Health Education: Session 2

• Immanuel Kant promulgated the deontological notion of the "Golden Rule,"
• John Stuart Mill, who purported a teleological approach
• DEONTOLOGY (from the Greek word deon, which means "duty" and logos which means "science" or "study") - It is an ethical belief system that stresses the importance of doing one's duty and following the rules
• TEOLOGICAL or UTILITARIAN approach allows the sacrifice of one or more individuals so that a group of people can benefit in some important way. Greatest good for the greatest number of people.
• Ethics refers to the guiding principles of behavior, and ethical refers to norms or standards of behavior
• Moral refers to an internal value system. This value system, defined as morality, is expressed externally through ethical behavior.
• Legal rights and duties, on the other hand, refer to rules governing behavior or conduct that are enforceable under threat of punishment or penalty, such as a fine or imprisonment or both
• Practiced Acts are documents that define a profession, describes the profession's scope of practice, and provide guidelines for state professional board of nursing regarding standard for practice, entry to profession via licensure, and disciplinary actions that can be taken if necessary
• Informed Consent: the right to full disclosure; the right to make one's own decisions.
• Right to self-determination; the right to protect one's own body and to determine how it shall be treated
• Informed consent, which is a basic tenet of ethical thought, was established in the courts as early as 1914 by Justice Benjamin Cardozo
• Code of Ethics: This code represents an articulation of professional values and moral obligations in relation to the nurse-patient relationship and in support of the profession and its mission.
• AUTONOMY is derived from the Greek words auto ("self") and nomos ("law") and refers to the right of self- determination.
• Patient Self-Determination Act (PSDA) requires, either at the time of hospital admission or prior to the initiation of care or treatment in a community health setting, "that every individual receiving health care be informed in writing of the right under state law to make decisions about his or her health care, including the right to refuse medical and surgical care and the right to initiate advance"
• Veracity, or truth telling, is closely linked with informed decision making and informed consent.
• Four Elements Making Up the Notion of Informed Consent Competence: which refers to the capacity of the patient to make a reasonable decision.

  Disclosure of information: which requires that sufficient information regarding risks and alternative treatments be provided to the patient to enable him or her to make a rational decision

  Comprehension: which speaks to the individual's ability to understand or to grasp intellectually the information being provided

  Voluntariness, which indicates that the patient has made a decision without coercion or force from others.
• Confidentiality refers to personal information that is entrusted and protected as privileged information via a social contact, healthcare standard or code, or legal covenant
• Nonmaleficence is defined as "do not harm" and refers to the ethics of legal determinations involving negligence and/or malpractice
• Negligence is define as "conduct which falls below the standard established by law for the protection of others against unreasonable risk of harm
• Professional Negligence. "Involves the conduct of professionals that falls below a professional standard of due care
• Due care is the kind of care healthcare professionals give patients when they treat then attentively and vigilantly so as to avoid mistakes
• Malpractice refers to limited class of negligent activities committed within the scope of performance by those pursuing a particular profession involving highly skilled and technical services"

  It has been specifically defined as "negligence, misconduct, or breach of duty by a professional person that results in the injury or damage to the patient
• Beneficence is defined as "doing good for the benefit of others.
• Justice speaks to fairness and equal distribution of goods and services.
• Direct Costs, those that are tangible and predictable, such as rent, food, heating, etc.
• Fixed Costs: those that are stable and ongoing, such as salaries, mortgage, utilities, durable equipment, etc.
• Variable Costs: those related to fluctuation in volume, program attendance, occupancy rates, etc
• Indirect Costs: those that may be fixed but not necessarily directly related to a particular activity, such as expenses of heating, lighting, housekeeping, maintenance, etc.
• Hidden Costs, those that cannot be anticipated or accounted for until after the fact
• Cost Savings money realized through decreased use of costly services, shortened lengths of stay, or fewer complications resulting from preventive services or patient education
• Cost Benefit occurs when the institution realizes an economic gain resulting from the educational program, such as a drop in readmission rates
• Revenue Generation income earned that is above the costs of the programs offered
• Cost Recovery occurs when revenues generated are equal to or greater than expenditures
• Cost-Benefit Analysis: the relationship (ratio) between actual program costs and actual program benefits, as measured in monetary terms, to determine if revenue generation was realized
• Cost-Effectiveness Analysis: refers to determining the economic value of an educational offering by making a comparison between two or more programs, based on reliable measures of positive changes in the behaviors of participants.