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ETHICS AND THE CTRS HPR 453 Chapter 18 Ethics in Life and Practice When there is no right or wrong answer that is clearly evident How should I behave? Would my profession support my behavior? Is my behavior consistent with other practitioners? Why explore ethics and professional conduct? It’s the right thing to do! What shapes our ethics? Family Values Education Government and Judicial Systems Religious Beliefs Cultural Heritage Personal and Professional Peers Business Values and Corporate Culture Personal Experiences VA Center for National Ethics Model Figure 18.1 pg 300 Integrative Perspective for Ethics in Healthcare Internal and External Factors Comprehensive view Ethics in professional practice is not simple Today tremendous focus on healthcare fraud and abuse In a study ¼ of public sector employees identify their work environments as conducive to misconduct Enron as an example HIPAA Health Insurance Portability and Accountability Act (1996) One aspect is fraud and abuse – Federal, State and Local law enforcement programs work together Since inception in 1997 $8.85 bil turned over to Medicare Trust Fund Sarbanes-Oxley Act of 2002 Repercussion of Enron scandal CEOs and CFOs of all publicly traded companies certify that financial reports are accurate Strict Conflict of Interest rules Protects Whistle Blowers Implications for Ethics and TR Billing for tx and services not provided Providing unnecessary services Substandard quality of care in nursing homes Submitting false claims or false cost reports Being in violation of scope of practice or state licensure laws ATRA Code of Ethics Guides our ethical behavior Ethics defined as principles or standards of human conduct (morals), character, values Moral philosophy Human actions in respect to right or wrong History 5th Century B.C. – Hippocratic Oath “I will use tx to help the sick according to my ability and judgment, but never with a view to injury or wrongdoing” Latin principle of medical practice – Primum non nocere – “First, do no harm” (beneficence and nonmaleficence) Ethics have been a part of medical practice for hundreds of years Until WW II the physician was the authority Due to experimentations gradual shift of decisionmaking from physician to patient (autonomy) – patient-based self-determination Right and Good may not always be the same Ethics in Healthcare Today We are capable of acting toward others in such a way as to increase or decrease the quality of their lives We experience ethics on personal, professional , and organizational levels Ethical dilemmas occur when a decision/action must be made/taken that has 2 or more competing courses of action based on different value sets, moral frameworks, or varying or inconsistent organizational philosophy The decision should be the “best possible” because there is no right or wrong answer Law is a minimal standard of morality established by society 4 quadrants Legal and ethical Unethical and legal Unethical and illegal Ethical and illegal What helps you make the decision? ATRA Code of Ethics (to be distributed) Ethical Decision-Making Model pg 304 in book