Ethics and Law/Technology H Edu 4790/6790

Technology - History Growth of 1950s Immunizations MRI … an example

Types of technology Definitive Halfway Deferral Competing Cost-saving

Effects of Technology Morbidity Mortality

Forces affecting Technology Education and practice Reimbursement The public Competition

Responses to Use of Technology Public sector activities –FDA –PSRO/PRO –CON Private sector –JCAHO –ISO 9000 –Tort law

Questions to ask

Managing Biomed Equipment Planning Service

Health Information Systems Process management Care management Demand management Health management

Philosophical Bases Respect for persons –Autonomy –Truth telling –Confidentiality –Fidelity Beneficence Nonmaleficence Justice

Views of Ethical Behavior Teleology – Utilitarian Deontology Individualism Moral-rights Justice

Ethical Dilemma A situation that although offering potential benefit or gain is also unethical.

Some theories… James Childress Nicholas Rescher

What is an ethical dilemma?

Ethical Problems Discrimination Sexual harassment Conflicts of Interest Customer confidence Organizational resources

Maintaining Ethics Mission, vision, values Patient’s Bill of Rights Codes of ethics Ethics committee Advance medical directives Training

Patient Bill of Rights Right to considerate and respectful care Right to information Make decisions Advance directives Privacy Confidentiality Review Records

University Hospital It is our goal to provide… Your help is needed to achieve these goals by…

Codes of Ethics AMA ANA

Advanced Medical Directives Personal Medical Decisions Medical Treatment Plan Living Will Special Power of Attorney

Public Health Policy Public versus private Authoritative Decisions

Forms of Health Policy Laws Rules/regulations Operational decisions Judicial decisions Macro policies

Categories Allocative (distributive) Regulatory Redistributive

Garbage Can Model Problems Policies Politics

Rulemaking Implementation Legislative to Executive Legal effect

Policy Outcomes Individuals Health-related organizations Interest groups

Contracts Offer and acceptance Consideration Legal capacity Lawful

Torts Civil wrong Results –Punitive –Actual Intentional torts –Types –Consent

Negligence Duty Breach of that duty Substantial factor in harm Injury

Agency/Corporate Liability Respondeat superior Corporate liability

Some specifics… Antitrust Emergency Medical Treatment ERISA Medicare and Medicaid Fraud Tax exempt status

Record Keeping!