Code of Ethics

CODE OF ETHICS

The focus on ethical and legal issues advances the knowledge and understanding of the decision making process of ethical dilemmas. A medical professional is expected to behave in accordance with society’s perception of right and wrong, regardless of the legal implications. It is somewhat comforting however that the laws that govern the individual’s behavior is built upon ethical considerations. The physician’s code of ethics and the American Association of Medical Assistants (AAMA) code of ethics set out the guidelines for ethical behavior.  The AAMA code of ethics sets out five guiding principles which require its members to always:

A. render service with full respect for the dignity of humanity;

B. respect confidential information obtained through employment unless legally authorized or required by responsible performance of duty to divulge such information;

C. uphold the honor and high principles of the profession and accept its disciplines;

D. seek to continually improve the knowledge and skills of medical assistants for the benefit of patients and professional colleagues;

E. participate in additional service activities aimed toward improving the health and wellbeing of the community.

The code of ethics endeavors to set the guidelines for ethical and moral conduct of the medical professional. It behooves them to strive for excellence in their personal and professional pursuits and exhorts them to adhere to the highest standard in caring out their professional responsibilities.

The Healthcare Portability and Accountability Act of 1996 (HIPAA) was enacted to guide the behavior of healthcare workers in the dispensation of their daily functions and interactions with patients. The primary purpose of HIPAA are three fold:

1                    Improve the efficiency and effectiveness of health-care delivery by creating a national framework for health privacy protection that builds on efforts by states, health systems, and individual organizations and individuals

2                    Protect and enhance the rights of patients by providing them access to their health information and controlling the inappropriate use or disclosure of that information

3                    Improve the quality of health care by restoring trust in the health-care system among consumers, health-care professionals, and the multitude of organizations and individuals committed to the delivery of care.

HIPAA speaks directly to the ethical and moral conduct of the employees, both medical practitioners and administrative staff. It engenders respect for patients’ rights to privacy and security and autonomy.  

Reference:  CODE OF ETHICS

Virtues and Values

Virtues and Values

The concept of virtue is related to the individual behavior pattern. It is the innate characteristics of the person that is evaluated rather than the activities performed. The individual is judged based on the moral excellence or beneficial qualities that set them apart from others.  Persons are categorized as good or bad solely upon their way of life. A virtuous and upstanding citizen is one who is pleasant, honest, trustworthy and kind hearted. Virtue-based ethical theories emphasize the development of traits such as these and actions that are just a basic way of life without the chains of rules and regulations.

It is said that virtues are abstract means that create to specific ends.  These ends are the resulting values that we place on things that we desire in life. Value is relative. People are do different things for different reasons, in the same way the perception of value is based on the individual’s standards. Values may change as the people grow and develop and acquire the desires of life.  Once a need is met the value place on such acquisitions diminishes. Values give purpose to life. A life might be sacrificed for the acquisition of tangible things. A family member might be willing to take the mother of life support to hasten the distribution of insurance benefits in order to acquire a house. The other family might be willing to keep that mother on life support and use the insurance benefits to finance the decision. Values are the motivating force behind a person’s action.

In the application of compassion in the healthcare facility, certain virtues that are designated valuable in the face of ethical dilemma will form the basis for specific outcomes or decisions. Virtue or value underpins the application of compassion in the healthcare setting.  Some important virtues that are deemed to have value in the deliberation of healthcare dilemmas.

Here we have some examples of qualities or traits that will anchor the actions of the moral individual faced with a healthcare dilemma –

Courage as a virtue Wisdom as a virtue Education/Learning as a virtue Temperance Commitment Compassion Hopefulness Integrity

Conscientious Discernment Fairness Fidelity Freedom Tolerance Respect Kindness

These are some of the pillars that build one’s moral strength.

Issues that Influence Medical Ethics and the Application of Appropriate Ethical Conduct

Issues that Influence Medical Ethics and the Appropriate Ethical Conduct

In the healthcare organizations the medical professionals are governed by a body of ethical statements that was developed specifically for the benefit of the patient. These ethical statements are established standards of conduct that guides the honorable and professional behavior of the medical practitioner. The nine (9) code of medical ethics clearly defines the physician professional responsibility to his patients, his colleagues, to society as well as to himself.  

There are several guiding ethical principles that have be identified as fundamental to the decision making process related to healthcare related ethical dilemmas. Pozgar (2012) described these principles as universal rules of conduct that are derivatives of ethical theories. Ethical principles provide a framework for the analysis of various ethical dilemmas. The caregiver is often times faced with the difficult task of choosing between conflicting ethical principles.  

Beneficence – The desire to provide excellent quality care for the patients, by demonstrating compassion, kindness, generosity and helpfulness. Caregivers are expected to strike a balance between benefits to be gained and the risks involved in a recommended procedure.

Nonmaleficence – The caregiver endeavors not to cause harm to the patient which is in alignment with the In re Conroy concept that states that the physician basic obligation to the patient is “....first do no harm.”

