Healthcare Ethics and Responsibilities

CANMEDS

• A framework to describe the roles and responsibilities of physicians.
• Emphasizes that a physician's role extends beyond the traditional clinical skills to encompass professional, ethical, and leadership responsibilities.

Constitution

• Establishes the basic framework of a nation's government.
• Defines individual rights.
• Outlines the processes for making laws and governing the country.

The Bill of Rights

• A document that outlines the basic individual rights and freedoms that are protected by the government.

Patient Rights Charter

• A document that sets out the rights of patients in relation to their healthcare.
• It can be used to ensure patients are treated with respect and dignity, and that they have a say in their own care.

Pfulandlela Pledge

• A pledge written by Wits HS faculty, it emphasizes the importance of a caring and ethical approach to healthcare.

WHO

• Stands for the World Health Organization.
• A specialized agency of the United Nations that is concerned with international public health.
• Focuses on promoting health, preventing disease, and improving the health outcomes of people worldwide.

National Core Standards

• Set of standards for clinical practice in a country.
• Designed to ensure that healthcare services are delivered safely, effectively, and equitably.

Standard 1: Patient Rights

• Patients have rights and privileges related to their health care.
• These include the right to informed consent, the right to privacy, and the right to refuse treatment.

Standard 2: Safety, Clinical Risk

• Protecting patients from harm through safe practices and procedures.
• Minimizing risks associated with medical interventions.
• Includes promoting a culture of safety in healthcare settings.

Standard 3: Clinical Support

• Providing necessary support services to facilitate effective clinical care.
• Includes access to laboratory services, imaging studies, and other diagnostic and therapeutic interventions.

Standard 4: Public Health Services

• Ensuring that healthcare services are organized and delivered in a way that promotes the overall health and well-being of the community.
• Includes preventive medicine, disease surveillance, and health education.

Standard 5: Leadership & Corporate Governance

• Making decisions about clinical processes.
• Managing resources effectively in a clinical setting.

Standard 6: Operational Management

• Ensuring that healthcare facilities operate efficiently and effectively.

Standard 7: Facilities & Infrastructure

• Maintaining safe, clean, and functional healthcare facilities.
• Includes infrastructure such as equipment, supplies, and utilities.

6 Priorities

• A list of priorities for improving healthcare delivery.

Priority: Patient Safety, Patient Rights: Clinical - Values and Attitudes

• Treating patients with dignity and respect.
• Demonstrating empathy and compassion.
• Making sure patients are comfortable and safe at all times.

Priority: Patient Safety, Patient Rights: Clinical - Waiting Times

• Minimizing wait times for appointments, treatments, and procedures.
• Ensuring that patients are seen in a timely manner.

Priority: Patient Safety, Patient Rights: Clinical - Cleanliness

• Maintaining a clean and hygienic environment for patients.

Priority: Facilities & Infrastructure - Cleanliness

• Cleanliness and hygiene are essential to prevent infections.

Priority: Governance & Care - Patient Safety

• Ensuring patients are safe from harm.

Priority: Governance & Care - Infection Prevention and Control

• Implementing measures to prevent the spread of infections.

Priority: Clinical Support Services - Availability of Medicines & Supplies

• Ensuring that patients have access to the medication and medical supplies they need.

Self-Reflection Mandate

• Being self-aware helps individuals learn from both successes and mistakes.
• Self-care is vital in the healthcare profession. It is important to prioritize well-being to help others effectively.
• The SPaRC model is based on a belief that one is capable to learn in real-life situations by engaging in real-life practices. This will develop competence and effectiveness in providing care to others.

Ethics of Care

• A way of thinking about ethics that emphasizes the importance of relationships, compassion, and empathy.
• Focuses on the care, needs, and well-being of others.

Ethics At Large

• Traditional ethical theories often focus on individual autonomy and rational decision-making.

Principalism

• A framework for ethical decision-making that emphasizes four key principles:
  • Autonomy: Respecting the patient's right to self-determination.
  • Beneficence: Acting in the best interests of the patient.
  • Non-maleficence: Avoiding harm to the patient.
  • Justice: Treating patients fairly and equitably.

Normative Ethics

• Deals with questions of what we should do.

Care Ethics

• Developed from feminist perspectives, emphasizing the importance of relationships and care in ethical decision-making.
• It is often applied in healthcare, education, and other fields.

Premises

• Patient-Centredness: The patient is viewed as an individual with unique needs and preferences.
• Interdependency of Human Existence: People rely on each other for care and support.

Relationships, Person, and Society

• Individuals are relational beings and are shaped by their relationships.
• The concept of a self-sufficient, independent individual is often unrealistic.

Does Care = Girly?

• Care ethics is not solely associated with women. It is a universal value that is important for people of all genders.

Ethics of Care - Principles

• Competency: Possessing the necessary skills and knowledge to provide high-quality care.
• Responsibility: Being accountable for actions and decisions.
• Advocacy: Supporting the patient's rights and interests.
• Care: Providing compassionate and attentive care to patients.
• Good person: Demonstrating integrity, honesty, and trustworthiness.
• Resource Management: Utilizing resources responsibly and efficiently.
• Social Justice: Promoting fairness and equity in the distribution healthcare resources.

Interprofessional Learning and Practice

• Working collaboratively across different professions.

Aims of Interprofessional Learning and Practice

• Enhance understanding of the roles and responsibilities of healthcare professionals.
• Encourage communication and teamwork among healthcare teams.
• Promote patient-centered care.

WHO Framework for Interprofessional Practice

• A framework for interprofessional practice that emphasizes collaboration and teamwork.
• Provides guidance on how to implement interprofessional practice in healthcare settings.

