ETHICS AND MORALITY

• Ethical principles


  Ideals that guide one's behaviour
• Ethics


  Guiding principles of behavior, and ethical refers to norms and standard of behavior
• Morals


  An internal value system (the moral fabric of one's being) and this value system, defined as morality, is expressed externally through ethical behavior
• Legal


  Rights and obligations that are laws that control behavior or conduct and are enforced through the fear of punishment or consequence, such as a fine, imprisonment, or both
• Approximately 40 years ago, the field of modern western bioethics arose in response to the increasing complexity of medical care and decision making
• Moral


  Principles of right and wrong action, as well as the goodness and badness of human character
• Differences between morals and ethics

  • Morals refer to the individual's internal beliefs and values that guide their behaviour and judgments of right and wrong
  • Ethics are a broader and more systematic set of guidelines that govern the conduct and interactions of individuals within a specific group, profession or society
• Morals are more subjective and individual-oriented whereas ethics are more objective and are meant to ensure consistent and responsible behaviour within a group
• Provisions of the Code of Ethics for Nurses


  • Service to others
  • Integrity and Objectivity
  • Professional Competence
  • Solidarity and Teamwork
  • Social and Civic Responsibility
  • Global Competitiveness
  • Equality of all professions
• Patient's Bill of Rights

  • Right to Appropriate Medical Care and Humane Treatment
  • Right to Informed Consent
  • Right to Privacy and Confidentiality
  • Right to Information
  • The Right to Choose Health Care Provider and Facility
  • Right to Self-Determination
  • Right to Religious Belief
  • Right to Medical Records
  • Right to Leave
  • Right to Refuse Participation In Medical Research
• The patient has the right to leave hospital or any other health care institution regardless of his physical condition, provided that: a) he/she is informed of the medical consequences of his/her decision, b) he/she releases those involved in his/her care from any obligation relative to the consequences of his decision, c) his/her decision will not prejudice public health and safety
• No patient shall be detained against his/her will in any health care institution on the sole basis of his failure to fully settle his financial obligations. However, he/she shall only be allowed to leave the hospital provided appropriate arrangements have been made to settle the unpaid bills
• Unpaid bills of patients shall be considered as loss income by the hospital and health care provider/practitioner and shall be deducted from gross income as income loss only on that particular year
• The patient has the right to be advised if the health care provider plans to involve him in medical research, including but not limited to human experimentation which may be performed only with the written informed consent of the patient
• An institutional review board or ethical review board in accordance with the guidelines set in the Declaration of Helsinki be established for research involving human experimentation
• The patient involved in the human experimentation shall be made aware of the provisions of the Declaration of Helsinki and its respective guidelines
• The patient has the right to communicate with relatives and other persons and to receive visitors subject to reasonable limits prescribed by the rules and regulations of the health care institution
• The patient has the right to express complaints and grievances about the care and services received without fear of discrimination or reprisal and to know about the disposition of such complaints
• Every person has the right to be informed of his rights and obligations as a patient
• The Department of Health, in coordination with heath care providers, professional and civic groups, the media, health insurance corporations, people's organizations, local government organizations, shall launch and sustain a nationwide information and education campaign to make known to people their rights as patients, as declared in this Act
• It shall be the duty of health care institutions to inform of their rights as well as of the institution's rules and regulations that apply to the conduct of the patient while in the care of such institution
• Do-Not-Resuscitate (DNR) order


  A written order by a doctor instructing healthcare providers not to perform cardiopulmonary resuscitation (CPR) if a patient stops breathing or if their heart stops beating
• Violating a patient's confidentiality

  Can have legal and ethical consequences for healthcare providers, according to the Health Insurance Portability and Accountability Act (HIPPA)
• Malpractice and Negligence


  Medical errors are the third leading cause of death in the U.S., and patients affected by it may never recover or it may take years
• Physician-assisted suicide


  The act of intentionally killing oneself with the aid of someone who has the knowledge to do so
• Informed Consent


  Patients have the right to know the truth about their medical condition, and they can choose treatment options
• Professional Boundaries


  Health care professionals must maintain appropriate boundaries as patients are vulnerable
• Data Privacy


  Protecting patient privacy is essential, in accordance with the Health Insurance Portability and Accountability Act
• Access to Care


  Striking a balance between quality care and efficiency can be challenging for health care professionals
• Digital technologies are getting priorities in all areas of the patient dealings, both within research area and the clinical sectors, throughout healthcare systems across the world
• Patient security in digital health care

  Patients being concerned about their confidentiality in digital communication and their privacy being a key element of trustworthy artificial intelligence
• Freedom of informed choice in digital health care

  Preservation of dignity and support of human autonomy in digital health care services
• Accountability in digital health care

  Important in procedural value for digital health which maintain trustworthiness of artificial intelligence
• Transparency in digital health care

  A key element of trustworthy artificial intelligence which has important procedural value for digital health
• Relation of trust in digital health care


  Important in between service receiver and service provider to mitigate ethical risk
• AI is going to be increasingly used in healthcare and hence needs to be morally accountable
• Data bias needs to be avoided by using appropriate algorithms based on un-biased real time data
• Diverse and inclusive programming groups and frequent audits of the algorithm, including its implementation in a system, need to be carried out
• While AI may not be able to completely replace clinical judgment, it can help clinicians make better decisions
• Autonomy


  The right to self-determination, where nurses encourage patients to make their own decisions without any judgments or coercion