1
Q
6 steps of ethical decision making
A
- gathering information
- identify the ethical problem (moral distress, ethical dilemma, locus of authority)
- theory or approach
- look at alternatives, explore options and how do you do it
- act
- evaluate the process and outcome
2
Q
conscientious objection
A
- act of resistance or defiance against existing practices, policies, laws, and other expectations that others in the persons position has agreed to
- you cannot object in an emergency, if the burden is too much on other employees, or if you are discriminating
- act of resistance of defiance against practices, laws in place
- asking to be exempt
- can never be used to discriminate others (saying no to an abortion because of race)
- cant be used if you applied knowing their practices
- if it is an emergency and everyone is needed you cant object
- health care workers refuse to participate in lethal injection
- clinical suicide
- abortion
- force feeding
3
Q
material cooperation
A
- a way to think of justification for wrong doing
- cooperation with wrongdoing is easier to justify if it would be done with or without you
- you are not responsible for the wrongdoing yourself you are apart of the group
- the more remote the personal cooperation the better
- benefits must outweigh the wrongdoing
- going against company policy -> agree to cooperate
4
Q
confidentiality
A
- duty
- practice
- ethical issue
- trust
- relationship
5
Q
privacy
A
- a legal issue
- a right
- the right to privacy gives legal standing to the ethical principle of confidentiality
- law that upholds the practice of confidentiality
6
Q
confidentiality is lost in return for:
A
- insurance coverage
- employment
- application for government benefits
- investigation of health and safety at work site
- if the pt is threatening to harm self or others
- state specific:
- communicable disease
- occupational diseases
- wounds of violence
- suspected abuse
- loss of consciousness
7
Q
HIPAA
A
-1996
-
8
Q
who is covered by HIPAA
A
- applies to covered entities
1. a health plan
2. health care clearing house
3. health care provider who transmits any health information in electronic form in connection with a transaction
9
Q
health care clearing house
A
-the term health care clearing house means a public or private entity that processes or facilitates the processing of nonstandard data elements of health information into standard data elements
10
Q
FERPA- Family education rights and privacy act
A
-education and certain other records subject to, or define, in the family educational rights
11
Q
permitted uses and disclosures
A
- a covered entity is permitted, but not required, to use and disclose protected health information, without an individuals authorization, for the following purposes or situations:
- to the individual (unless required for access or accounting of disclosures)
- treatment, payment, and health care operations
- public interest and benefit activities
- limited data set for the purposes or research, public health or health care operations
12
Q
Privacy rule (HIPAA)
A
- individual has a right to adequate notice of how a covered entity may use and disclose protected health information about the individual.
- Covered entities must develop and provide individuals with this notice of their privacy practices
- the notice of privacy practice must be available to patients upon request
- the notice must be posted in a prominent location of the facility
13
Q
Department of Health and Human Services, Office for Civil RIghts (OCR)
A
responsible for administering and enforcing privacy rule and may conduct complaint investigations and compliance reviews.
14
Q
HITECH Act
A
- 2009
- created to promote the use of electronic health records (EHR) by covered entities
- expanded the requirements for:
- data breach notification
- protection of electronic PHI
15
Q
breach notification rule
A
-requires covered entities and their business associates to notify the OCR and patients impacted of a breach of unsecured PHI
16
Q
what is ethics
A
- systematic reflection on, and analysis of morality
- goal is to arrive at a caring response
- primary loyalty is to the pt
- A process that sees ‘what is’ and asks ‘what really ought to be?’
17
Q
nonmaleficence
A
- do no harm
- passive
- refrain from abuse
- will my actions hurt the patient?
18
Q
beneficence
A
- active
- prevent harm
- remove harm
- positive good
- can you benefit the patient?
