1. Ethics in HealthCare

2. Treating Patients With Dignity Sometimes health professionals get so wrapped up in the scientific principles of healthcare that they forget they are dealing with human beings. Human beings that may be in pain, frightened or upset. Sometimes health professionals get so wrapped up in the scientific principles of healthcare that they forget they are dealing with human beings. Human beings that may be in pain, frightened or upset.

3. The Inequality of Power Healthcare professionals exercise a great deal of power over patients. It is important to make sure that this power is never abused.Healthcare professionals exercise a great deal of power over patients. It is important to make sure that this power is never abused. In an attempt to protect patients, many hospitals have implemented a patient’s bill of rights.In an attempt to protect patients, many hospitals have implemented a patient’s bill of rights. Healthcare professionals exercise a great deal of power over patients. It is important to make sure that this power is never abused.Healthcare professionals exercise a great deal of power over patients. It is important to make sure that this power is never abused. In an attempt to protect patients, many hospitals have implemented a patient’s bill of rights.In an attempt to protect patients, many hospitals have implemented a patient’s bill of rights.

4. Patients Bill of rights include: The right to know the professional status of all people providing care To know the name of their attending doctor To receive complete information on their diagnosis and treatment To be given the prognosis for their illness To review all information in their medical record To have every procedure, treatment or drug therapy explained to them in language they understand The right to know the professional status of all people providing care To know the name of their attending doctor To receive complete information on their diagnosis and treatment To be given the prognosis for their illness To review all information in their medical record To have every procedure, treatment or drug therapy explained to them in language they understand

5. Bill of Rights Cont… To know the possible risks, benefits, and costs of every procedure, treatment or drug therapy To accept or refuse treatment To prepare in advance treatment directives and to expect that these will be honored To appoint a person to make decisions about their care, if they become mentally disabled To know the possible risks, benefits, and costs of every procedure, treatment or drug therapy To accept or refuse treatment To prepare in advance treatment directives and to expect that these will be honored To appoint a person to make decisions about their care, if they become mentally disabled

6. Cont… To have personal privacy To receive compassionate care and proper management of pain To seek a second opinion To ask that the hospital ethics committee review their case To have personal privacy To receive compassionate care and proper management of pain To seek a second opinion To ask that the hospital ethics committee review their case

7. Ethics is: The study of ‘right’ and ‘wrong’ A branch of human thought concerned with how human beings treat each other The study of ‘right’ and ‘wrong’ A branch of human thought concerned with how human beings treat each other

8. Other Definitions Morals—personal standards of right and wrong Laws—rules that enforce behavior * Just because something is legal does not necessarily mean it is moral. Morals—personal standards of right and wrong Laws—rules that enforce behavior * Just because something is legal does not necessarily mean it is moral.

9. Relationship between Morals, Values and Ethics Ethical Principles of Analysis Cultural & Religious Traditions Social & Economic Situations Personal Value Judgments Moral Standards Moral Dilemmas Benefit to Some

10. Throughout history, philosophers have developed many models to guide people in ethical decision making. Hippocrates Plato Socrates

11. Some of these Models for Ethical Decision Making are Fairly Complex Theoretical perspective Relativism Utilitarian Subjectivism Egoism Golden Rule Theoretical perspective Relativism Utilitarian Subjectivism Egoism Golden Rule Universal Rule Economic efficiency Government requirement Personal values Distributive Justice Stakeholder

12. Two schools of ethical thought Deontological School Teleological School Deontological School Teleological School

13. Deontological School The Greek word ‘Deon’ means ‘duty.’ This school studies moral obligations. Followers believe in the existence of good and evil and believe that people have an obligation to do good for other people. The Greek word ‘Deon’ means ‘duty.’ This school studies moral obligations. Followers believe in the existence of good and evil and believe that people have an obligation to do good for other people.

14. Teleological School The Greek word ‘Telos’ means ‘end.’ The branch of ethics dealing with right action and the nature of duty, without regard to the goodness or value of motives or the desirability of the ends of any act. In other words: This school believes that the end is all that matters, that “the end justifies the means.” The Greek word ‘Telos’ means ‘end.’ The branch of ethics dealing with right action and the nature of duty, without regard to the goodness or value of motives or the desirability of the ends of any act. In other words: This school believes that the end is all that matters, that “the end justifies the means.”

15. Bioethics... Came into existence as a discipline in about 1970. –During this period science shifted from focusing solely on science and treatment to focusing on the patient as a human being. Came into existence as a discipline in about 1970. –During this period science shifted from focusing solely on science and treatment to focusing on the patient as a human being.

16. What caused bioethics to become so important? New technologies that necessitated a new definition of the term “death” Revelations of abuses in the use of human subjects in medical research New technologies that necessitated a new definition of the term “death” Revelations of abuses in the use of human subjects in medical research

17. Euthanasia Abortion In vitro fertilization Organ transplants Genetic engineering Euthanasia Abortion In vitro fertilization Organ transplants Genetic engineering What caused bioethics to become so important?

18. Increasing healthcare costs necessitating a rethinking of the allocation of healthcare resources What caused bioethics to become so important?

19. How does all of this apply to me? Many students upon graduating are surprised to find that there is a great deal of ambiguity in the real world. SometimesSometimes there are no clear cut answers. Many students upon graduating are surprised to find that there is a great deal of ambiguity in the real world. SometimesSometimes there are no clear cut answers.

20. How does all of this apply to me? Healthcare personnel often find their decisions clouded by dilemmas, paradoxes ( A seemingly contradictory statement that may nonetheless be true ), inconsistencies, and with differing expectations.

21. Applying the Model to Case Studies

22. Case Studies One way to teach health ethics is through case studies. Case studies allow the discussion of real-world situations absent the stress and politics that unjustifiably influence ethical decisions. One way to teach health ethics is through case studies. Case studies allow the discussion of real-world situations absent the stress and politics that unjustifiably influence ethical decisions.

23. Framework Since many ethical problems involve ambiguity (uncertainty as regarding to interpretation), it is good to have a framework to provide structure in analyzing these situations.

24. The model in Healthcare is based on the following principles: Free agency Equality Kindness Obligation to do good for others Obligation to do no harm Honesty Legality Free agency Equality Kindness Obligation to do good for others Obligation to do no harm Honesty Legality

25. Free Agency A patient has the right to make decisions about his or her own body without outside control.

26. Equality The healthcare system has an obligation to treat all patients fairly.

27. Kindness A patient has a right to expect that a healthcare worker will be merciful, kind and charitable.

28. Obligation to do Good for Others Healthcare workers are obligated to take the action that will result in the best outcome for the patient.

29. Obligation to do no Harm The first obligation of the healthcare practitioner is to avoid injury to his or her patient.

30. Honesty A healthcare worker should be honest.

31. In-class Assignment Break into groups of four to five students. Read the Nightingale Pledge and the Hippocratic Oath Analyze their meaning Break into groups of four to five students. Read the Nightingale Pledge and the Hippocratic Oath Analyze their meaning

32. The End!