Educate the Educator
Healthcare Ethics
Healthcare Ethics Module Description
• This module emphasizes the use of sound ethical practices in healthcare.
• Ethical practices and standards include the care of clients/individuals and
interactions with peers, colleagues, team members, and family members.
• Ethical frameworks are provided for discussion on understanding the types of
ethical challenges in healthcare and the difficult decisions that need to be made.
General Teaching Notes
The curriculum for this module is broken into 2 parts, Values and Ethics.
It is important to discuss with students the definition and development of values and
their own personal values.
General Teaching Notes
The following statements can help distinguish the difference between values and
ethics and provide guidance throughout the module.
• All human interactions are value-based, guide our behavior, and tell us right
from wrong.
• Values are essential to ethics. Ethics are concerned with human actions, and
the choice of those actions.
• Ethics evaluates those actions, and the values which created them. It
determines which values should be pursued, and which shouldn't.
• Ethics is a code of values.
Module Outline and Instructor Resources
This module consists of 5 competencies.
Each competency is divided into unit competencies with learning activities to help
students master the competency.
Each learning activity is explained on the Module Outline and the resources are
described
Choose the learning activities that best meet your classroom needs.
Module Outline and Instructor Resources
Find these learning activities and resources on the website or create your own.
The Course Outline also has documents that the instructor can use in teaching the
lesson.
These competencies are listed on the following slide and will then be addressed
throughout the remainder of the power point.
Module Competencies
1. Describe dimensions of values as they impact healthcare.
2. Describe basic principles of professional relationships.
3. Describe aspects of ethical decision making in health care.
4. Explain how an individual’s diversity, socioeconomic or religious beliefs could lead
to potential ethical differences from other health care employees.
5. Using an ethical decision making model applied to healthcare situations, describe
how ethics influence the care of clients.
Competency 3
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Competency 3
Describe aspects of ethical decision making in health care.
Units in this competency include:
• Define ethics.
• Define the code of ethics.
• Explain the purpose of a code of ethics.
• Identify steps/framework for ethical decision making.
• Discuss the difference between legal guidelines and ethical decision-making.
Definition of Ethics
Recommended Content
The module introduces the student to ethics, this can provide for some lively
discussions.
The term ethics has several meanings in common use:
• A method of inquiry that helps people to understand the morality of human behavior
(study of morality)
• The practices or beliefs of a certain group (medical ethics, nursing ethics)
• The expected standards of moral behavior of a particular group as described in the
group’s formal code of professional ethics.
Ethics: The study of conduct and character; concerned with determining what is good
or valuable for individuals, for groups of individuals, professions, and for societies.
Potter, P.A. & Perry, A.G. (2009); Ramon, P.R. & Niedringhaus, D. M. (2008)
Code of Ethics
Code of Ethics: a set of guiding principles that all members of a profession accept;
a collective statement about the group’s expectations and standards of behavior,
reflects the group’s moral judgments over time, and works as a standard for their
professional actions.
Codes of Ethics serve as guidelines to assist professional groups when questions
arise about correct practice or behavior.
Potter, P.A. & Perry, A.G. (2009)
Code of Ethics
Ethical behavior of the healthcare worker/nursing assistant includes
responsibilities to other caregivers that they work with, as well as ultimately
reflecting the care being given. So the patient is a direct recipient of the
caregiver’s Code of Ethics.
Many students seem to be unaware of what a ‘Code of Ethics’ is. When asked if
their place of employment has a ‘Code of Ethics’ and what is it, they typically will
stare straight ahead.
Code of Ethics
Ethical behavior of the healthcare worker/nursing assistant also includes
responsibilities to the employer.
Some of these behaviors are:
• Reporting to work on time
• Reliably fulfilling assignments
• Notifying supervisor when ill
• Working as a team member
• Doing one’s job to the best of his/her ability according to JOB DESCRIPTION
• Conserving supplies/equipment
Code of Ethics
Establishment of Code of Ethics
International, national, state, and provincial nursing associations have established
codes of ethics.
The American Nurses Association (ANA) established the first code of nursing ethics
decades ago and reviews and revises the code regularly to reflect changes in
practice.
Basic principles remain constant and are responsibility, confidentiality,
accountability, advocacy.
