Transcript Ethics in Daily Practice

Ethics in Daily Practice
Vicki Judd, MD., University of Utah
Paul Myers, Ph.D., University of
Portland
Ethics Committee Members
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Paul Myers, Director, Univ. of Portland (chair, voting member) (term 20082010)
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Sam Alexander, Director, Univ. of Denver, (secretary, voting member) (term
2008-2010)
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Cathy Felix, Director at Cal. State, Chico (voting member) (term 2010-2012)
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John Kolligian, Exec. Director, Princeton Univ. (voting member) (term 20102012)
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Marc Hiller, Professor, Univ. New Hampshire (voting member) (term 20092011)
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Vicki Judd, Professor, University of Utah (voting member) (term 2008-2010)
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Chad Williams, Student, (voting member, so may or may not be available for
the second year) 2009-2010
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Jerry Wilmes, Director, NW Missouri State Univ. (voting member) 2010-2012
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Eryn Oberlander, Psychiatrist, New York City (voting member) 2010-2012
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Tim Crump, Liaison to ACHA Board of Directors and Regional Representative
for the Pacific Coast College Health Association
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Bob Ward, Liaison to ACHA
Objectives
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Describe ACHA Ethical Principles and
Guidelines
List the changes of the ACHA Ethical
Principles and Guidelines
Discuss the application of the ACHA
Ethical Principles and Guidelines to
actual situations
Quiz
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Which two ancient philosophers
were also physicians?
Hippocrates and Aristotle
Ethics of Hippocratic Medicine
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Harnessing the principles of nature as a guide to
healing
Be of benefit, do no harm
Asclepius
“Practiced medicine for those who were healthy in
their nature but were suffering from a specific
disease; he rid them of it …then ordered them to
live as usual…for those however, whose bodies
were always in a state of inner sickness he did
not attempt to prescribe a regimen to make their
life a prolonged misery…medicine was not
intended for them and they should not be treated
even if they were richer than Midas.”
Plato, The Republic
Four Principles
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Establishment of 4 Principals
(Beauchamp and Childress) 1979
“A Reminder of What You Already
Know”
A) Beneficence
B) Non-maleficence
C) Autonomy
D) Justice
Beneficence
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Obligation to preserve life, restore
health, relieve suffering, and
maintain function
To do “good”
Nonabandonment – obligation to
provide ongoing care
Conflict of interest – must not
engage in activities that are not in
students best interest
Nonmaleficence
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“Do no harm, prevent harm, and
remove harm”
Autonomy
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Right to self-determination
Requires decision making capacity
• Lack should be proven not assumed
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Competence – legal determination
Liberty – freedom to influence course
of life/treatment
Justice
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Allocation of resources must be fair
and according to need
Should not make decisions regarding
individuals based upon societal needs
Values and Ethical Priorities
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Culture bestows
values
Values set up
Morals
Ethics are rules
used to assist in
making good
choices and
avoiding bad
choices
Cultural Influence on Values
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Family
Ethnicity
Religion
Race
Economic status
Education
Life experiences
Sexual orientation
Gender
Values
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What do you value?
Values
Values are things that an
individual believes to be
intrinsically worthwhile or
desirable, that are prized for
themselves (e.g. truth, beauty,
honesty, justice, respect for
people and the environment).
Values Examples
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Extend hospitality
to strangers and
travelers
Give alms
Don’t trust
professionals
Us and Them
Do unto others…
Idleness is the
devil..
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Penny saved is
penny earned
There but for the
grace of God, go I
Don’t share the
family’s business
“My dad would kill
me!”
And……
“Be sure you are
right, then go
ahead.”
Davy Crockett
1786-1836
Teddy
Roosevelt
said, “To
educate a
person in
mind and not
in morals is to
educate a
menace to
society.”
Values Examples
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“Education without values, as useful
as it is, seems rather to make man a
more clever devil.”
C. S. Lewis
President
Lincoln
said:
“Honor is
better
than
honors.”
When the situation
needs improvement,
Gandhi offers
guidance: “You must
be the change you
wish to see in the
world.”
The reputation of a thousand years may be
determined by the conduct of one hour.
Japanese proverb
“To see what is
right and not to
do it is want of
courage.”
