Transcript Medical Ethics 4

Pearson's Comprehensive
Medical Assisting
Administrative and Clinical Competencies
Second Edition
CHAPTER
CHAPTER
3
Medical Law and Ethics
Lesson 4:
Medical Ethics
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Lesson Objectives
Lesson Objectives
•
•
•
•
Upon completion of this lesson, students
should be able to …
Explain the importance of the Hippocratic
Oath today.
List the seven main points of the AMA
Principles of Medical Ethics.
List and discuss the main points of the AAMA
Principles of Medical Ethics.
Discuss what is meant by the medical
assistant’s standard of care.
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Lesson Objectives
Lesson Objectives
Upon completion of this lesson, students
should be able to …
• Describe the Patient’s Bill of Rights.
• Explain the HIPAA guidelines concerning
the patient’s right to privacy and
confidentiality in the medical office.
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Pearson
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• Routh • Gohsman • Reagan
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Critical Thinking Question
1. What is the difference between ethics
and laws?
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Ethics
• Branch of philosophy related to morals or
moral principles
• Involves:
– The examination of human character and
conduct
– The distinction between right and wrong
– A person’s moral duty and obligation to the
community
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Medical Ethics
• Refers to the moral conduct of people in
medical professions
• The members of the profession set
principles and standards for themselves
• They willingly choose to follow through on
these behaviors
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Critical Thinking Question
1. What do you think some of the behaviors
are in the medical code of ethics?
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Hippocratic Oath
• Earliest code of ethics to govern conduct
in medicine
• Statement of principles written in 400 BC
by a Green physician, Hippocrates
• Recited at medical school graduation
ceremonies
• Notes the importance of the physician to
teach others and the obligation to act in
such a way as to never knowingly harm a
patient or divulge a confidence
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The Hippocratic Oath
Click here or go to www.pbs.org to read the
Classical Version or the Modern Version of the
Hippocratic Oath
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Critical Thinking Question
1. How do these versions of the Hippocratic
Oath differ? Should they differ? Why or
Why not?
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Characteristics of Ethical
Standards
• Typically more severe than those
standards required by law
• Often more demanding than the law
• A violation of an ethical standard could
mean the loss of the physician’s reputation
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Critical Thinking Question
1. What if your personal ethics are different
from medical ethics?
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Ethical Behavior According to the
American Medical Association (AMA)
• Moral principles or practices
• Customs of the medical profession
• Matters of medical policy
Unethical behavior = any action that does not
follow ethical standards
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Critical Thinking Questions
1. What is lost by violating a medical ethic?
2. How can patients suffer?
3. How can the medical profession suffer?
4. How can the individual physician or
health care worker who violates medical
ethics suffer?
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AMA Actions for Ethical
Violations
• AMA takes violations very seriously!
• AMA may:
– Investigate the member in confidence
– Conduct an investigative hearing
– Reprimand or admonish the member
– Place the member on probation
– Suspend the member
– Expel the member
• AMA cannot take legal actions for ethical
violations
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State Medical Board Actions for
Ethical Violations
• When an ethical complaint is made
against a licensed physician to a state
medical board, the board may:
– Limit the physician’s practice
– Warn the physician
– Revoke the physician’s license to practice
medicine in the state
If it is alleged that a physician has committed a
criminal act, the medical society must report it to
the state board.
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Areas Covered in the AMA
Principles of Medical Ethics
•
•
•
•
•
•
•
Human dignity
Honesty
Responsibility to society
Confidentiality
Need for continued study
Freedom of choice
Responsibility of the physician to improve the
community
Read the AMA Principles in its entirety by clicking here
or visiting www.ama-assn.org
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Code of Ethics of the American
Association of Medical Assistants
• Describes ethical and moral conduct for
medical assistants
• Similar to the AMA’s Principles of Ethics
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Pledge Made Under the AAMA
Code of Ethics
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;
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Pledge Made Under the AAMA
Code of Ethics
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
well-being of the community.
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Critical Thinking Question
1. How do the AMA and the AAMA Code of
Ethics compare?
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Creed of the AAMA
• I believe in the principles and purposes of the
profession of medical assisting.
• I endeavor to be more effective.
• I aspire to render greater service.
• I protect the confidence entrusted to me.
• I am dedicated to the care and well-being of all
people.
• I am loyal to my employer.
• I am true to the ethics of my profession.
• I am strengthened by compassion, courage, and
faith.
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Ways to Follow the Creed
• Spend time reading
about and discussing
ethical problems
• Understand the ethical
issues patients face
• Be committed to
treating patients with
respectful care
regardless of the
patient’s religious
beliefs or cultural
practices
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Critical Thinking Question
1. When might it be difficult to live up to this
creed?
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Medical Assistant’s Standard
of Care
• Actions you make as a medical assistant
can have legal consequences for the
physician who employs you
• You are not held to the same standard of
care as the physician because you have:
– Different credentials
– Different licensure
– Different education
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Medical Assistant’s Standard
of Care
• Since you carry out your duties under the
supervision of the physician, you must use
the same approved methods as the
physician for tasks you do perform
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As a Medical Assistant, You Are
NOT Expected to….
• Diagnose medical conditions
• Interpret results of tests
• Prescribe medications
These responsibilities are within the physician’s
standard of care.
An MA must take caution to not do anything for
which he or she is not trained and remain within the
scope of his or her practice.
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The Patient’s Bill of Rights
• Developed by the American Hospital
Association
• Describes the patient-physician
relationship
• MAs must also follow these guidelines
when working with the physician’s patients
• Most medical offices have these printed
for patients
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The Patient’s Bill of Rights
1. The patient has the right to considerate and
respectful care.
2. The patient has the right to and is
encouraged to obtain from physicians and
other direct caregivers relevant, current,
understandable information concerning
diagnosis, treatment, and prognosis.
