applied ethics
practical application of moral standards to the conduct of individuals involved in organizations
amoral
lacking or indifferent to moral standards
bioethicists
persons who specialize in the field of bioethics
bioethics
the moral dilemmas and issues of advanced medicine and medical research
comparable worth
theory that extends equal pay requirements to all persons doing equal work, aka pay equity
compassion
ability to have a gentle, caring attitude toward patients and fellow employees
cost/benefit analysis
an ethical approach in which the benefit of the decision should outweigh the costs; also called utilitarianism
due process
the entitlement of all employees to have certain procedures followed when they believe their rights are in jeopardy
duty-based ethics
focuses on performing one's duty to various people and institutions
empathy
the ability to understand the feelings of another person without actually experiencing the pain or distress that a person is going through
ethics
branch of philosophy relating to morals and moral principles
fidelity
loyalty and faithfulness to others
indigent
a person who is impoverished and without funds
integrity
the unwavering adherence to one's principles; dedication to maintaining high standards
justice-based ethics
based on the moral restraint of the veil of ignorance
laws
rules or actions prescribed by a governmental authority that have a binding legal force
litigious
excessively inclined to sue
medical ethics
moral conduct based on principles regulating the behavior of healthcare professionals
medical etiquette
standards of professional behavior that physicians use for conduct with other physicians
medical practice acts
laws established in all 50 states that define the practice of medicine as well as requirements and methods for licensure in a particular state
morality
the quality of being virtuous or practicing the right conduct
precedent
a ruling of an earlier case that is then applied to subsequent cases
principle of autonomy
the right to make decisions about one's own life
principle of beneficence
action of helping others and performing actions that result in the benefit to another person
principle of justice
warns us that equals must be treated equally
principle of nonmalfeasance
means, "first, do no harm
quality assurance
gathering and evaluating information about the services provided as well as the results achieved and comparing this information with an accepted standard
rights-based ethics
a natural rights ethical theory that places the primary emphasis on an individuals rights
sanctity of life
sacredness of human life; all human beings must be protected
sexual harassment
unwelcome sexual advances or requests for sexual favors
sympathy
pity for someone else
tolerance
a respect for those whose opinions, practices, race, religion, and nationality differ from our own
utilitarianism
an ethical theory based on the principle of the greatest good for the greatest number
virtue-based ethics
a character trait based on a concern for the person
to promote good patient care and protect patients from harm
what is the primary duty of healthcare workers?
it can help protect you and your employer from being sued;
helps the medical professional in making sound decisions based on reason and logic instead of emotion or gut feeling
why study medical ethics and law?
medical law
category of law the addresses legal rights that affect patients and protect individual rights, including those of healthcare employees
unethical
in general, an illegal act is always.......
no
is an unethical act always illegal?
defensive medicine
form of medicine where physicians may order unnecessary tests and procedures in order to protect themselves from a lawsuit
the law allows many actions that are morally offensive
what is the problem with measuring our actions only using the law and not considering the ethical aspects of an issue?
negative; positive
the requirements of the law tend to be .............; while the standards of morality are seen to be ......................
reactive
laws are often ...........and may lag behind the moral standard of society
reason; logic
ethics uses ........... and ........... to analyze problems and find soluctions
improving the welfare of people in a moral way
ethics is concerned with the actions and practices directed at what?
people
ethics always involves .......
the interests of others in deciding how to act or behave
ethics involves the formal consideration of .......
teological theory
ethical theory that asserts an action is right or wrong depending on whether it produces good or bad consequences
utilitarianism
example of a teological ethical theory
deontological theory
ethical theory that asserts that at least some actions are right or wrong and, thus, we have a duty to perform them or refrain from them
duty-based ethics
example of a deotonlogical ethical theory
utilitarianism
-rightness or wrongness of act is determined by its consequences
-the ends justify the means
-cost/benefit analysis justifies the means of achieving a goal
-some people will fall through the cracks
-can result in a biased allocation of resources, ignoring the rights of some vulnerable people
two problems with utilitarianism
-Medicare system
-organ distribution when there is a limited supply
examples of utilitarianism
rights-based ethics
-rights belong to all people purely by virture of them being human
-due process
protects the individual from injury (i.e. OSHA laws)
strength of rights-based ethics
incidents of individualistic selfish behavior that is independent of the outcomes (i.e. unions protecting other union members while excluding the rights of nonunion members)
weakness of rights-based ethics
duty-based ethics
-actions should be universal
-everyone should act the same way with the same set of circumstances
-conflicting opinions about what our duty or responsbility is in particular circumstances
-conflict when employers asks you to do something you feel is wrong or unethical
-people from different cultures may have a different sense of what duty means
problems with duty-based ethics
justice-based ethics
-based on the "veil of ignorance"
-no one person is advantaged or disadvantaged
-every citizen should have equal access to medical care
federal single-payer health system
veil of ignorance
all social contracts should be handled so that no one knows the gender, age, race, health, number of children, income, wealth, or any other arbitrary personal information about an individual