(Confucius)
“It behooves every man who values liberty of conscience for himself, to resist
invasions of it in the case of others: or their case may, by change of
circumstances, become his own.”
Thomas Jefferson
Values Examples
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It behooves every man who values
liberty of conscience for himself, to
resist invasions of it in the case of
others: or their case may, by change
of circumstances, become his own.
Thomas Jefferson
MORALITY
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Morality involves peoples' views of
what is good, right, or proper; their
beliefs about their obligations; and
their ideas about how they should
behave.
Morality concerns duties and
obligations to one another and is
characterized by words such as right,
ought, just, and fair.
Inventory of Applicable Principles
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Inventory of Applicable Principles
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Justice
Care
Fidelity
Honesty
Trustworthiness
Personal Autonomy
Liberty
Accountability
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No Harm
Happiness
Do Good
Role Fidelity
Professional
Autonomy
Confidentiality
Pain Avoidance
ETHICS
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Ethics is the study of right and
wrong, duties and obligations.
Ethics involves critical
reflection on morality,
including the ability to make
choices between values and
the examination of the moral
dimensions of relationships.
AHCA’s Ethical Principles
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Ensure respect and
autonomy
Promote Justice
Protect privacy
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Do no harm
Provide beneficial
and caring services
ACHA Ethical Guidelines
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Responsibility in the Provision of Services
Professional Responsibility and Competence
Responsible and Ethical Relationships
Responsibility to One’s Institution
Responsibility to the American College Health
Association (ACHA) and to the Field of College
Health
What Does a
Code of Ethics Do?
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Creates a profession’s sense of identity
Identifies the issues the profession cares about
and wants new members to care about
Communicates with those outside the
profession what they can expect from its
members
PROFESSIONAL ETHICS
The moral commitments of a profession
that:
 involve moral reflection that extends and
enhances the personal morality
practitioners bring to their work,
 concern actions of right and wrong in the
workplace, and
 help individuals resolve moral dilemmas
they encounter in their work.
Recommendations
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ACHA members expected to uphold
the principles and guidelines
Use this document as a guide in day
to day practice and when breaches in
ethics are evident
Suggested Resources
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The following are suggested reading materials from the
Ethics Committee. ACHA does not endorse or accept
responsibility for the content or use of external websites or
materials.
Institute for Global Ethics: http://www.globalethics.org
The Ethics of Health Care: A Guide for Clinical Practice, by
Raymond S. Edge and John Randall Groves
Foundations of Ethical Practice, Research and Teaching in
Psychology, by Karen Strohm Kitchener
Principles of Biomedical Ethics, 5th Edition, by Tom L.
Beauchamp & James F. Childress
Suggested Resources
Gough, R. W. (1998). Character is destiny. Rocklin, CA: Prima.
Kidder, R. M. (2005). Moral courage. New York: HarperCollins
Publishers
Corey, G., Corey M.S., and Callanan, P. (2007). Issues and ethics
in the helping professions. Pacific grove, CA: Brooks/Cole.
Callanan, P. (2004). The cheating culture. New York: Harcourt Inc.
Fadiman, A. (1998). The spirit catches you and you fall down: A
Hmong child, her American doctors and the collision of two
cultures.
Kidder, T. (2003). Mountains beyond mountains: The quest of Dr.
Paul Farmer.
Mortenson, G. & Relin, D.O. (2006). Three cups of tea: One man's
mission to promote peace one school at a time.
How can ethics be used is real life
situations?
Discuss Sources of Similarity and Difference
Among Participants in Both Process and
Outcomes of These Analyses
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Small Group Discussion of Case Examples
• Principles and Guidelines Used
• Cultural, Professional & Diversity
Considerations
• Ethical “Method” Employed
• What will, or might happen?
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Large Group Sharing of Similarities and
Differences Identified
Small Group Discussion Time
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Pick a scribe for reporting back to
large group
Identify a case situation, “unpack it”
Apply different principles and actors
from different perspectives and
backgrounds
Track what principles or guidelines
are applicable, or at odds with one
another
Reports to the Large Group
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What was your group’s case
situation?
What were key issues/dilemmas?
What principles were involved?
What role did diversity play?
Other highlights?