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The Patient’s Bill of Rights
3. The patient has the right to make decisions
about the plan of care prior to and during
the course of treatment and to refuse a
recommended treatment or plan of care to
the extent permitted by law and hospital
policy and to be informed of the
consequences of this action.
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The Patient’s Bill of Rights
4. The patient has the right to have an
advance directive (such as a living will,
health care proxy, or durable power of
attorney for health care) concerning
treatment or designating a surrogate
decision maker with the expectation that the
hospital will honor the intent of that directive
to the extent permitted by law and hospital
policy.
5. The patient has the right to every
consideration of privacy.
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The Patient’s Bill of Rights
6. The patient has the right to expect that all
communications and records pertaining to his
or her care will be treated as confidential by
the hospital, except in cases such as
suspected abuse and public health hazards
when reporting is permitted or required by law.
7. The patient has the right to review the records
pertaining to his or her medical care and to
have the information explained or interpreted
as necessary, except when restricted by law.
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The Patient’s Bill of Rights
8. The patient has the right to expect that, within
its capacity and policies, a hospital will make
reasonable responses to the request of a
patient for appropriate and medically-indicated
care and service.
9. The patient has the right to ask and be
informed of the existence of business
relationships among the hospital, educational
institutions, other health care providers, or
payers that may influence the patient’s
treatment or care.
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The Patient’s Bill of Rights
10. The patient has the right to consent to or
decline to participate in proposed research
studies or human experimentation affecting
care and treatment or requiring direct patient
involvement, and to have those studies fully
explained prior to consent.
11. The patient has the right to expect reasonable
continuity of care when appropriate and to be
informed by physicians and other caregivers of
available and realistic patient care options
when hospital care is no longer appropriate.
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The Patient’s Bill of Rights
12. The patient has the right to be informed of
hospital policies and practices that relate to
patient care, treatment, and responsibilities.
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Patient Rights Specified by the
Medical Patient’s Rights Act
• All patients have the right to have their
personal privacy respected and their medical
records handled with confidentiality.
• Information such as test results, patient
histories, or that a person is even a patient
cannot be told to another without permission.
• No information can be given over the phone
without permission.
• No records can be given to another person or
physician without permission.
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HIPAA
• Health Insurance Portability and
Accountability Act of 1996
• Regulates the privacy of patient health
information
• Was an effort to reduce the cost of health
care and streamline the system
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HIPAA
• Four objectives:
– Improve the portability of health insurance
– Combat fraud, abuse, and waste in health
care
– Promote the expanded use of medical
savings accounts
– Simplify the administration of health insurance
Click here or visit www.hhs.gov/ocr/hipaa to
explore the HIPAA Website.
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Patient Rights Under HIPAA
• Right to a copy of the privacy notice from the
health care provider
• Right to access their medical records, and
the right to restrict access by others, request
changes, and learn how their records have
been accessed
• Right to ask the provider to limit the way in
which health care information is shared and
to keep disclosures to the minimum needed
for treatment and business operations
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Patient Rights Under HIPAA
• Right to ask for an accounting of to whom
the health care information was given
• Right to examine and copy the health
information the provider has recorded
• Right to complain to the covered entity and
the Department of Health and Human
Services if the patient believes there is a
violation of his or her privacy
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HIPAA Training
• All medical office employees must
undergo HIPAA training during their
orientation
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HIPAA Requirements
• Patient information
may not be shared
with others without
written authorization
To watch a scenario on Protecting Patient Privacy,
insert the DVD from the back of the textbook and select
this video.
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HIPAA Requirements
• Offices must make
sure that computers
with confidential
patient information
cannot be seen or
accessed by
individuals who are
not authorized to see
the information
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HIPAA Requirements
• Faxes and e-mails that contain private
patient information must have a note
stating that the information is confidential.
• If accidentally transmitted to someone
without clearance, the recipient must
immediately notify the office and destroy
the information.
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Human Dignity
• Human dignity of
each patient must be
preserved regardless
of the patient’s
– Socioeconomic
background
– Race
– Age
– Nationality
– Sexual orientation
– Gender
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Critical Thinking Questions
1. Why is confidentiality important?
2. Should friends or family have access to a
patient’s medical information? Why or
why not?
3. What confidentiality challenges does
communications technology bring?
4. What challenges does telemedicine
bring?
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What Do You Do?
When a physician performs a
procedure that you strongly disagree
with ethically (such as an abortion)?
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Recommendations
• Discuss these types of issues during the
interview
• If you find that you will be in an ethical
dilemma, consider not taking the job
• If the situation arises after you are hired,
discuss the situation immediately with your
employer
• Remember – the health and safety of the
patient is always the priority
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What Do You Do?
1. When one of your patients
expresses an opinion or belief with
which you strongly disagree?
2. When a coworker expresses an
opinion or belief with which you
strongly disagree?
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Medical Ethical Issues
•
•
•
•
•
When should life support be withdrawn?
When does a life begin?
Should abortion be lawful?
Should partial abortion be lawful?
Is euthanasia ever permissible?
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Medical Ethical Issues
• Should an unborn baby be sacrificed to
save the mother?
• What are the ethical issues associated
with artificial insemination?
• Should couples use fertility drugs to
increase their chances of pregnancy?
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Medical Ethical Issues
• Should eugenic sterilization be allowed?
• Should sterilization be allowed as a form
of birth control?
• Should genetic testing and counseling be
something that every couple or parent
should undergo?
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Medical Ethical Issues
• What are ethical considerations
surrounding wrongful life issues?
• Should we be able to clone tissues,
organs, or organisms?
• Where does one draw the line?
• Should human stem cells be used to treat
certain diseases?
• Others?
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Questions?
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