ETHICS
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General principles of ethics
Morals are the values in one’s own heart.
Ethics are the external values that are expected by society.
Cardinal moral virtues
Prudence is being careful about what you're doing. For example you do not treat every patient
with the same diagnoses in the same manner.
Justice means to treat people fairly, treat the paying patient and non-paying patient in the same
manner, use the same standard of care for both.
Temperance -- practice with self discipline, exercise control. (When you have a new diagnostic
machine not everyone coming into your office means that particular test to help you pay for the
machine )
Fortitude - the virtue of having courage, treating a patient you really rather not treat, standing up
to the HMO, just doing the right thing. Start
There are other moral virtues, like compassion, kindness, honesty, forgiveness, truthfulness.
Ethical principles
1. Autonomy -- the patient gets to decide what happens, he has the right to decide treatment.
This is what drives informed consent.
2. Beneficience - to doing good for your patient. The doctor gets to see the good he does.
3. Non-malificience - " first to do no harm" - often times this is a balancing act.
4. Justice - again, this means, to treat people fairly and honestly.
Decision-making models
1. Utilitarianism – looks at the end result not the way you got there. The end justifies the means.
This can be dangerous (soldiers/radiation experiments)
2. Deontology - focus on the means not on the end results. There's a set of rules you need to
follow, no matter what the outcome. But: what are the rules? Rules are not 100 percent, there
are exceptions.
Focus on both the end in the means.
Codes of ethics
1. Purpose -- to give guidance, to tell us where the lines are. To set a standard. This protects
the patient and allows for better care. If we don't do it ourselves someone else will do it for us
(Medicare) . The public expects this.
2. Voluntary vs. mandatory -- ACA, statutes take priority.
3. Malpractice -- patient has to have been injured for malpractice to have occurred.
No injury = no compensation.
Ethics -- if you violate these rules, you can be disciplined. Good faith is not a defense.
ACA Code of Ethics - voluntary code
1. Responsibility to the patient
2. Responsibility to the public
3. Responsibility to the profession
ACA code is:
1. extremely vague
2. overemphasizes the business side
3. tends to be overly concerned with promoting the status of the profession
TEXAS Chiropractic Act is
1. extremely vague
Marie Paas
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Tri 1 Ethics
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2.
3.
4.
5.
6.
7.
8.
deception, fraud
grossly unprofessional conduct
can’t use the term “physician” other thatn for filing an insurance claim
sexual misconduct
need to tell the public in advertising that you are a DC not an MD
protects the insurance companies
frequency and duration of treatment ( supportive vs maintenance(=elective) )
Mercy Guidelines
1. specific
2. a lot of people didn’t like them because they thought the insurance companies would abuse
them
3. only a guideline, adherence is voluntary
4. Don’t use equipment as practice building tools
5. Be effective about hx taking, elicit additional info
6. Prevent profit motivated use
7. Document to think about things
Marie Paas
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Tri 1 Ethics
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