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ETHICS AND THE CTRS
HPR 453
Chapter 18
Ethics in Life and Practice
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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?
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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?
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ATRA Code of Ethics (to be distributed)
Ethical Decision-Making Model pg 304 in book