Ethical Foundations of Legal Analysis in Healthcare

Ethical Underpinnings of Legal Analysis

• Good practice is equivalent to ethical practice from a philosophical stance.
• Ethical orientations guide actions of health professionals, but legal decisions embody policy choices made by society.
• Policy choices do not always provide adequate support to act beneficently for vulnerable or uninsured groups, often served by APNs.

Promoting Patient Autonomy

• Autonomy refers to self-chosen action and is viewed as self-determination in law.
• Autonomy may be compromised when a person is cognitively impaired.
• Health concerns of the poor, such as physical and mental health, can obscure the moral "health" of the individual.

APN Autonomy

• APNs must experience autonomy in their judgments and practice for professional roles to evolve.
• Ethical conflicts in practice can decrease NPs' perceived autonomy.
• NPs are concerned about ethical conflicts between patient needs and managed care organization requirements.

Justice and Vulnerable Populations

• Justice means fair and equitable treatment of others.
• Justice in health care ethics refers to fairness, treating people equally and without prejudice, and the equitable distribution of benefits.

Sources of Ethical Conflict

• Access to care due to transportation problems and reimbursement rules can be a source of moral distress.
• End-of-life care poses challenges for APNs, from questions of assistance in achieving a peaceful death to advanced planning for death.
• Ethical challenges arise at the beginning of life, when vulnerable newborns need important health care decisions made on their behalf.
• Decisions made by adolescents create concerns for APNs.
• Refusal of treatment is a common ethical issue in NP practice, including patient refusal of vaccines.

Privacy and Confidentiality

• Privacy refers to the right to limit access of others to one's personal information.
• Confidentiality prevents the release of personal information to others.

Responsibilities in Health Care System

• Health care providers have many responsibilities towards the patient and the community.
• Clients also have responsibilities towards the health care system.

Definition of Health Care System

• A health care system is the totality of services offered by all health disciplines.

Health Care Providers

• Health care providers include individuals or institutions that provide preventive, curative, promotional, or rehabilitative health care services.

Types of Health Care Services

• Health promotion and illness prevention (primary prevention)
• Diagnosis and treatment (secondary prevention)
• Rehabilitation and health restoration (tertiary prevention)

Health Promotion and Illness Prevention

• Health promotion activities include adequate and proper nutrition, weight control, exercise, and stress reduction.
• Illness prevention programs emphasize immunization, identifying risk factors of illness, and environmental programs that reduce illness or disability.
• Early detection of disease is also a part of health promotion.

Responsibilities of Government, Health Care Providers, and the Community

• Governmental agencies support the system through providing resources.
• Health care providers conduct health programs, provide health teaching, and maintain records.
• The community participates in health care programs, follows instructions, and provides reliable data.

Rehabilitation, Health Restoration, and Palliative Care

• Rehabilitation is a process of restoring ill or injured people to optimum and functional levels of wellness.
• The goal of rehabilitation is to help people move to their previous level of health or to the highest level they are capable of given their current health status.

Responsibilities of Governmental Agencies, Health Care Providers, and the Community

• Governmental agencies provide rehabilitative centers, free services, and educate people about the importance of rehabilitation.
• Health care providers respect clients, provide accurate information, and consider them as unique individuals.
• Clients provide complete and accurate information, keep appointments, and clear their queries.