1. Moral Beliefs Questions
Name the individual who has had the greatest influence on your understanding of right & wrong. Why?
What do you value most? Why?
What do you use as a benchmark for making moral decisions? Where did it come from?
Who is your personal hero? Why?
Who is your professional hero? Why?
State 3 qualities you consider important in order to maintain professional integrity and why.

2. Medical Ethics

3. Ethics
Ethics is a set of principles relating to what is morally right or wrong, providing guidelines for acceptable behavior.
Ethical decisions are based on moral values formed through influence of family, culture and society

4. ethics
The standards of behavior required by a health care provider to carry out their duties:
Confidentiality
Accuracy
Honesty
dependability

5. Ethics
Professional ethics should NOT differ from personal ethics

6. Ethics
Formalized codes of ethics: DO not deliver solutions, but act as a guide for ethical and moral conduct:
Govern behavior of health care members
Increases level of competence
Provides standards of care within the profession

7. Talking Points and Notes for Presenter
Hippocratic Oath
“I swear by Apollo the Physician…to keep according to my ability and judgment the following oath”
“I will prescribe regimen for the good of my patients according to my ability and my judgment and never do harm to anyone”
The Oath of Hippocrates of Kos, 5th Century BC
Talking Points and Notes for Presenter
The Hippocratic Oath established the Western paradigm of a profession as a “morally self-regulating” discipline. Authorship of the Oath is sometimes attributed to Hippocrates of Kos, but the document itself dates from anywhere between the fifth and third centuries BC.
The most substantive section of the Hippocratic Oath focuses on prohibiting certain conduct such as “prescribing a deadly drug” or giving “advice which may cause his death.” Thus, the medical profession is commonly considered by many to be guided by the Hippocratic maxim, “first do no harm” (which does not appear in the Oath itself but rather elsewhere in the Hippocratic corpus).
Reference:
1. Orr RD, Pang N, Pellegrino ED, Siegler M. Use of the Hippocratic oath: a review of twentieth century practices and a content analysis of oaths administered in medical schools in the US and Canada in J Clin Ethics. 1997;8:

8. Basic rules of ethics
Put saving of life and promotion of health above all else
Treat all patients equally
Maintain competent level of skill consistent with occupation
Maintain confidentiality and respect for privacy of others

9. Basic rules of ethics Refrain from immoral and illegal practices
Show loyalty to patients, co-workers, and employer
Be sincere, honest, and caring

10. The Final Chapter Why are advance directive important?
What is the #1 fear of dying patients?
What is their 2nd greatest fear?
Why is mercy killing so controversial?
What is an alternate to mercy killing?
Why is this alternative a viable option?

11. Right to Die Issue
Came about with ability to sustain life of terminally ill
Conflict occurs between ethical concerns of promotion of life & allowing pts to die

12. Laws Allowing “Right to Die”
Patient Self Determination Act of 1990:
Established advance directives
Living Will:
DNR (Do Not Resuscitate)
Durable power of Attorney
Supportive care
Providing oxygen
Food and fluids
Medication for pain, nausea, and other discomforts
Physical care and personal hygiene

13. Advanced Directives

14. Will
is a document that states who will get your money and property after you die.

15. Living Will
is a legal document stating a person’s wishes regarding life-prolonging medical treatments

16. Healthcare Power of Attorney
A document which allows you to appoint someone to make health care decisions for you if you’re incapacitated

17. Revocation of Power of Attorney
A document which allows you to revoke a power of attorney document

18. General Power of Attorney
Authorizes your Agent to act on your behalf in a variety of different situations.

19. “Durable”
A document which will remain in effect if you become mentally incompetent by adding the word “durable” to other documents.

20. Do not resuscitate (DNR)
A document filled out by the physician, patient, and family in cases where quality of life is severely decreased

21. Suicide Self-inflicted, self-intentional cessation of life Victims:
Adolescents: 3rd leading cause of death
White, male, >45, divorced, separated, or widowed
Causes:
Social isolation
Inability to cope
Fear
Illness/ mental status

22. Suicide Signals of possible suicide: Verbal statements “When I’m gone”
“I won’t be around then”
Personality changes
Deep depression
Apathy
Giving away personal possessions
Places to call for help
Telephone hot lines
Mental health associations, clinics
Counselors, Teachers ,Parents

23. Euthanasia Comes from Greek meaning “easy death”
Common term: mercy killing
Painlessly put to death pt who is terminally ill

24. Euthanasia Performed in 2 ways: Active euthanasia Passive euthanasia:
An intentional act designed to bring about death
When pt takes own life or assisted
Illegal
Example: lethal injection
Passive euthanasia:
Allows pt to control dying experience
Allowed by law through advance directives

25. Role of the Health Care Provider
First understand own personal feelings about death & come to terms with these feelings
Response should be consistent and guided by patient’s attitude and care plan
Should be open and responsive to patient’s attitude about terminal illness
Never try to force your own ideas about death on the patient

26. Hospice Care Philosophy
Hospice care is provided by teams who working with the terminally ill person and the family
The team:
Physician
Nurse
Nursing assistant
Social workers
Clergy

27. Hospice Care Philosophy
Goals of hospice care include:
Control of pain
Coordinate psychological, spiritual and social support service for the patient and family
Counseling for family for up to 1 year