Introduction to Health Care Ethics



in today's world ethics is not always the first consideration in any scenario things that were once black and white seem to have faded to gray why is that with ethical uncertainty uncertainty confronting us daily it is important to know yourself and your own values and attitudes where is the line that separates ethical from unethical as a health care professional you will be faced with decision-making daily we live in such a litigious society that our daily decisions are oftentimes met with reserve and what ifs through this course you will read about ethical situations combining your own personal values and systems and new information in this course you should consider all angles and come to conclusions through reasoning skills what does ethics mean to you think about it the typical replies include well ethics has to do with what my feelings tell me is right or wrong another is ethics has to do with my religious beliefs a third being ethical is doing what the law requires another ethics consists of the standards of behavior our society accepts and of course the last one is I don't know what the word means so let's look at the first four to help us define what ethics is feelings many people equate ethics with feelings however being ethical is clearly not a matter of following your feelings feelings frequently deviate from what is considered ethical religion religions do advocate high ethical standards and provide intense motivations for ethical behavior but ethics cannot be confined to religion nor is it the same as religion therefore religion should not be identified with ethics law law incorporates ethical standards to which citizens subscribe but ethics ethics is not the same as following the law the law of a society can deviate from what is ethical examples include slavery and apartheid socially acceptable behavior ethics is not the same as doing whatever society accepts standards of behavior like the law can deviate from what is ethical for example Nazi Germany so what is ethics ethics is well founded standards of right and wrong it is what humans ought to do in terms of rights obligations benefits to society fairness and specific virtues ethics is a continuous effort of studying our own moral beliefs and our own conduct so it can be boiled down to the study of right and wrong in the context of our own moral beliefs and conduct we will be looking at many different cases where the answers are just not obvious and I know you don't like that these cases we look at are usually caught up in a lot of public controversy there are seven universal principles of biomedical ethics they are autonomy beneficence justice veracity non malfeasance confidentiality and role fidelity at this time I want to briefly review the first three autonomy beneficence and justice and this justice is distributive justice as it relates to health care what is autonomy well autonomy means self-determination in medicine that is the ability to control what happens to your own body or the right to control your own life in medicine this means the ability of one to refuse treatment create advance directives appoint a proxy and receive informed consent problems with autonomy come into play when parents refuse treatment for their child can parents control their children's lives what if the children disagree with the parents and want the treatment what if the lack of treatment will lead to certain to certain death of a child can children and teens refuse treatment without parental consent what about mentally ill patients refusing treatment there are more questions than answers it seems what about determination of a person's competence to make decisions about treatment does the person understand the consequences of his or her actions there is no universal standard this type of competency here is a typical example of a case of autonomy an end-stage COPD patient who was intubated a year ago for an acute exacerbation of COPD is now in the emergency department the patient has advanced advanced directives that state in addition to other things that life-sustaining procedures may be withdrawn or withheld if he has an illness disease or injury or experience extreme mental deterioration such that there is no reasonable expectation of recovering or regaining a mean of meaningful life however the patient and his family consent to a trial of non-invasive ventilation the patient continues to deteriorate and has been unresponsive for the last five days the family refuses to withdraw the non-invasive ventilation or have the man intubated should the non-invasive ventilation be withdrawn over the family's objections what is the ethical dilemma here well was there informed consent for the non-invasive ventilation is this what the patient would have wanted and can the family override the patient's previously stated wishes it so happens that the physician removed the non-invasive ventilation according to the patient's advanced wishes the patient died shortly after the question is the deposition do the right thing was it ethical was it legal these are the questions that you have to think about another case of autonomy a woman is in the emergency department with stomach pains that are not responding to treatment a CT scan reveals she has an abdominal aortic aneurysm the physician informs the patient that surgery is the only way to fix this problem and gives her a 50/50 chance of survival without surgery the aneurysm will most likely burst the woman's occupation is an erotic dancer she is worried about having a scar from the surgery and refuses the surgery the surgeon feels the patient is not in her correct state of mind and decides on his own to proceed without consent the aortic aneurysm is repaired and the patient lives so the patient survives and then turns around and Sue's the hospital for millions of dollars do you believe that the surgeons action actions can be justified in any way is there anything else that could have been done for this patient is it ever right to take away someone's autonomy would a court order make the surgeons decision ethical as you begin this course think about what you currently know about ethics keep an open mind about new information you that is introduced to you and use both to arrive at conclusions

16 Comments

  1. I believe the doctor would not win that case due to neglecting her consent and autonomy and made no assessment to her competence. The doctor is right by trying to decrease harm but ignored autonomy, her rights

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  8. what a good woman you are

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  16. very good. thank you for this educational video!

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