Question How do these versions of the Hippocratic Oath differ? Should they differ? Why or Why not? 10

Characteristics of Ethical Standards Typically more severe than those standards required by law Often more demanding than the law A violation of an ethical standard could mean the loss of the physician’s reputation 11

Critical Thinking Question What if your personal ethics are different from medical ethics? 12

Ethical Behavior According to the American Medical Association (AMA) Moral principles or practices Customs of the medical profession Matters of medical policy Unethical behavior = any action that does not follow ethical standards 13

Critical Thinking Questions What is lost by violating a medical ethic? How can patients suffer? How can the medical profession suffer? How can the individual physician or health care worker who violates medical ethics suffer? 14

AMA Actions for Ethical Violations AMA takes violations very seriously! AMA may: Investigate the member in confidence Conduct an investigative hearing Reprimand or admonish the member Place the member on probation Suspend the member Expel the member AMA cannot take legal actions for ethical violations 15

State Medical Board Actions for Ethical Violations When an ethical complaint is made against a licensed physician to a state medical board, the board may: Limit the physician’s practice Warn the physician Revoke the physician’s license to practice medicine in the state If it is alleged that a physician has committed a criminal act, the medical society must report it to the state board. 16

Areas Covered in the AMA Principles of Medical Ethics Human dignity Honesty Responsibility to society Confidentiality Need for continued study Freedom of choice Responsibility of the physician to improve the community Read the AMA Principles in its entirety by clicking here or visiting www.ama-assn.org 17

Code of Ethics of the American Association of Medical Assistants Describes ethical and moral conduct for medical assistants Similar to the AMA’s Principles of Ethics 18

Pledge Made Under the AAMA Code of Ethics Render service with full respect for the dignity of humanity; Respect confidential information obtained through employment unless legally authorized or required by responsible performance of duty to divulge such information; Uphold the honor and high principles of the profession and accept its disciplines; 19

Pledge Made Under the AAMA Code of Ethics Seek to continually improve the knowledge and skills of medical assistants for the benefit of patients and professional colleagues; Participate in additional service activities aimed toward improving the health and well-being of the community. 20

Critical Thinking Question How do the AMA and the AAMA Code of Ethics compare? 21

Creed of the AAMA I believe in the principles and purposes of the profession of medical assisting. I endeavor to be more effective. I aspire to render greater service. I protect the confidence entrusted to me. I am dedicated to the care and well-being of all people. I am loyal to my employer. I am true to the ethics of my profession. I am strengthened by compassion, courage, and faith. 22

Ways to Follow the Creed Spend time reading about and discussing ethical problems Understand the ethical issues patients face Be committed to treating patients with respectful care regardless of the patient’s religious beliefs or cultural practices 23

Critical Thinking Question When might it be difficult to live up to this creed? 24

Medical Assistant’s Standard of Care Actions you make as a medical assistant can have legal consequences for the physician who employs you You are not held to the same standard of care as the physician because you have: Different credentials Different licensure Different education 25

Medical Assistant’s Standard of Care Since you carry out your duties under the supervision of the physician, you must use the same approved methods as the physician for tasks you do perform 26

As a Medical Assistant, You Are NOT Expected to…. Diagnose medical conditions Interpret results of tests Prescribe medications These responsibilities are within the physician’s standard of care. An MA must take caution to not do anything for which he or she is not trained and remain within the scope of his or her practice. 27

The Patient’s Bill of Rights Developed by the American Hospital Association Describes the patient-physician relationship MAs must also follow these guidelines when working with the physician’s patients Most medical offices have these printed for patients 28

The Patient’s Bill of Rights The patient has the right to considerate and respectful care. The patient has the right to and is encouraged to obtain from physicians and other direct caregivers relevant, current, understandable information concerning diagnosis, treatment, and prognosis. 29

The Patient’s Bill of Rights The patient has the right to make decisions about the plan of care prior to and during the course of treatment and to refuse a recommended treatment or plan of care to the extent permitted by law and hospital policy and to be informed of the consequences of this action. 30

The Patient’s Bill of Rights The patient has the right to have an advance directive (such as a living will, health care proxy, or durable power of attorney for health care) concerning treatment or designating a surrogate decision maker with the expectation that the hospital will honor the intent of that directive to the extent permitted by law and hospital policy. The patient has the right to every consideration of privacy. 31

