Ethical Boundaries
and Practices
Ethical issues and their implications
in healthcare.
What is ethics?
• Principles of right and wrong.
• Who should practice ethical behavior?
• Is there such a thing as ethical behavior
among friends?
• When was the importance of ethics in
health care first recognized?
Hippocrates
• What do you know about Hippocrates?
– Greek
– Physician
– Lived 2500 years ago
– Wrote Hippocratic Oath, which is still
taken by physicians today.
Codes of Ethics
• Professional associations write codes of
ethics.
• Purpose: Set standards of professional
conduct that promote the welfare of
patients and assure high quality care.
• Is there a professional code of ethics
for your future health profession?
AAMA Code of Ethics
• Render service with full respect for the
dignity of humanity.
• Respect confidential information obtained
through employment.
• Uphold the honor and high principles of the
profession.
• Seek to continually improve the knowledge
and skills of medical assistants for the
benefit of patients and colleagues.
Ethics and the Law
• Laws are based on ethical principles.
• Most laws enforce ethical standards.
• Sometimes laws are in conflict with a
person’s ethical principles.
• Healthcare workers should act in the
best interest of patients and support
legal standards for patient care.
Ethics and the Law
• As a future healthcare professional, do
you think you will ever be put in a
position where your personal ethics are
in conflict with the requirements of your
profession? What will you do?
• As a healthcare professional, will you be
able to disengage your emotions when
dealing with ethical conflicts?
Guiding Principles
• Ethical principles for healthcare
workers and the corresponding laws
that were created to support them.
Guiding Principles
1) Preserve life
2) Do good
3) Respect
autonomy
4) Uphold
justice
5) Be honest
6) Be discreet
7) Keep
promises
8) Do no harm
Healthcare Ethics: Euthanasia
•
•
•
Results in death to alleviate
suffering or when there is no hope
for recovery.
Many healthcare professionals feel
euthanasia is contrary to their
professional ethics.
Regardless of their beliefs,
healthcare workers should follow
state laws.
Healthcare Ethics: Organ Transplants
•
•
•
Organ donations come at a time
of crisis when somebody dies.
Healthcare workers should ask
about donation.
Illegal to transplant organs
without patient or family
permission.
Healthcare Ethics: Conception
• IVF – In vitro fertilization
• Egg and sperm donation
• Surrogates
• Fertility drugs
• What are the ethical
considerations?
Should there be limits to IVF?
• Should obese people be
allowed to have IVF?
• Should a couple be
approved for IVF if they
both smoke?
• Should a single person
who is unemployed be a
candidate for IVF?
Codes of Conduct
• Ethical responsibilities include respecting
the cultural, social and ethnic differences of
patients and other healthcare workers.
• “Scope of practice” helps define the code of
conduct for healthcare workers.
• Performing skills outside the scope of
practice is illegal and unethical.
• Ethical codes of conduct are based on moral
standards and society’s expectations.
Ethical Dilemmas
• Advances in health care have created ethical
dilemmas for healthcare providers.
• There are no easy answers when addressing
ethical dilemmas.
• The question is –
what is the responsibility
of healthcare providers
when addressing ethical
dilemmas?
Ethical Dilemmas
• Should family members be allowed to
discontinue life support?
• Do parents have a religious right to refuse
life-saving blood transfusions for their child?
• Should people be allowed to sell organs for
use in transplant?
• Should human beings be cloned?
• What should be done with fertilized frozen
embryos when the parents no longer want
them?
Incident Reports
• To ensure prompt reporting and
documentation of all incidents resulting in
injury or having potential adverse affects to
patients, employees, or visitors.
• To accurately document threats or actions of
violence and environmental emergencies.
• To accurately document incidents of property
damage.
Incident Reports
• Follow your agency’s policies in filling out
and submitting incident reports.
• Focus on the facts.
• The purpose of the incident report is for legal
record keeping – NOT punishment.
• Can you think of examples of when an
incident report might be completed?
Electronic Incident Reports
Ethics Committee
• Most hospitals have ethics committees that
examine ethical issues related to patient
care.
• They can advise patients, families and
healthcare providers.
• A hospital ethics committee might decide
the best action to take for a terminally ill
patient on a respirator.
• An ethics committee might also be asked to
pass judgment on the actions of a
healthcare provider.
Professional Practice
1. Use the approved methods when
performing procedures.
2. Obtain proper authorization before
performing any procedure.
3. Identify the patient.
4. Observe all safety precautions.
Most codes of Ethics that govern the
behavior of healthcare Professional
are written by::
A.) Licensing Agencies
B.) State Boards of Health
C.) Professional Organizations
D.) Health Science Textbook companies
Hippocrates wrote standards for the
ethical behavior of physicians 2500
years ago in:
A.) Rome
B.) Florence
C.) Venice
D.) Greece
What statement about euthanasia
and healthcare professionals is
true?
A.) The decision to employ methods of euthanasia is exclusively
the physicians
B.) Most HCW feel that euthanasia is contrary to their
professional ethics
C.) HCW shoul always follow their ehtical beliefs, regardless of
what the physician orders or patient requests
D.) Euthanasia is always illegal and unethical
A grief stricken family in an ER have
just been notified of the death of their
child, who was hit by a car. What
should the physician ask regarding
organ transplantation?
A.) Do not ask as the family is grief stricken and cannot make an
informed decision
B.) Wait 5 or 6 hours until the family has had time to absorb their
loss, then ask about organ donation
C.) Immediately ask the family for permission to donate the
childs organs for transplantation
D.) Start the process of removing the organs, and hope that the
family will give permission when asked
A couple wishes to have their own
biological child, but the wife had a
hysterectomy for medical reasons when
she was 25. What option would give them
the best hope for having a child?
A.) Genetic counseling and fertility drugs
B.) Artificial insemination with sperm from a sperm bank
C.) Implantation of 5-10 frozen embroys
D.) IVF of their own eggs and sperm with implantation in a
surrogate
A nursing assistant refuses a request
by the charge nurse to take a pain pill
to a patient. The assistant believes
that giving the pain medication would
be a violation of his/her
A.) Scope of Practice
B.) Religious Beliefs
C.) Reasonable Accomodation
D.) Rights under OSHA rules
What MOST LIKELY would be the
task of a hospital ethics
committee?
A.) Approve discontinuatiuon of life support on a terminally ill
patient
B.) Allow the hiring of a physical therapist whose license has
been revoked
C.) Termination of an employee with excessive absences
D.) Discipline of a physician who is dating a laboratory technician
Which of the following is an ethical
dilemma that an ethics committee
would be asked to consider?
A.) Removing a terminally patient from a respirator
B.) Following through on a DNR request
C.) Transplanting an organ into a patient who is first on the
transplant list
D.) Patient who is opting for a less invasive treatment when an
invasive procedure is available
Dr. North went to a meeting with other physicians and
spoke about a patient he had, Mrs. Kennedy. He was
telling jokes about some odd complaints that she had
made. One of the physicians was a personal friend of
Mrs. Kennedy's, who informed her about what Dr. North
had said.
What ethical principle has Dr. North violated?
A.) Be honest
B.) Preserve Life
C.) Be discrete
D.) Unhold justice