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ethics
- systematic study of how we make judgements in regards to right or wrong
- developed from moral values instilled by our families and influenced by religious beliefs, laws, and the norms of society
- doing the right thing as we go about our daily activites
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medical ethics (aka Bioethics)
- a specific type of ethics that relates to the choices HCP (health care practicioner) must make everyday in medical situations.
- reside in the realm of human values, morals, individual culture, person beliefs, and faith ( a person's worlds view)
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human value development
- theorist attempt to explain human behavior
- human behavior is nonrandom, but designed to produce som result
- reflection of our attending to percieved needs or values
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needs and values
- need- necessity
- value- something important to you
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maslow's heirarchy of basic human needs
- physiological- oxygen, food, water, and a relatively constant body temperature.
- safety needs
- love and belonging (social)
- self-esteem
- self-actualization
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kohlberg's stages of moral reasoning
- preconventional (2-7)npunishment/obedience, egoism (satisfy one's desire)
- reward & punishment stage- a child knows the difference between right and wrong based on consequences
- self interest stage- know right from wrong b/c when they share people share back
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kohlberg's stages cont'd
- conventional (7-12) please others,respect rules- conform to social norms (good boy/girl stage)
- postconventional (12 and up) social contract, personal conscience
- respect social rules and obey them
- recognize rules are there for a reason to keep civilized
- become aware of universal principles and follow rules because of self respect
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Morris Massey's value cohorts
- you are what you are because of where you were when
- traditionalists- 1930s-40s
- challengers- 1960s-70s
- synthesizers-1970s-early 80s
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system of ethical decision making
- telelogical theory (telos means end)-
- conseqeunce oriented-> decisions made on consequences right thing to do brings about the best outcome, thus the right thing to do is also the good think.. theorists may disagree on what is good
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system of ethical decision making cont'd
- utalitarianism- most common form of the consequence based reasoning
- utility is ther cole standard, so the right action provides "the good for the greatest number"
- criticisms-
- hard to predict outcomes
- may be unfair or violate rights of others
- justifies acts in conflict with our values
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system of ethical decision making cont'd
- deontological theory (deos means duty)- the rightness or wrongness of an act depends on its intrinsic nature
- an act is either right or wrong but not both
- generally accepted principle often based on religious beliefs
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immanuel kant
- consequences are irrelevant
- based his philosophy on man being a rational being
- principles derived from reason are universal
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virtue ethics
- places the focus on the characteristics, traits, or virtues a good person should have, its about personal character
- we function on how a good nurse or MA would act, based on history and tradition
- when we enter a practice we accept the standards of that role
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limitations of virtue ethics
- roles change over time
- new situations with new technology
- role conflict
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devine command ethics
devine being established a finite set of rules to provide quidance for most, if not all moral decisions
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6 steps in problem solving
- identify problem and principles involved
- gather facts of the case
- examine the options
- weigh and evaluate options
- make your decision and act on it
- assess and evaluate the results
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ethical principles
- basis ethical principles have been developed to help HCP to determine right from wrong in regards to value issues relating to their patients
- autonomy, veracity, confidentiality, beneficence, nonmaleficence, justice, role fidelity
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autonomy
- self-determination
- form of personal liberty
- individual is free to choose, free from deceit, constraint, durress & coercion
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3 basic elements to autonomy
- ability to decide
- power to act on one's own decision
- respect autonomy of others
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veracity
- truth telling
- patient expect a higher level of truthfullness from HCP
- HCP is bound to volunteer all relevant info
- truth is necessary for patient to exercise autonomy
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beneficence
a duty to do or promote good actions taken to benefit another
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nonmaleficence
- DO NO HARM
- often difficult to follow when many treatments have bad side effects
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confidentiality
- patient has right to provacy
- patient had a right to expect all communication and records will be treated confidentially
- it is important for trust in patient/HCP relationship
- patient's bill of rights
- HIPAA
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justice
- individuals should receive their due share
- treat people fairly
- allocation of resources/distributive justice
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role fidelity
- each member of the health care team has an assigned role to perform
- carrying out your duties within the scope of your practice
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professional gatekeeping
- characteristics of a profession:
- self regulation
- specialized body of knowledge
- standards of eduactaion and practice
- fiduciary relationship with those served
- provision of a particular service to society
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legal principles
law is a standard or rule of conduct established and enforced by the govt of a society
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sources of laws
- constitutes
- statutes
- administrative rules & regulations
- common or case law
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miranda rights
"right to remain silent..."
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branches of law
- criminal (public) citizen welfare & safety
- govt vs. individual
- civil (private) netween private citizens
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court system
- state
- district court, common pleas, superior, state supreme
- federal
- federal court, federal appeal, supreme
only issues of law can be heard on appeals
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tort
- violation of civil law other than a breach of contract
- basis of most lawsuits against HCP
- money is used as penalty
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types of torts
- intentional-deliberate violations of another person's legal rights: assault
- unintentional torts- bfailure to use such care as a reasonable person would use under similar circumstances
- negligence- breach of duty that causes injury, failure to exercise care that a prudent person woulod udually use
- malpractice- a professional fails to meet the standard of care resulting in negligence
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distinction between intentional tort and negligence
- intent
- proof and damages
- standard of care
- consent
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