Code of Ethics
Origins of Ethical Problems in Healthcare
Ethical problems in healthcare are due to social and technological changes and healthcare
workers’ conflicting loyalties and obligations.
Social Changes: Women’s movement, growing consumerism, large number of uninsured , high
cost of health care, and workplace redesign under managed care—raise issues about fairness
and allocation of resources (justice).
Technology: monitors, ventilators, parenteral feedings, growth of premature infants, prolonging
biological life
Some questions to ask students might be: who should be treated—everyone, only if they can pay,
only those who have a chance to improve?
Ramon, P.R. & Niedringhaus, D. M. (2008)
Purpose of a Code of Ethics
Purposes of a Code of Ethics:
• Inform the public about the minimum standards of the profession and help them
understand professional healthcare/nursing conduct.
• Provide a sign of the profession’s commitment to the public it serves.
• Outline the major ethical considerations of the profession.
• Provide general guidelines for professional behavior.
• Guide the profession in self-regulation.
• Remind healthcare workers of the special responsibility they assume when caring
for the sick.
Ramon, P.R. & Niedringhaus, D. M. (2008)
Code of Ethics
Recommended Learning Activities
Assignment
Resources
Notes
Compare sample
Codes of Ethics from
various health
professions
Two samples of codes
of ethics available in
Module Outline and
Instructor Resources
Students to research Code of Ethics from a healthcare
profession that they are interested in.
Code of Ethics
Students create their own Code of Ethics for a profession
that interests them
Guiding Principles
Recommended Content
The module addresses 8 guiding principles of ethics and asks the student to identify
them.
These guiding principles are:
•
•
•
•
Preserve life
Do good (beneficence)
Respect autonomy
Uphold justice
•
•
•
•
Be honest (veracity)
Be discreet (confidentiality)
Keep promises (fidelity)
Do no harm (no maleficence)
Guiding Principles
Recommended Learning Activities
Assignment
Location
Notes
Review vocabulary list
On website and in Module Outline
Class Discussion
and Instructor Resources Document
Review Oregon’s ‘Death with
Dignity Act’
Death with Dignity Act
Class Discussion
Framework for Ethical Decision-making
Recommended Content
This unit helps students to understand a rational and systematic method to make
decisions. The key is to identify the ethical principles and code to be used, rather
than emotion.
On the following slide, let’s take a brief look at ethical theory, ethical dilemmas and
ethical decision-making.
Framework for Ethical Decision-making
Ethical theory examines the different philosophies, systems, ideas, and principles used to
make judgments about what is right and wrong and good and bad. For example:
• A person who believes that life is sacred may not be able to sanction the removal of life
support services on a client with a severe head injury.
• A person who believes that life begins as conception may not support the use of birth
control methods that prevent implantation (intrauterine devices, morning after pill).
Ethical dilemmas occur when the choice available include only undesirable alternatives.
Ethical decision-making is the use of a systematic approach that enhances decisionmaking and subsequent satisfaction with the decision.
Framework for Ethical Decision-making
Three characteristics of an ethical problem:
The existence of a conflict of values
Obligations, loyalties, interests, or
Needs in a patient care situation, such as:
• Disagreement about treatment between health professionals and patients or health
care team members and patients’ families
• Ethical principles or values are at stake, such as respect for patient autonomy, doing
the least harm, or the values of caring and patient advocacy; and the situation involves
the feelings and values of all key persons involved in the situation.
Framework for Ethical Decision-making
Following are 10 steps to follow when making an ethical decision:
1. Review the overall situation to identify what is going on.
2. Identify significant facts about the client, including the medical, social history,
decision-making capacity, existence of an advance directive for treatment.
3. Identify the parties or stakeholders involved in the situation or affected by the
decision(s) that is made.
4. Identify relevant legal data
5. Identify specific conflicts of ethical principles or values
Framework for Ethical Decision-making
6.
Identify possible choices, their intent, and probable consequences to the welfare of the
client/clients as the primary concern.
7. Identify practical constraints, i.e., legal, organizational, political, economic.
8. Make recommendations for action that are determined to be ethically supportable,
recognizing that the possible choices often have positive and negative aspects.