19
Q
2nd level principle
A
- veracity
- if the pt trusts you, you can form a good relationship
- maintains fidelity
20
Q
therapeutic privilege
A
- details are too much for the pt to handle at one time -> they may cause harm to others or themselves
- withholding info for the best interest of the pt
- used as a last resort
- exception to veracity
21
Q
morality is relational
A
- morality protects the quality of life for individuals, groups or the community
- ones language and behavior impact the interest of others
22
Q
group morality
A
- ex. health care
- the moral guidelines adopted by a religious group, workplace culture, a club, a service organization, or ethnic cluster
23
Q
societal morality
A
- humans relationship with God (or gods), with one another and with the world
- laws, customs, and policies reflect societal morality
24
Q
gold standard of ethics
A
What do human dignity and respect demand of us?
25
character
- traits and dispositions or attitudes that set the goundwork for us to trust each other and to provide for human flourishing in times of stress
- combined compassion, courage, honesty faithfulness, respectfulness and humility make up high moral character
26
brain dead
- irreversible sesation in respiratory function -> brain and heart stop
- irreversible sesation of all function of the brain including the brain stem in charge of breathing and other important functions
27
persistent vegetative state
- person is chronic wakefulness but not conscious or aware
- at least 4 weeks
- unable to communicate or respond to stimulate
- eyes may be open or blink
- possible spontaneous body movements or groaning
- after 3 months not likely to recover
- you can appeal to court to put them to death
28
informed consent
- cornerstone of the health care system
- respect
- maximizes autonomy
- minimizes paternalism
29
components of informed consent
- decision capacity- are they able to make the decision
- voluntary decision (no coercion)
- risks and benefits
- alternatives (including nontreatment)
30
capacity
- medical term
| - pts ability to weight medical information and make health decisions
31
competence
- legal term
| - all persons are presumed competent until legally judged otherwise
32
expressed consent
- patient acknowledges they want you to provide care
- most often applies to simple, common procedures
- if someone goes into an office with an ear ache -> expressed consent they want treatment
33
involuntary consent
- court making decision or decision being legally imposed upon situation
- applies to patients who are:
- mentally ill
- in behavioral crisis
- intellectual or developmental disabilities
34
proxy
- must be 18 and 2 witnesses when signing
| - in the living will
35
depersonalization
-characterized by difficulty making personal connections -> if values dont align with work you may feel depersonalized
36
3 hallmarks of burnout
- emotional exhaustion
- lack of personal accomplishment
- depersonalization
37
patient self determination act of 1990
- inform pts of their rights to make decisions concerning their care
- regularly inquire to whether a pt executed an advanced directive to document the pts wishes regarding their medical care
- not discriminate against persons who have executed an advance directive
- ensure that legally documented directive wishes are granted
- provide education program for staff, pt, and community on ethical issues
38
chronic conditions
- 1 in 3 adults
- advances in health care increase chronic disease
- symptoms persist over time, months, years or life
- arthritis, diabetes, clinical depression, or cardiovascular disease
39
disability
- an umbrella term for impairments, activity limitations and participation restrictions
- people can have chronic conditions and not be disabled
40
utilitarianism/teleology
- jeremy bentham
| - john stuart mills
41
deontology
immanuel kant
42
childhood moral development
- carol gilligan/lawrence
| - kohlberg
43
virtue theory
-artistotle/maimonides/thomas aquinas
44
shared moral beliefs (all the principles)
david hume
45
personl morality
plutarch 650 BC
46
professional responsibility
richard niebuhr
47
emotions place in morality
nancy sherman
48
palliative care
- comfort
- when curative and restorative treatment doesnt work anymore
- for patients with conditions that lead to death BUT also people with chronic conditions
- not setting specific
49
hospice care
- caring not curing
- expert medical care
- pain management
- emotional and spiritual support
- 6 month or less to live
50
palliative and hospice care
both are not expected to get better
51
clinically assisted suicide
-patient needs to do the final act (take the lethal medication)
52
medical euthanasia
- physician directly commits the act by medical means
- ending a patients life with medical means administered by the physician
- patient is a passive bystander
Ethics
flashcards
Decks in class (11)
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