Justice – the principle that obligates the caregiver to be conscientious in the distribution of scarce benefits and risks. There should be no preferential treatment of one patient over another.

Autonomy – This principle recognizes the rights of the individual to make his own decision. Adherence to this principle is provide for the Constitution of the United States. Based on the Patient’s Bill of rights the patient has the right be given information and to take part in the treatment decision process. The patient must be given all relevant information regarding benefits, the risks and the alternatives to a recommended course of action. The caregiver must respect the decision of an autonomous patient, with sound mental capacity to act on his own.

One of the healthcare guiding principles states that “A physician shall respect the rights of patients, of colleagues, and of other health professionals and shall safeguard patient confidences within the constraints of law”

How Ethics Committee Decide upon Issues of Morality

How Ethics Committee Decide upon Issues of Morality

In the discussion on the decision on issues of morality, let us first look at the goals of the ethics committee. Pozgar (2012) gave us list which includes:

•       Support : They provide guidance to patients, members of their family, the healthcare               decision making team
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•       Review :     Upon request the evaluate cases that present conflicts basic value system   
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•       Clarification:   The committee is a vital resource in ambiguous situations (ethical, legal or               religious in nature) that are outside the realm of day-to-day operations
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•       Rights of Patients: They are instrumental in promoting patient’s rights and privileges.
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•       Patient-Centered: The ethics committee promotes fair policies and procedures that                    optimizes the probability of patient-centered results  -  Provide relevant assistance for patient and families in the determination of best care needs

•       Ethical Tenor:  Optimization of ethical environment and behavior of both healthcare                  facilities and the medical practitioners.

In order to achieve these goals the healthcare ethics committee relies on some fundamental theories that have informed the development of medical ethics. These are the key moral theories and ethical framework that have had significant impact on decisions relating to issues of morality.  

Ethical Theory

According to Pozgar (2012) ethical theories and principles introduce order into the way people think about life. It is the attempt to explain our moral judgment by defining our actions as right or wrong.

Ethical theories present different scenarios that guide the caregiver’s decision-making process. It presents the ‘other side of the story’ enabling the caregiver visualize possible outcomes of alternative medical procedures and treatment plans.

§  Normative ethics – seeks to determine the moral standards to be adopted to ensure morally correct behavior.

§  Consequential ethics – determines that the morality of an action is in the optimization of the balance of good versus evil. It is accomplishing the greatest good for the greatest number.

§  Situational Ethics –  Thus given circumstances determine the course of action, not necessarily adhering to moral values.

§  Deontological Theory – It is proceeding on a course of action based on duty bound obligations.

§  Nonconsequential Ethics – The rightness of wrongness is found inside the action and not the consequences.

§  Ethical Relativism – Morality or the concepts of right or wrong are based on the cultural norms of the society.

Ethical decision making is determining the right course of action when faced with a moral dilemma.

RULES GOVERNING HOW ETHICS COMMITTEE WORKS

Rules Governing how Ethics Committee Work

The healthcare industry which has been described as one of the most challenging and complex in the United States is also one of the most highly regulated bodies. The scope and complexity of these regulations should not come as any surprise, fact is the two most precious gifts of health and life are the primary factors that are involved.  A significant component of the complex nature of healthcare lies in the myriad of ethical and legal issues that impact the delivery of quality patient care.  Ethical dilemmas are common occurrence during the course of patient encounter.  The irony is, ethical challenges have been exacerbated by the technological innovations and scientific discoveries that have effectively advanced the quality and delivery of medical care and treatment. The hospital ethics committee (HEC) provides an impartial forum that addresses legal-ethical issues and difficult treatment decisions. Not surprisingly there are also rules governing how ethic committee works.

Ethics as Pozgar (2012) posited “is the branch of philosophy that seeks to understand the nature, purpose, justification, and founding of moral rules and the systems they comprise.” Morality is a code of conduct. Morals knowledge of right and wrong, thus morality is a set of social rules that governs individuals’ behavior. HEC must be guided by the established policies and procedures of the institution. Although HEC is not the final authority on ethical dilemma they are integral contributors to the development of policies and procedures that guide the process of resolving ethical dilemmas.

The committee members must be of a multidisciplinary background including an ethicist, educators, clinicians, legal advisers, political leaders, members of the clergy and executives from corporate America and community members. HEC should be a functional and effective voluntary body that educates by increasing awareness of ethical issues and offer consultative assistance to patients, their families, healthcare professionals and practitioners, and caregivers and by resolving unusual, complicated ethical issues that encompasses the entire life span – from the right to be born to the right to die (Pozgar, 2012). The committee offers objective council during issues relating to quality of life, terminal illness and the allocation of scarce resources. The ethics committee is primarily concerned with issues of morality, patient autonomy, federal legislation and the states’ interests (Pozgar, 2012).