1. Chapter 8 ETHICS Ethics has been defined in terms of what is considered right or wrong; also known as “morals” or “codes”.Ethics has been defined in terms of what is considered right or wrong; also known as “morals” or “codes”. Codes of ethics bring standards of moral and ethical behavior together in one place.Codes of ethics bring standards of moral and ethical behavior together in one place.

2. Principle-Centered Leadership Stephen R. Covey, author of The 7 Habits of Highly Effective People and Principle- Centered Leadership.Stephen R. Covey, author of The 7 Habits of Highly Effective People and Principle- Centered Leadership. Identified eight characteristics of leaders:Identified eight characteristics of leaders: 1.Are you continually learning? 2.Are you service-oriented? 3.Do you radiate positive energy? 4.Do you believe in other people

3. Principle-Centered Leadership Cont’d 5.Do you lead a balanced life? 6.Do you see life as an adventure? 7.Are you synergistic? 8.Do you exercise for self-renewal? The answers to these questions can give you insight into your ability to function ethically and be successful in the world of medicine.

4. Five Ps of Ethical Power 1.Purpose: Understand your objective or purpose. 2.Pride: Have pride in what you do. 3.Patience: Strive to believe that no matter what happens, everything will work itself out. 4.Persistence: Strive to act in an ethical manner at all times. 5.Perspective: Keep your life and purpose in perspective.

5. Ethics Check Questions 1.Is it legal? Is it against the law or any company policy? 2.Is it balanced? Is this the best possible approach for all concerned? Does it promote a win-win situation? 3.How will it make me feel about myself? Will I feel good if my decision is published in a newspaper? Will my family and coworkers be proud of my decision? NOTE: ethical means determining who you are and who you will act.

6. Bioethics Defined: brings the entire focus of ethics into the field of health care and into those ethical issues dealing with life.Defined: brings the entire focus of ethics into the field of health care and into those ethical issues dealing with life. Examples of bioethics:Examples of bioethics: –Scarce medical resources –Genetic engineering or manipulation –Abortion and fetal tissue research

7. Ethical Guidelines for Physicians AdvertisingAdvertising –not illegal or unethical as long as truthful and not misleading ConfidentialityConfidentiality –must not reveal confidential information about patients without their consent unless they are required to do so by law. –Patients need to feel comfortable and safe so they will reveal information about themselves that may be important to their health care

8. Medical Records The medical chart and the information in it are the property of the physician and the patient. The record is confidential.The medical chart and the information in it are the property of the physician and the patient. The record is confidential. –Do not reveal information without patient consent –records are property of physician and patient –physician should provide copy or summary if patient requests –cannot be withheld because of unpaid bill –transfer records to another physician if office closes

9. Professional Fees and Charges Illegal and excessive fees should not be chargedIllegal and excessive fees should not be charged fees should be based on customary to locale and should reflect difficulty of services and quality of performancefees should be based on customary to locale and should reflect difficulty of services and quality of performance may charge for completing complex insurance formsmay charge for completing complex insurance forms may charge for missed appointmentmay charge for missed appointment bill only treatments documented in patient’s chartbill only treatments documented in patient’s chart

10. Professional Rights and Responsibilities of a Physician may choose whom to servemay choose whom to serve may NOT refuse patient on basis of race, color, religion, national origin, or other illegal discriminationmay NOT refuse patient on basis of race, color, religion, national origin, or other illegal discrimination cannot deny treatment of an HIV patientcannot deny treatment of an HIV patient cannot neglect or refuse treatment of their patient’s unless withdraw from casecannot neglect or refuse treatment of their patient’s unless withdraw from case Financial interests are not to influenceFinancial interests are not to influence Avoid “conflict of interest”Avoid “conflict of interest”

11. Abuse Physicians and employees must: Report ALL cases of suspected child abuseReport ALL cases of suspected child abuse Protect and care for the abusedProtect and care for the abused Treat the abuser (if known) as a victimTreat the abuser (if known) as a victim

12. Bioethical Dilemmas Harder to define than are guidelines for ethics, because each of the bioethical issues calls on us to make decisions that directly affect a person’s life.Harder to define than are guidelines for ethics, because each of the bioethical issues calls on us to make decisions that directly affect a person’s life. In some instances, the bioethical issue requires a choice about who lives and requires a definition of the quality of life.In some instances, the bioethical issue requires a choice about who lives and requires a definition of the quality of life.

13. Allocation of Scarce Medical Resources Medical resources not available to everyoneMedical resources not available to everyone –Appointment selection being made on availability to pay –Patients turned away because they have no insurance or financial resources to pay –Decisions made by Congress, health systems agencies and insurance companies is called macroallocation –Decision made by physicians and members of health care team is called microallocation.

14. Abortion and Fetal Tissue Research Roe v. WadeRoe v. Wade –Continual challenge in the courts of its validity. –Law stipulates that a woman has a right to an abortion in the first trimester without interference from regulations in any state. –State restrictions vary in second and third trimester. –Health care professionals are not forced to perform abortions –Use of fetal tissue to benefit patient with various diseases and medical conditions.

15. Genetic Engineering Manipulation New discoveries are increasingly being seen.New discoveries are increasingly being seen. Biotechnology is being used in the diagnosis of disease, production of medicines, forensic documentation (DNA), and research.Biotechnology is being used in the diagnosis of disease, production of medicines, forensic documentation (DNA), and research. Continuous study may aid in the prevention or cure of various genetic disorders and major diseases.Continuous study may aid in the prevention or cure of various genetic disorders and major diseases.

16. Artificial Insemination Surrogacy Only way for some individuals to conceive a childOnly way for some individuals to conceive a child Recommends the signed consent of each party be obtainedRecommends the signed consent of each party be obtained Recommends that meticulous screening be performed prior to the inseminationRecommends that meticulous screening be performed prior to the insemination Surrogate (substitute) mothers and fathersSurrogate (substitute) mothers and fathers

17. Dying and Death Patients are making more choices regarding their health care and death.Patients are making more choices regarding their health care and death. Via a Living Will or Physician’s Directive, patients can mandate life support systems be removed.Via a Living Will or Physician’s Directive, patients can mandate life support systems be removed. Oregon is the only state to pass physician- assisted suicide.Oregon is the only state to pass physician- assisted suicide. What is “quality of life?”What is “quality of life?”

18. AIDS and HIV Confidentiality essential and must be protected as much as possibleConfidentiality essential and must be protected as much as possible Unethical to deny treatment to individuals with HIV or test positive for HIV.Unethical to deny treatment to individuals with HIV or test positive for HIV. Encourage HIV person to cease endangering othersEncourage HIV person to cease endangering others Physicians can notify authoritiesPhysicians can notify authorities Partner Notification Programs (anonymously notify the patient at risk, keeping source confidential)Partner Notification Programs (anonymously notify the patient at risk, keeping source confidential) Physician can notify person at riskPhysician can notify person at risk