virtue based ethics
-emphasis is on persons and not necessarily the decisions or principles involved
-seek the "good life"
-Aristotle
-goal of life is happiness
-happiness is not solely on what we gain in life but also on who we are
-based on belief that we have a duty or re
-causes emotional or physical harm to someone else
-goes against one's deepest beliefs
-makes a person feel guilty or uncomfortable about a particular action
-breaks the law or traditions of their society
-violates the rights of another person
an action is considered wrong or unethical if it:
beneficance, fidelity, gentleness, humility, justice, perseverance, responsbility, sanctity of life, tolerance, and work
the 10 most respected virtues
beneficance
the action of helping others and performing actions that would result in benefit to another person
gentleness
a mild, tenderhearted approach to other people
humility
-acquiring an unpretentious and humble manner
-requires that we recognize our own limits
justice
-fairness in all our actions with other people
-same rules apply to everyone
perseverance
-persisting with a task or idea even agains obstacles
-steady determination to get the job done
responsbility
-a sense of accountability for one's actions
-implies dependability
work
an effort applied toward some end goal
respect, integrity, honesty, fairness, empathy, sympathy, compassion, loyalty
8 virtures of interpersonal ethics
respect
the ability to consider and honor another person's beliefs and opinions
honesty
quality of truthfulness, no matter what the situation
fairness
-treating everyone the same
-implies an unbiased impartiality and a sense of justice
loyalty
sense of faithfulness or commitment to other persons
privacy, due process, sexual harassment, and comparable worth
specific issues that affect the workplace
privacy
the ability to safeguard another person's confidences or information
both a legal and ethical issue
what kind of issue is violating patient confidentiality?
-protect's the worker's state certification, license, or registration to practice
-worker must receive notice of charges, an investigation of the allegations, and a hearing if necessary
why is due process importat for healthcare workers?
objective
what must the decision maker always be when making ethical decisions?
-three-step model
-seven-step decision model
-Bernard Lo clinical model
three decision-making models that can be helpful when making ethical decisions
Blanchard-Peale Model
alternative name for the three-step ethics model
-is it legal?
-is it balanced?
-how does it make me feel?
three steps in the three-step ethical model
-makes sure that there is not an imbalance so that one person or group suffers or benefits more than another as a result of your action
what is the purpose of step 2 (is it balanced?) in the 3-step ethical model?
a "yes" to questions 1 and 2 and a "good" to question 3
what answers in the 3-step ethical model indicate that the action is ethical?
analysis
the ability to carefully take apart issues, restate them in your own words, and offer an interpretation or criticism of them
1. determine the facts
2. define the precise ethical issue
3. identify the major principles, rules, and values
4. specify the alternatives
5. compare values and alternatives
6. assess the consequences
7. make a decision
what are the 7 steps in the 7-step ethical model?
- what do we need to know
- who is involved in the situation
-where does the ethical situation take place?
-when does it occur?
what questions need to be answered to determine the facts in the 7-step ethical model?
to determine if one principle or value is so compelling that the proper alternative is clear
why should we compare values and alternatives in the 7-step ethical model?
look at short-term, long-term, positive, and negative consequences of major alternatives
how are consequences assessed in the 7-step ethical model?
seven-step decision model
ethical model that forces us to closely examine the facts before making an ethical decision and has many sub-decision questions to answer
Bernard Lo clinical model
decision making model developed to ensure that no important considerations relating to patient care are overlooked
1. gather information
2. clarify the ethical issues
3. resolve the dilemma
what are the 3 steps of the Bernard Lo clinical model?
-meet with patient and healthcare team
-list alternatives of care
-negotiate a mutually acceptable decision
how is an ethical dilemma resolved in the Bernard Lo clinical model?
Bernard Lo clinical model
ethical model that is most widely used in a hospital or clinical setting
reason; fact
ethics must be grounded in ........... and ............
1. principle of autonomy
2. principle of beneficance
3. principle of nonmalfeascance
4. principle of justice
four principles that serve as guidelines when confronting bioethical dilemmas
principle of autonomy
informed consent"; patients must be informed and understand what they are told before they can provide consent for treatment
principle of beneficance
-we must not harm patients while trying to help them
-medical science must do what is best for each individual patient
principle of nonmalfeascance
-taken from the latin Primum non nocere
-not only do good for the patient, but do no harm in the process
"first, do no harm
principle of justice
-equals must be treated equally
-same treatments must be given to all patients no matter their demographics
when patients are unable to provide their personal wishes
when are the four bioethical guidelines most useful?
ethics committees
what do hospitals have to examine ethical issues relating to patient care?
-serve in an advisorry capacity to patients, family, and staff for case review of difficulty ethical issues
-develop and review health policies and guidelines regarding ethical issues
-determines recommendations based on predetermined criteria
what is the role of the ethics committee?
-patient complaints relating to confidentiality
-errors in dispensing medication
-errors in labeling of lab speciments
-adverse reactions to treatments or medications
-inability to obtain venous blood on the first attempt
-safety and monitoring practices
types of issues reviewed by a QA committee
-phone calls to fellow doctors will be taken promptly
-doctors wil be seen immediately when visiting another doctor's office
-physicians should be referred to as Doctor
examples of medical etiquette