9. Take action if your are the decision-maker and implementer of the decision(s) made.
10. Review and evaluate the situation after action is taken, in order to determine what was
learned that will help in resolution of similar situations in client care and related policy
development.
Framework for Ethical Decision-making
Recommended Learning Activities
Assignment
Resources
Notes
HCE Competency 3
Scenarios Ethical
Decisions
Worksheet on
Website
In this assignment there are 3 scenarios and students answer
questions on ethical issues and professional boundaries. The
topics include Home Health Aide, Long Term Care, and Health
Care Worker.
Legal Guidelines vs. Ethical Decision-making
Recommended Content
As the famous saying goes. “Which came first the chicken or the egg?”. Laws and
ethics can be viewed in the same way. For example, there were abortions being
performed, ethical dilemma, and then the laws pertaining to abortion came into
being.
Framework for Ethical Decision-making
Recommended Learning Activities
Assignment
Location
Notes
HCE Competency 3
Project Medical Ethics
Collage.
Worksheet
on Website
In this assignment the students use their creativity to make a collage
that involves ethical situations. The student explain the pictures and
their meaning relating it to the ethical situation.
HCE Competency 3
Project – Presentation
Ethical Situations
Worksheet
on Website
In this assignment, students research an ethical issue and either write a
letter to a fictitious editor, develop an advertisement poster, or give a
persuasive speech
Competency 4
Competency 4
Explain how an individual’s diversity, socioeconomic or religious beliefs could lead
to potential ethical differences with that of other health care employees.
Units included for this competency include:
Identify possible factors that may contribute to ethical differences between
employees.
Ethical differences between employees
Recommended Content
Ethical differences between any two people can be drastically different and can many times
cause tension, arguments, broken relationships and be the beginning of an ethical dilemma.
The curriculum address 3 factors in which these differences may develop:
1. Personal issues
2. Diversity issues
3. Status issues
Ethical differences between employees
Ethical differences may come about due to personal issues. Personal issues are
broken down into the following.
Lack of knowledge – people often times fear what they don’t understand
Previous experience – if a person’s previous experience is a negative one, why
would their next experience be any different
Lack of self confidence – a lack of knowledge in the area
Fear of being misunderstood – if a person is pro-choice does that mean they
support abortions? Maybe not.
Ethical differences between employees
The second factor that contributes to ethical differences between employees is
diversity issues.
The 4 areas of diversity that the curriculum addresses are:
1. Ethnic
2. Gender
3. Political
4. Religious
It is safe to say that these areas need no explanation and yet can provide for hot
and interesting discussion among the students.
Ethical differences between employees
The third and finally factor that may contribute to ethical differences between
employees is status issues.
Two part of status issues need to be addressed and they are:
Social – everyone desires to be accepted, liked and even loved
Financial – often times a person’s self worth is directly related to how much
money they have or how much money it looks like they have.
Ethical differences between employees
Recommended Learning Activities
Assignment
Location
Notes
HCE Competency 4
Ethical and Legal
Dilemmas
Website
This learning activity lists 7 thought provoking ethical and
legal questions for discussion.
Review Oregon’s
‘Death with Dignity Act’
Death with Dignity Act
Class Discussion
References
College of Registered Nurses of British Columbia (CRNBC). (2011). Practice standard principles. Retrieved from
https://www.crnbc.ca/Standards/ClientRelationships/Pages/Default.asp
Hegner, B.R., Acello, B., & Caldwell, E. (2004). Nursing assistant: A nursing process approach (9th ed.). Clifton
Park, NY: Thompson Delmar Publishing
Lane, A. (2009). The importance of accountability. Retrieved from http://EzineArticles.com/3471801
Potter, P.A. & Perry, A.G. (2009). Ethics and values. In P.A. Potter & A.G. Perry (Eds.). Fundamentals of nursing
(7th ed.) (pp. 313-342). St. Louis, MO: Elsevier, Mosby
References
Ramon, P.R. & Niedringhaus, D. M. (2008). Legal and ethical issues of nursing. Fundamental nursing care (2nd
ed.) (pp. 25-44). Upper Saddle River, NJ: Person Prentice Hall
Weiss, T.C. (2009, July 21). Certified Nursing Assistant Code of Ethics. Retrieved from
http://www.disabled-world.com/disability/caregivers/cna-code-ethics.ph
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