Ethics and Healthcare Policy I Week 1 Chapter 11 ETHICAL AND LEGAL CONSIDERATIONS Modified by K. Gourd-Ascencio LO 11.1 Ethics and Ethical Theories Ethics Standards of moral conduct in a society Ethical theories Deontology Utilitarianism Copyright © 2020 by Elsevier Inc. All rights reserved 2 Deontology Stresses the rightness or wrongness without concern for the consequences Foundational theory for Code of Ethics for Nurses Rigid adherence to rules Can be difficult to apply to complex or multicultural situations Utilitarianism Behaviors are right or wrong dependent on outcome or consequences Focus on the greater good social justice and resistant to rules Individual rights less important than the needs of society LO 11.2 Essential Principles of Ethics in Nursing Beneficence Nonmaleficence Respect for autonomy Veracity Justice Accountability Advocacy Confidentiality Fidelity Responsibility Copyright © 2020 by Elsevier Inc. All rights reserved 5 Ethical Principals Autonomy --The freedom to make decision for oneself Nonmaleficence -- No harm to be done, either deliberately or unintentionally Beneficence -- Good being done for the benefit of others Justice -- To treat every person equally Fidelity -- Fulfilling all commitments made to oneself and to others, loyalty Confidentiality -- Keeping anything regarding the care of patients in the strictest confidence Veracity -- Truthful Accountability -- Accepting responsibility for one’s actions Occur when a problem exists between ethical principles Ethical Dilemmas Deciding in favor of one principle usually violates another. Both sides have “goodness” and “badness” associated with them. LO 11.3 Codes of Ethics (1 of 2) Code of ethics Historical background Defines the values, morals, and standards guiding practice in a specific discipline or profession Nightingale Pledge Code of ethics for nurses Code of Ethics for Nurses with Interpretive Statements (2015) https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/codeof-ethics-for-nurses/coe-view-only/ Copyright © 2020 by Elsevier Inc. All rights reserved 8 9 LO 11.3 Codes of Ethics (2 of 2) Responsibility of nurse educators Responsibility of student nurses Professional ethical standards in the academic setting Copyright © 2020 by Elsevier Inc. All rights reserved 10 Quick Quiz! (1 of 2) Copyright © 2020 by Elsevier Inc. All rights reserved Your patient is about to undergo a controversial orthopedic procedure. The procedure may cause periods of pain. Although nurses agree to do no harm, this procedure may be the patient’s only treatment choice. This example describes the ethical principle of: Autonomy. Fidelity. Justice. Nonmaleficence. 11 Quick Quiz! (2 of 2) Copyright © 2020 by Elsevier Inc. All rights reserved Answer: D. Nonmaleficence. LO 11.4 Bioethics Challenges in Health Care (1 of 2) Bioethics Study of ethical and philosophical issues in biology and medicine Bioethical issues Genetic testing Cloning and embryonic stem cell research End-of-life care Resource access and allocation Copyright © 2020 by Elsevier Inc. All rights reserved 12 13 LO 11.4 Bioethics Challenges in Health Care (2 of 2) Ethical decision makers Ethics committees Copyright © 2020 by Elsevier Inc. All rights reserved HIPAA Health insurance portability and accountability act 1996 Law to protect health care information Limits access to PHI to those who need it to properly care for patients The Privacy Rule: Limits disclosure of patient health care information to the patient and only those people and health care agencies to which the patient has granted specific permission Electronic transmission Nurses need to be more careful when transmitting information HIPAA Protected Information Any information that could be used to identify an individual Verbal and written communications Medical History Address, DOB, Name, SSN, MRN Medical images Doctors’ and nurses’ notes Test results HIPAA Permitted Disclosures • To the individual • Treatment, payment, and healthcare operations • Uses and disclosures with opportunity to agree or object by asking the individual or giving opportunity to agree or object • Incident to an otherwise permitted use and disclosure • Public interest and benefit activities (e.g., public health activities, victims of abuse or neglect, decedents, research, law enforcement purposes, serious threat to health and safety) • Limited dataset for the purposes of research, public health, or healthcare operations HIPAA Client Rights Have the right to a copy of their PHI Have the right to request to change incorrect information Have the right to know who has accessed their PHI