The Patient’s Bill of Rights The patient has the right to expect that all communications and records pertaining to his or her care will be treated as confidential by the hospital, except in cases such as suspected abuse and public health hazards when reporting is permitted or required by law. The patient has the right to review the records pertaining to his or her medical care and to have the information explained or interpreted as necessary, except when restricted by law. 32

The Patient’s Bill of Rights The patient has the right to expect that, within its capacity and policies, a hospital will make reasonable responses to the request of a patient for appropriate and medically-indicated care and service. The patient has the right to ask and be informed of the existence of business relationships among the hospital, educational institutions, other health care providers, or payers that may influence the patient’s treatment or care. 33

The Patient’s Bill of Rights The patient has the right to consent to or decline to participate in proposed research studies or human experimentation affecting care and treatment or requiring direct patient involvement, and to have those studies fully explained prior to consent. The patient has the right to expect reasonable continuity of care when appropriate and to be informed by physicians and other caregivers of available and realistic patient care options when hospital care is no longer appropriate. 34

The Patient’s Bill of Rights The patient has the right to be informed of hospital policies and practices that relate to patient care, treatment, and responsibilities. 35

Patient Rights Specified by the Medical Patient’s Rights Act All patients have the right to have their personal privacy respected and their medical records handled with confidentiality. Information such as test results, patient histories, or that a person is even a patient cannot be told to another without permission. No information can be given over the phone without permission. No records can be given to another person or physician without permission. 36

HIPAA Health Insurance Portability and Accountability Act of 1996 Regulates the privacy of patient health information Was an effort to reduce the cost of health care and streamline the system 37

HIPAA Four objectives: Improve the portability of health insurance Combat fraud, abuse, and waste in health care Promote the expanded use of medical savings accounts Simplify the administration of health insurance Click here or visit www.hhs.gov/ocr/hipaa to explore the HIPAA Website. 38

Patient Rights Under HIPAA Right to a copy of the privacy notice from the health care provider Right to access their medical records, and the right to restrict access by others, request changes, and learn how their records have been accessed Right to ask the provider to limit the way in which health care information is shared and to keep disclosures to the minimum needed for treatment and business operations 39

Patient Rights Under HIPAA Right to ask for an accounting of to whom the health care information was given Right to examine and copy the health information the provider has recorded Right to complain to the covered entity and the Department of Health and Human Services if the patient believes there is a violation of his or her privacy 40

HIPAA Training All medical office employees must undergo HIPAA training during their orientation 41

HIPAA Requirements Patient information may not be shared with others without written authorization To watch a scenario on Protecting Patient Privacy, insert the DVD from the back of the textbook and select this video. 42

HIPAA Requirements Offices must make sure that computers with confidential patient information cannot be seen or accessed by individuals who are not authorized to see the information 43

HIPAA Requirements Faxes and e-mails that contain private patient information must have a note stating that the information is confidential. If accidentally transmitted to someone without clearance, the recipient must immediately notify the office and destroy the information. 44

Human Dignity Human dignity of each patient must be preserved regardless of the patient’s Socioeconomic background Race Age Nationality Sexual orientation Gender 45

Critical Thinking Questions Why is confidentiality important? Should friends or family have access to a patient’s medical information? Why or why not? What confidentiality challenges does communications technology bring? What challenges does telemedicine bring? 46

What Do You Do? When a physician performs a procedure that you strongly disagree with ethically (such as an abortion)? 47

Recommendations Discuss these types of issues during the interview If you find that you will be in an ethical dilemma, consider not taking the job If the situation arises after you are hired, discuss the situation immediately with your employer Remember – the health and safety of the patient is always the priority 48

What Do You Do? When one of your patients expresses an opinion or belief with which you strongly disagree? When a coworker expresses an opinion or belief with which you strongly disagree? 49

Medical Ethical Issues When should life support be withdrawn? When does a life begin? Should abortion be lawful? Should partial abortion be lawful? Is euthanasia ever permissible? 50

Medical Ethical Issues Should an unborn baby be sacrificed to save the mother? What are the ethical issues associated with artificial insemination? Should couples use fertility drugs to increase their chances of pregnancy? 51

Medical Ethical Issues Should eugenic sterilization be allowed? Should sterilization be allowed as a form of birth control? Should genetic testing and counseling be something that every couple or parent should undergo? 52

Medical Ethical Issues What are ethical considerations surrounding wrongful life issues? Should we be able to clone tissues, organs, or organisms? Where does one draw the line? Should human stem cells be used to treat certain diseases? Others? 53

Questions? 54