ETHICAL ISSUES RELATED TO HEALTH PROMOTION JACEY SHECKLER, RDH, MS FALL 2017 Copyright © 2014 by Mosby, an imprint of Elsevier Inc. HEALTH PROMOTION AS A MORAL ENDEAVOR • WHEN WE PROVIDE SERVICE TO SOCIETY THROUGH HEALTHPROMOTION INTERVENTIONS, THEIR CARE FOR INDIVIDUALS CAN BE SEEN AS A MORAL ENDEAVOR. • IN ORDER TO SET HIGHER STANDARD OF HEALTH FOR ALL PEOPLE, THERE NEEDS TO BE A CHANGE IN OUR APPROACH TO UNDERSTANDING HEALTH AND THE DEVELOPMENT OF HEALTHPROMOTION ETHICS. Copyright © 2014 by Mosby, an imprint of Elsevier Inc. HEALTH CARE ETHICS • APPLIED ETHICS—USES MORAL PHILOSOPHY TO FORMULATE THEORIES GUIDING ACTIONS IN PRACTICE THAT MOST CONSISTENTLY RESULT IN GOOD ACTION OR AVOID HARMFUL ACTIONS • MORAL PHILOSOPHY—CONCERNED WITH WHAT IS RIGHT OR WRONG, GOOD OR BAD, IN HUMAN ACTION TOWARD OTHER HUMANS, ANIMALS, AND THE ENVIRONMENT Copyright © 2014 by Mosby, an imprint of Elsevier Inc. HEALTH PROFESSIONALS’ MORAL RESPONSIBILITIES • HEALTH PROFESSIONALS HAVE MORAL RESPONSIBILITIES TOWARD INDIVIDUALS AND SOCIETY WITH REGARD TO FACILITATING HEALTH AND WELL-BEING, OR THE RELIEF OF SUFFERING • PROFESSIONAL RESPONSIBILITIES/OBLIGATIONS ARE LAID OUT IN THE PROFESSION’S CODE OF ETHICS • DENTAL HYGIENE CODE OF ETHICS Copyright © 2014 by Mosby, an imprint of Elsevier Inc. APPLYING ETHICS TO PRACTICE • ETHICAL THEORIES CAN BE USEFUL IN HIGHLIGHTING SALIENT ASPECTS OF COMPLEX PROBLEMS, SERVING AS POTENTIAL TOOLS IN PROBLEM-SOLVING. • HOWEVER, ALL MORAL THEORIES HAVE FLAWS; IT IS NOT PRUDENT TO ADOPT ONE THEORY TO GUIDE ACTIONS IN EVERY SITUATION. • COMBINING PRINCIPLES DERIVED FROM A VARIETY OF ETHICAL THEORIES (A PHILOSOPHICAL FRAMEWORK FOR ACTION) WITH CONTEXTUAL CONSIDERATIONS INCREASES THE LIKELIHOOD OF EFFECTIVE/BENEFICIAL ACTIONS. Copyright © 2014 by Mosby, an imprint of Elsevier Inc. ETHICAL PROBLEM SOLVING • ISSUES—ETHICAL PROBLEMS IN WHICH A CHOICE MUST BE MADE • DILEMMAS—SITUATIONS IN WHICH A CHOICE MUST BE MADE BETWEEN TWO OR MORE EQUALLY UNDESIRABLE OPTIONS • TRUE DILEMMAS ARE RARE, BUT NEGLECTED ISSUES CAN BECOME DILEMMAS • PREVENTATIVE ETHICS- AIMS TO INTERRUPT POTENTIAL ETHICAL PROBLEMS BEFORE THEY DEVELOP Copyright © 2014 by Mosby, an imprint of Elsevier Inc. ETHICAL PRINCIPLES IN HEALTH PROMOTION • AUTONOMY • FREEDOM OF ACTION • SELFDETERMINATION • VERACITY • DEVOTION TO THE TRUTH • NONMALEFICENCE • NOT HARMING OTHERS Copyright © 2014 by Mosby, an imprint of Elsevier Inc. • BENEFICENCE • TO DO GOOD • CAN CONFLICT WITH AUTONOMY • JUSTICE • FAIRNESS INFORMED CONSENT • INFORMED CONSENT TO RESEARCH, TREATMENTS, OR HEALTHPROMOTION ENDEAVORS INVOLVES ENSURING THAT A PERSON HAS ALL OF THE INFORMATION NECESSARY TO COME TO A DECISION THAT FACILITATES AUTONOMOUS ACTION Copyright © 2014 by Mosby, an imprint of Elsevier Inc. CONFIDENTIALITY • CONFIDENTIALITY—PEOPLE HAVE THE RIGHT TO DECIDE WHO SHALL HAVE ACCESS TO INFORMATION ABOUT THEM, THUS LIMITING THE NEGATIVE USE OF PERSONAL INFORMATION BY OTHERS • HEALTH CARE PROFESSIONALS MUST STRIVE TO KEEP PATIENTS’ PERSONAL INFORMATION CONFIDENTIAL • DISCLOSE ONLY AS MUCH INFORMATION AS NECESSARY TO PERMIT OPTIMAL CARE AND ONLY INFORMATION THAT IS PERTINENT TO THE SITUATION • OVERRIDDEN ONLY IN SITUATIONS IN WHICH EXTREME HARM TO THE PATIENT OR OTHERS IS IMMINENT Copyright © 2014 by Mosby, an imprint of Elsevier Inc. THE PRIVACY RULE • DEVELOPED AS A RESULT OF THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) • ATTEMPTS TO ENSURE THAT INDIVIDUALS’ HEALTH INFORMATION IS PROPERLY PROTECTED, WHILE ALLOWING FLOW OF INFORMATION NEEDED TO PROVIDE HIGH-QUALITY CARE AND PROTECT PUBLIC HEALTH • ENSURES THAT PATIENTS ARE GIVEN A COPY OF THE PRIVACY PRACTICES AT A GIVEN INSTITUTION Copyright © 2014 by Mosby, an imprint of Elsevier Inc. CONFIDENTIALITY ISSUES WITH ADOLESCENTS • CONFIDENTIALITY ISSUES IN THE TASK OF FACILITATING ADOLESCENTS’ EMERGING AUTONOMY AND CONFIDENTIALITY NEEDS • HEALTH CARE PROFESSIONALS POTENTIALLY CAUGHT IN TENSION BETWEEN A TEENAGER WANTING TO ASSERT INDEPENDENCE AND PARENTAL FIGURE(S) WHO FEEL THEY HAVE A RIGHT TO INFORMATION • HANDLE SITUATION IN A MANNER THAT PRESERVES TRUST AND SUPPORT; IF NECESSARY, SOLICIT APPROPRIATE ADVICE FROM A PEER/RESOURCE Copyright © 2014 by Mosby, an imprint of Elsevier Inc. STRATEGIES FOR ETHICAL DECISION MAKING • IDENTIFY THE PROBLEM OR ISSUE • IDENTIFY THE LEVEL OF THE PROBLEM OR ISSUE • INDIVIDUAL, GROUP, SOCIAL • IDENTIFY THE ETHICAL PRINCIPLE(S) INVOLVED • IDENTIFY WHO/WHAT CREATED THE PROBLEM OR ISSUE • DETERMINE PREVALENT VALUES Copyright © 2014 by Mosby, an imprint of Elsevier Inc. STRATEGIES FOR ETHICAL DECISION MAKING (CONT.) • IDENTIFY INFORMATION GAPS • FORMULATE POSSIBLE COURSE OF ACTION AND PROBABLE CONSEQUENCES • INITIATE SELECTED COURSE OF ACTION AND EVALUATE THE OUTCOME • ENGAGE IN SELF- AND PEER-REFLECTION Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
