Ethics 2

• Morality


  What is believed to be right and good
• Ethics


  Generic term for the study of how we make judgments regarding right and wrong
• Ethics offer a way of examining the moral life
• Professional ethics


  • Applied ethics
  • Designed to bring about ethical conduct of the profession
  • Differing professions have different views
  • These views shape the application of the basic ethical principles
• Universal ethical principles


  These principles:

  •Guide your course of action in the morally right direction

  •Derive our professional ethical rules and codes

  •Not intended to be applied in any order

  •All of equal importance

  • Veracity
  • Autonomy
  • Beneficence
  • Nonmaleficence
  • Role Fidelity
  • Justice
  • Paternalism
  • Confidentiality
• Autonomy

  From the Greek (self-governance)

  • Ability to decide
  • Power to act
  • Respect for the autonomy of others
• Paternalism


  Healthcare provider acting in what they believe is the patient's best interest, even against the patient's wishes

  -interference with the liberty or autonomy of another person, with the intent of promoting good or preventing harm to that person.

  
  

  •Examples of paternalism in everyday life are laws which require seat belts, wearing helmets while riding a motorcycle, and banning certain drugs.
• Veracity


  • Habitual truthfulness and honesty
  • Opposite of intentionally deceiving or misleading
  • In healthcare veracity is a special relationship between the patient and the healthcare provider
  • Truthfulness founded on a respect for persons
• Beneficence


  • Every patient has the right to assume that the health care provider is actively seeking their good
  • One ought to prevent evil or harm
  • One ought to remove evil or harm
  • One ought to do or promote good
• Nonmaleficence


  • One of the first principles of health care is the admonition: "primum non nocere" (first do no harm)
• Confidentiality


  • If patients begin to believe that we do not protect their confidentiality, then they will cease to tell us what we need to know
  • Confidentiality is a central element of the therapeutic relationship
• Justice


  Distribution of scarce goods and services-

  •The obligation to be fair to all people

  •NEED

  •EFFORT

  •ABILITY TO PAY

  •CONTRIBUTION

  •EQUITY

  •MERIT
• Role Fidelity


  • The role each healthcare professional plays
  • Each professional operates within boundaries of acceptable practice
  • Some imposed by law, some imposed by custom
• The HIM profession operates within the boundaries of the CHIMA governing body
• Rights


  • Refer to a just claim or entitlement
  • Based on law, ethics or morality
  • Do not always encompass the ideas of fairness, honesty and impartiality
  • Can vary according to the moral values of a given culture
• Human rights


  Rights that apply to everyone alike

  •universal rights inherent to all people in all lands

  •Western civilization is rich in human rights language

  •In many cases, we judge countries by how well they protect these rights
• Thesis of Correlative Obligations

  • If we consider rights as justified claims, then built into the claim is the twin thesis of rights and obligations
  • Others are obliged to either provide the goods or services or not interfere with our gaining or possessing the desired thing
  • A patient's right to informed consent means the health care provider must give all appropriate information
• Examples of legal Negative rights

  • Equal opportunity for employment
  • Freedom of religious beliefs
  • Right to personal property
• As professionals, we have special obligations and duties to protect the rights of those we serve
• In our daily practice we need to honour the rights to do good
• • Autonomy vs. paternalism
  • Therapeutic privilege
  • Benevolent deception
• Veracity means

  
• Beneficence means

  
• Nonmaleficence means

  
• Nonmaleficence - Principle of Double Effect

  Ethical choices may result in untoward outcomes
• Justice

  •Deals with concepts of fairness, ‘just desserts’ (deserving of reward or punishment), entitlements
• Compensatory Justice

  when a patient is harmed (i.e. a person seeks compensation for a wrong that has been done)•Fines and compensation for injuries are requested
• •Retributive Justice –

  “an eye for an eye”

  •Equal suffering on the person that caused the harm

  •Not particularly suitable for health care
• Which do you think the HIM profession operates within?

  A.  CHIMA

  B.  AHIMA

  C.  CIHI
• CHIMA is the governing body for Canadian Health Information Management Professionals
• When rights are interpreted as applying to everyone alike, they are said to be what type of rights?

    A.  Civil  B.  Human    C.  Cultural
• Legal rights

  •Requires others to refrain from interference

  •“Life, liberty, pursuit of happiness”

  •Justified by consideration of autonomy and privacy
• Positive Legal rights:

  ¤Recipient right

  ¤Requires others (another person, organization, or government) to provide goods and services
• Example of legal rights

  
• Justification of Rights

  •Laws of nature

  •Given by a creator

  •By collective agreement

  •Legal rights-Rights are enforced through law
• -Professional rules/codes of ethics are derived from these universal principles while drawing on specific needs from each unique profession.As professionals, we have special obligations and duties to protect the right of those we serve. Hence, in our daily practice we need to honour the rights to do good
• Hierarchy of Reasoning by Values-World view, Basic Principles, Rules and code, Decisions