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Chapter 6
Ethical Issues
Copyright ©2012 Delmar, Cengage Learning.
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What is Ethics?
• Criteria for an ethical dilemma
– There does not appear to be any justice through
the legal system
– When there is no clear cut “right” or “wrong”
answer
– When the “right” behavior leads to the “wrong”
outcome
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Ethical Issues in Health Care
• Ethical issues can be considered using
concepts of autonomy, beneficence, and
distributive justice
– Autonomy: the patient has a right to make
determinations for him or herself
– Beneficence: requires people to do what is in the
best interests of others
– Distributive justice: the principle by which we as a
society (or health care community) decide to
allocate resources that are in scarce supply
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Ethical Issues in Health Care
• Distributive justice can be further divided
– Egalitarian approach: everyone gets and equal
share
– Earned approach: those who deserve get more
– Libertarian approach: each gets what he or she
can legitimately get
– Social justice approach: allocation should be made
to maximize the number of people helped
Copyright ©2012 Delmar, Cengage Learning.
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Examples of Ethical Issues
Abortion
Artificial
insemination
Gene therapy
Psychosurgery
Genetically modified Sex reassignment
food
therapy
Assisted suicide
Contraception
Human cloning
Human
advancement
Suicide
Surrogacy
Cryonics
Eugenics
Euthanasia
Life extension
Life support
Organ
transplantation
Vaccination
Xenotransplantation
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Ethical Issue: Abortion
• Consider the issue of abortion from the three
perspectives
– Autonomy: the woman has a right to selfdetermination over what happens to her body
– Beneficence: because the fetus cannot speak for
itself, those of us who can, should act in the best
interests of the fetus
– Distributive justice: if this procedure is legally
available, that it should be available to all,
including the poor
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Ethical Issue: DRGs and
Capitated Payments
• DRG
– Limits the amount a hospital can be paid based on the
diagnosis, irrespective of any complications that may
develop
• Capitated payment
– Limits the payment to a physician to a set amount
each month, despite how ill the patient may be
• The physician’s sense of professional ethics is
what stands between adequate care and
substandard care motivated by the payment
structure. Holds down unnecessary costs
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Ethics and Diversity
• MAs have a responsibility to care for all
people equally, without regard to race, creed
or color
• In order to be fully respectful of all patients,
recognize and respond appropriately to ideas
and elements from other ethnic and cultural
backgrounds
– Some items to consider: manner of dress,
communication style, consciousness of time,
values and beliefs
Copyright ©2012 Delmar, Cengage Learning.
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Distinguishing Legal, Ethical,
and Moral Judgments
• Law, ethics, and morals are three types of
categorizing principles
• If the situation is a legal matter, always follow
the law
Copyright ©2012 Delmar, Cengage Learning.
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Distinguishing Legal, Ethical,
and Moral Judgments
• If the situation is an ethical matter, ask three
questions:
– What promotes the right of the patient’s
determinations about their own health?
– What is in the best health interests of the patient?
– Is doing (or not doing) the act in question fair to
others?
• Moral issues stem from a belief system in which
one makes judgment about “right” and “wrong”
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Reporting Guidelines
• Criminal Conduct: Notify the local police
• Patient Information: Do not disclose
information with anyone other than the
patient or physician
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Reporting Guidelines
• Physician Misconduct: Notify a Practice
Administrator or Office Manager
• Staff Misconduct: Notify a Practice
Administrator or Office Manager
Copyright ©2012 Delmar, Cengage Learning.
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Professional Ethics
• Codes of Ethics that prescribe behavior for
professionals of a specific organization
– Many industries, associations, and fields have ethical
codes
• Code of Ethics for physicians
– American Medical Association’s Code of Ethics(AMA)
– Covers interprofessional relations, hospital relations,
confidentiality, fees, records and professional rights,
among others
– www.ama-assn.org
Copyright ©2012 Delmar, Cengage Learning.
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Ethics for Medical Assistants
• American Association of Medical Assistants
(AAMA)
– Code of Ethics
– Medical Assisting Creed
• American Medical Technologists (AMT)
– Standards of Practice for members of the
American Medical Technologists
Copyright ©2012 Delmar, Cengage Learning.
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Ethics for Medical Assistants
• Codes of ethics provide a general framework
for which to make ethical decisions but do not
provide guidance for every specific question
that may arise
• The medical assistant must use his or her best
judgment and critical thinking regarding the
application of ethical considerations to any
given situation
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Organizational Ethics
• The values the by which the organization
conducts its business
• Often, organizations have a specific Values
Statement developed by leaders
• Characteristics that encourage ethical behavior
– A written code of standards
– Ethics training for officers, managers, and employees
– Availability of advice for employees confronting
ethical issues
– A system for confidential reporting
Copyright ©2012 Delmar, Cengage Learning.
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Personal Ethics and
Professional Performance
• Professional and organizational ethics are
designed to inform your professional
performance
• Regardless of your personal perspective, you
will need to adapt your personal views to be in
complete alignment with the ethical standards
of your profession and your organization
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.