Legal Aspects of Health Information and Health Care Statistics Week 1 Robyn Korn, MBA, RHIA, CPHQ

General Information Discussion Board Enter first post by Saturday and a total of 3 posts by Tuesday Assignments Make sure your name is on the assignment attachments when they are submitted

General Information Late work will not be accepted unless there are clear and compelling extenuating circumstances. If you have extenuating circumstances that prevent you from completing course assignments/exams you must contact your instructor immediately—prior to the assignment/exam/quiz due-date unless prevented from doing so by emergency circumstances.

Ethical Standards Key Terms Ethics - the formal study of moral choices that conform to standards of conduct Morals - the principles or fundamental standards of right conduct that an individual internalizes. Values - concepts that give meaning to an individual’s life and serve as the framework for decision making Code of Ethics - written lists of a profession’s values and standards of conduct.

Ethical Standards Eugenics - efforts to improve the human species through control of hereditary factors in mating. Human Genome Project - designed to map the genes found in the human DNA and determine the sequences of the chemical base pairs that make up human DNA. Etiquette – the principles of how human beings relate to one another under certain circumstances Law – A body of rules of action or conduct prescribed by a controlling authority that has a binding legal force

Ethical Models Ethics - based on philosophy Morals - based on traditional religious beliefs and personal choices Etiquette - based on society Law - based on controlling authority Values - based on society, religion and family

Ethical Concepts Autonomy Ability to Decide Power to Actualize or implement a decision Respect for the Autonomy of others Example: Informed Consent

Ethical Concepts Beneficence Qualities of kindness, goodness and mercy Obligation to do good in all circumstances Example – Hippocratic Oath

Ethical Concepts Nonmaleficence Prohibition against doing harm Obligation to prevent evil or harm Example – Hippocratic Oath

Ethical Concepts Double-effect principle – recognizes that ethical choices may result in untoward outcomes. Examples – nosocomial infections or adverse drug reactions

Ethical Concepts Best Interest Standard Determining what is in the best interest of the patient when they are unable to make the decision alone Decision making is usually determined by patient competency Evidence of patient’s wishes are used (living will, power of attorney, etc)

Ethical Concepts Fidelity Faithfulness, loyalty and devotion to obligations or duties Example – Physician explaining a new diagnosis to a patient

Ethical Concepts Justice To be fair to all people Includes fairness, honesty, and impartiality Comparative Justice – balancing competing interests against one another (no independent standard) Distributive Justice – fair distribution of benefits (an independent standard)

Ethical Concepts Criteria When Resources are Limited 1. Need – required not elective procedures 2. Equity – trying to provide to all who need 3. Contribution – future contributions to society 4. Ability to pay 5. Effort – willingness to comply with instructions 6. Merit – potential for benefit after initial investment

Ethical Concepts Rights Just claim or entitlement Derived from the concept of justice Rights vary according to moral values of a given culture

Ethical Concepts Patient Rights – Confidentiality – obligation of the provider to maintain information in a confidential manner – Privacy – right to be left alone or control personal information

Ethical Concepts Veracity Habitual truthfulness and honesty Special relationship between the patient and health-care provider Example – human research

Ethical Theories Principles used to deal with ethical dilemmas Utilitarianism – promote good over harm – Cost benefit analysis Deontology – duty orientation (follow the letter of the law and not the spirit) – Human research

Ethical Decision Making Code of Ethics – professions values and standards Ethic Committees Patient Rights – PDSA – advance directives – HIPAA – rights granted to patients – ARRA – rights regarding electronic PHI

Ethical Decision Making 1. Define the issue 2. Get the facts 3. Know who is involved 4. Evaluate options 5. Make decision and implement 6. Evaluate outcome 7. Process to prevent again

Ethical Challenges Conflict of Interest – Potential and actual Impaired colleagues Disparagement – Criticize skills, knowledge or qualifications

Ethics In Supervision Role model Encourage ethical behavior Monitor employee conduct

Health Information Challenges Coding – Reimbursement Information Security Data Resource Management Protection of Sensitive Information

Bioethic Issues Ethical issues related to advancements in technology and science, especially biology and medicine

Beginning of Life Issues Family Planning – Contraception – Adoption/Infertility treatment Abortion Perinatal ethics – Testing, screening, surgery Eugenics

Quality of Life HIV/AIDS – Treatment/confidentiality Organ Transplants – Travel medicine/xenografts Genetic Science – GINA confidentiality of genetic information – Gene therapy/stem cell research

Death and Dying Planning for end of life – Advance directives, living will, power of attorney Euthanasia – Passive and active Withdrawing/Withholding treatment

Access by the Researcher Ethical Approach – Declaration of Helsinki – National Research Act – Belmont Report Respect for persons Beneficence Justice

Access by the Researcher Regulatory Approach – Institutional Review Board (IRB) HIPAA – data collection and usage GINA – informed consents

Questions