* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Ethics 101 Power Point Presentation
Ethics of eating meat wikipedia , lookup
Sexual ethics wikipedia , lookup
Aristotelian ethics wikipedia , lookup
Compliance and ethics program wikipedia , lookup
Philosophy of healthcare wikipedia , lookup
Moral responsibility wikipedia , lookup
Morality and religion wikipedia , lookup
Thomas Hill Green wikipedia , lookup
Secular morality wikipedia , lookup
Accounting ethics wikipedia , lookup
Marketing ethics wikipedia , lookup
Ethics of artificial intelligence wikipedia , lookup
Ethics of technology wikipedia , lookup
Ethical intuitionism wikipedia , lookup
Nel Noddings wikipedia , lookup
Patient safety wikipedia , lookup
Patient advocacy wikipedia , lookup
Jewish ethics wikipedia , lookup
Declaration of Helsinki wikipedia , lookup
Arthur Schafer wikipedia , lookup
Ethics 101 Case Study: Sam, the Patient • An 85 year-old retired school teacher. • C/O decreased vision in both eyes. • Exam = 20/80 best corrected in right eye 20/60 best corrected in left eye • Biomicroscopy = 3+ nuclear sclerotic cataracts • Dr. E explains the risks and benefits to Sam of having surgery to improve his vision. Case Study: Sam, the Patient • Dr. also explains an alternative option to surgery that is part of a clinical trial. • Dr. E is the PI in this trial. If this innovative technique proves effective, it may revolutionize cataract treatment. Dr. E could become famous and benefit financially. • Sam asks Dr. E to do whatever he thinks is best - after all, he’s the expert. 1) What are the Ethical Issues in Sam’s Case ? 2) How should the ophthalmologist respond when Sam asks him to make the decision? 3) Should the ophthalmologist use therapeutic privilege and make the decision for Sam? 4) Is there a conflict of interest for Dr. E to offer Sam the option of participating in his study? Overall Ethical Principle Sanctity of Life Respect for Life 4 Core Ethics Principles Autonomy Beneficence Non-maleficence Justice Respect for Autonomy Derives from patient’s right to: Self-determination Privacy Imposes responsibility on physician: Veracity - Telling the truth Informed consent Beneficence Derives from fiduciary relationship to: Do Good Act to Help Imposes responsibility on physician: Fidelity Advocacy Non-maleficence Derives from general rule of human conduct that applies to everyone to: Do No Harm to Others Act to Prevent Harm to Others Imposes responsibility on physician to: Analyze the Burdens vs. Benefits of Tx Maintain Patient’s Confidentiality Justice Derives from general rule of human conduct to treat others fairly: Like cases are treated alike - fairness. Imposes unclear responsibilities on physicians - society has not sorted this out! How well are resources allocated? What is futility? “People have the right to justice in the distribution of health resources as opposed to a right to any and all specific care/treatments whether or not they need them and/or are likely to benefit from them. . . . Citizens must acknowledge their responsibility to themselves to maintain their health to the best to their abilities.” - Leah Curtin, RN Principle Approach • Analyzes problems, identifies values • Does not always provide a good mechanism to resolve conflicts • Helpful to combine with concepts in Ethics of Care The Ethic of Care Focuses on patient’s relationships Recognizes the importance of feelings & emotions Moral responsibility derived from clinician’s relationship to patient Need to understand the context The Meaning of Caring Doing for Being responsive to Valuing Extending compassion, mercy & kindness The Meaning of Caring Enhancing human dignity Connecting with another Being touched Helping another find meaning Empowering Platinum Rule “Do Unto Others As They Would Like To Have Done Unto Them.” • Cultural Diversity • Quality of Life Sir William Osler, MD “It’s much more important to know what sort of patient has the disease than what sort of disease the patient has.” - Porter (1997) The Greatest Gift To Mankind Comparison Principle-based Ethics vs. Ethic of Care Rights & Duties Responsibility from the relationship Reason & Objectivity Emotions enhance reason Detachment enhances fairness Engagement enhances understanding & fairness Focused on individual Focused on family Ethics How people relate to each other Ancient Greeks 1960’s movements & beyond Trying to decide the “right” thing to do. Requires deliberation about facts and context reflective analysis of beliefs & values actions to solve moral problems Ethical Dilemmas When legitimate ethical reasons support more than one alternative When moral obligations exist on both sides When disagreements about the right thing to do exist among patient, family, health care team, institution, and/or 3rd party payers Why an Ethics Committee? • Each institution has a responsibility to assure ethical treatment is provided to patients • Professionals trained and experienced in ethics may provide insight and assistance to those faced with ethical dilemmas • A multidisciplinary committee provides protection against idiosyncratic perspectives The Role of the Ethics Committee Provide consultation Educate staff, patients/families, & public Recommend organizational policy Ethics Committee Goals • To assure ethical health care • To improve the quality of health care • To improve health care outcomes Ethics Consultation Approach Advisory* Collecting pertinent facts. Making sure everyone’s voice is heard. Examining benefits & burdens of options. Attempting to build a consensus. Honoring the physician’s right to conscientious objection. * NOT Authoritarian Ethical Process • Identifying ethical issues & conflicts • Analyzing underlying values and sources of disagreement • Resolving, if possible, ethical dilemmas in clinical cases The Ethics Committee Does NOT Respond to: Clinical Inquires or Questions re: Clinical Care Director of Clinical Quality Management Possible Physician Impairment Chair, Physician Impairment Committee Billing Issues and Business Conflicts of Interest Director of the Compliance Program Have an Ethical Issue ? Call: