HealthStream Regulatory Script

1 HealthStream Regulatory Script medical ethics Release Date: June 2009. HLC Version: 602. Lesson 1: Introduction Lesson 2: Overview Lesson 3: The Patient-Provider Relationship Lesson 4: Patients Near the End of Life Lesson 5: Practice, Society, and Colleagues 1. Lesson 1: Introduction 1001. Introduction Welcome to the introductory lesson on medical ethics [glossary]. IMAGE: As your partner, HealthStream strives to provide its customers with excellence in Regulatory learning solutions. As new guidelines are continually issued by Regulatory agencies, we work to update courses, as needed, in a timely manner. Since responsibility for complying with new guidelines remains with your organization, HealthStream encourages you to routinely check all relevant Regulatory agencies directly for the latest updates for clinical/organizational guidelines. If you have concerns about any aspect of the safety or quality of patient care in your organization, be aware that you may report these concerns directly to the Joint Commission.

2 Page 1 of 4. 1002. Course Rationale medical ethics refers to the discussion about: IMAGE: Choices and values in medical practice The duty of healthcare providers It examines questions of moral right and wrong. This course will help you: Understand what you should and should not do as a healthcare provider Do your job in an ethical way You will learn about: The four basic ethical principles for healthcare providers ethics around specific issues in healthcare today Page 2 of 4. 1003. Course Goals Upon completion of this continuing education activity, participants NO IMAGE. should be able to: List the four guiding principles of medical ethics to improve patient outcomes Recognize ethical duties related to patient care in general Identify ethical duties related to patients near the end of life that will improve patient care List the ethical duties that providers have in relation to their medical practice, society as a whole, and other providers Page 3 of 4.

3 1004. Course Outline This introductory lesson gave the course rationale and goals. FLASH ANIMATION: Lesson 2 presents the four guiding principles of medical ethics . Lesson 3 covers ethical duties related to patient care and the patient-provider relationship. Lesson 4 takes a closer look at ethical duties related to patients near the end of life. Finally, lesson 5 looks at ethical duties related to medical practice, society as a whole, and colleagues. Page 4 of 4. Lesson 2: Overview 2001. Introduction & Objectives Welcome to the overview lesson on medical ethics . FLASH ANIMATION: After completing this lesson, you should be able to: List the four guiding principles of medical ethics Cite one example of how these principles might conflict Page 1 of 8. 2002. History of ethics Many hundreds of years ago, physicians of ancient Greece first took IMAGE: the Hippocratic Oath.

4 They swore to do what was for the benefit of patients, and abstain from whatever is deleterious [glossary] and mischievous.. Page 2 of 8. 2003. History of ethics Today, healthcare providers face ethical questions that were IMAGE: unheard of even 10 or 20 years ago. These questions have come up because of: Advances in medicine Changes in society Because of these changes and new questions, it makes sense for healthcare providers to go back to basics. Providers must remind themselves of their basic ethical principles. Page 3 of 8. 2004. Four Basic Principles The four basic concepts of medical ethics are: CLICK TO REVEAL. Beneficence Non-maleficence Beneficence Respect for patient autonomy Beneficence means that healthcare providers have a duty Justice to: Do good Click on each to learn more. Act in the best interest of their patients Act in the best interest of society as a whole Non-maleficence Non-maleficence means that healthcare providers have a duty to: Do no harm to their patients Do no harm to society Respect for patient autonomy This principle means that healthcare providers have a duty to protect the patient's ability to make informed decisions about care.

5 Justice Justice means that healthcare providers have a duty to be fair to the community. In particular, providers have a duty to promote fair distribution of healthcare resources. Page 4 of 8. 2005. Dilemmas Unfortunately, the four guiding principles sometimes conflict. IMAGE: For example, you might have a patient who needs a kidney transplant. But kidneys are a scarce resource. If your patient gets a kidney, some other patient will not get the kidney. You job is to advocate for your patient. In doing so, you are taking a kidney from another patient. You are indirectly doing harm to that patient. But you must put aside non- maleficence, to act in the best interest of your patient ( , beneficence). Page 5 of 8. 2006. Dilemmas The ethical conflict on the previous screen is a simple example. It NO IMAGE. has a simple answer. Other conflicts and dilemmas can be much more complex.

6 To address ethical conflicts, you must be able to take into account: The guiding principles of medical ethics The particular situation Page 6 of 8. 2007. Review FLASH INTERACTION: Drag and drop the terms below to their correct place in the table. Beneficence Duty of the healthcare provider to do good Non-maleficence Duty of the healthcare provider to do no harm Respect for patient autonomy Duty of the healthcare provider to protect the patient's ability to make informed healthcare choices Justice Duty of the healthcare provider to promote fair distribution of healthcare resources Page 7 of 8. 2008. Summary You have completed the overview lesson on medical ethics . NO IMAGE. Remember: The four guiding principles of medical ethics are: beneficence, non-maleficence, respect for patient autonomy, and justice. These principles can sometimes conflict. To resolve conflicts, you must have a clear understanding of ethical principles.

7 You also must take into account the circumstances of each conflict. Page 8 of 8. Lesson 3: The Patient-Provider Relationship 3001. Introduction & Objectives Welcome to the lesson on the patient-provider FLASH ANIMATION: relationship. After completing this lesson, you should be able to: Identify the imbalance of power in the patient- provider relationship Recognize why providers should not treat themselves or loved ones Recognize the provider's ethical duty to maintain patient confidentiality Recognize the ethical duties of the healthcare provider around informed consent Identify the provider's ethical duty to provide care to patients, regardless of their disease state or ability to pay Page 1 of 23. 3002. Overview: An Equal Relationship? Remember: Respect for patient autonomy means that patients have IMAGE: the right to make decisions about their own care.

8 Providers must respect and protect this right. This might suggest that patients and providers are on an equal footing in their relationship. Page 2 of 23. = 3003. Overview: An Unequal Relationship In reality, patients and providers never have an equal relationship. IMAGE: The provider has specialized knowledge and skills. The patient is vulnerable and dependent. This results in an imbalance of power. This means that the provider has special duties in the relationship. At all times, the provider must: Act professionally Guide the relationship properly Keep the patient's welfare as top priority Page 3 of 23. 3004. Relationship Issues Specific ethical issues in the patient-provider relationship have to do NO IMAGE. with: The nature of the relationship Payment Confidentiality Disclosure and informed consent medical risk Let's take a closer look at each. Page 4 of 23.

9 3005. Nature of the Relationship In his or her relationship with patients, the healthcare provider must: IMAGE: Be competent Act responsibly Treat the patient with compassion and respect The provider must focus on the welfare of the patient. This focus must not be affected by: Market forces ( , healthcare coverage, drug companies, etc.). Social pressures Administrative concerns Page 5 of 23. 3006. Nature of the Relationship: Sexual Relations It is always unethical for a provider to have a sexual relationship with IMAGE: a current patient. This sort of relationship would be abusive due to: The knowledge and power of the provider The dependence and vulnerability of the patient This is true even if the patient: Consents to the sexual contact Initiates the sexual contact Page 6 of 23. 3007. Nature of the Relationship: Friends & Family Healthcare providers should not treat: NO IMAGE.

10 Themselves Close friends Family members Close employees If a provider does treat someone close, the provider or patient could end up feeling awkward or embarrassed. This could lead to: Incomplete medical histories Inadequate physical exams In addition, providers are unlikely to be objective about loved ones. This can lead to poor medical decisions. Page 7 of 23. 3008. Payment Providers should be paid fairly. IMAGE: However, the provider's duty to the patient comes before money. Providers have an ethical duty to care for patients, whether or not those patients can pay. Page 8 of 23. 3009. Money The ethical duty to care for patients, regardless of payment, is IMAGE: reflected in law. Under EMTALA [glossary], hospitals that participate in Medicare and have emergency departments must provide emergency services to patients. This is true whether or not the patient can pay.