What is Interprofessional Practice?

• Collaboration among professionals from different disciplines, including patient and family.

MacroSystem

• A broader social context that influences individual behavior and development.

ExoSystem

• Refers to institutions and organizations that influence the micro- and mesosystems.

MesoSystem

• Deals with the interaction of different microsystems.

MicroSystem

• The immediate environment of the individual.

The Continental Axis Theory - Jared Diamond

• Explains how the geographical orientation of continents influences the development of human societies.
• East-West axes - similar climate zones help spread farming, ideas.
• North-South - different climates, barriers.

Factors Underlying Broadest Pattern of History

• Ultimate Factors: The east-west axis, suitable wild species, ease of spreading species, domesticated plants and animals.
• Proximate Factors: Horses; guns, ships, swords; steel, writing; political organization; epidemic diseases.

Medical Ecology Model

• The relationships between humans, pathogens, the environment.
• Health and disease outcomes are influenced by the eco-health perspective.
• Influenced by environmental ethics, environmental justice, ecosystem services.
• Human ecology model is a multiprofessional practice of clinical work.
• Focuses on integrating patient health with the overall well-being of the environment.

Integrative Concepts of Health and Disease by Human Ecological Medicine

• George L Engel's biopsychosocial model emphasizes the interconnectedness of biological, psychological, and social factors in understanding health and disease.

Human-Environment Relationship and its Variants

• The human-environment relationship can be a complex interplay of give and take interactions.
• Unbalanced relationships can lead to health issues.
• Example of Incan downfall from the Spanish who brought swine flu.

Professional Identity Formation

• The core competencies of a healthcare practitioner are defined by the HPCSA/Afrimed/Canmed guidelines framework.
• These guidelines help healthcare practitioners integrate knowledge, skills, and professional attitudes in patient-centered care.
• The purpose of the session is to help healthcare practitioners identify their professional identity within the framework.

Values

• Values are individual beliefs about right and wrong and the principles that guide actions.
• Values guide interactions with others.

Professions and the Social Compact

• Professions require specialized training and come with a degree of respect and responsibility.
• Healthcare professions have a social compact/expectation to "do no harm."

Privilege and Self-Governance

• Healthcare professionals have a responsibility to act in the interests of the profession, even if it means opposing the state.
• This responsibility is facilitated by understanding the profession's role and appropriate behavior.

Professional Values

• Healthcare professionals should embrace compassion, respect, integrity, professionalism, communication, and teamwork.

The Role of the Healthcare Practitioner

• Healthcare practitioners are central to the framework of defining graduate attributes integrating all roles.

Points of Reference for Understanding Role

• Guidelines such as Batho Pele Principles, HPCSA guidelines, CANMEDS, Constitution, Bill of Rights, Patient Rights Charter, Pfulandlela Pledge, and WHO all contribute to defining the healthcare practitioner role.

Self-Reflection

• Self-awareness is essential for learning from mistakes and successes.
• Self-care is crucial for well-being and the ability to help others.

Experience-based Learning: The SPaRC Model

• The SPaRC model encompasses Support, Participation, Real Patient Learning, and Capability.
• The model emphasizes preparing, experiencing, reflecting, and performing in patient care.

Ethics of Care

• The session examines the cultural importance of a caring environment for colleagues and peers.
• The session aims to clarify the application of virtue ethics and care ethics in medical practice and resolve ethical dilemmas using case study scenarios.

Ethics at Large

• Traditional ethical theories like utilitarianism and deontology dominate.
• Society is seen as made up of autonomous, rational individuals who emphasize rules, duties, justice, rights, impartiality, universality, utility, and preference satisfaction.
• The WHO aims to achieve health equity through reforms in universal coverage, services, public policy, leadership, and stakeholder participation.

Sustainable Development Goals

• Sustainable Development Goals (SDGs) address various aspects of development, including health.
• SDG 3 focuses on good health and well-being.
• All SDGs work towards achieving primary healthcare and addressing health determinants.

COPC Tools

• COPC tools, such as situational analysis, the LISA tool, and the SWOT tool, help healthcare professionals understand the context of their practice and make evidence-based decisions.

Situational Analysis

• Situational analysis assesses the health status of a community, identifies resources and gaps, and determines factors influencing health outcomes.
• It involves reviewing data to understand demographic characteristics, health status, available resources, and environmental factors impacting health.

LISA Tool

• The LISA tool analyzes interactions between the locality, institutions, stakeholders, and activities within a community, emphasizing interconnectedness.
• It examines geographical, cultural, and socioeconomic characteristics of the community, institutional roles and capacities, key stakeholders, and ongoing health activities.

SWOT Tool

• The SWOT tool evaluates Strengths, Weaknesses, Opportunities, and Threats related to a community health initiative.
• It helps identify internal and external factors influencing success and enables strategic planning to capitalize on strengths, address weaknesses, and mitigate threats.

People in the PFC Space

• The session aims to enhance students' understanding of the healthcare system, communication skills, and professional development.
• It introduces the various stakeholders in the PFC space.

Government Bodies

• National Department of Health (NDOH): Formulates health policies, strategies, and guidelines; oversees implementation and monitoring; provides funding and resources to provincial health departments.
• Provincial Health Departments: Implement national policies at the provincial level; manage healthcare facilities and services; allocate and manage provincial health budgets.
• Local Municipalities: Ensure primary healthcare services at the local level; operate local clinics and health centers.

Explore the essential frameworks and documents that govern healthcare ethics, including the CANMEDS roles, the Patient Rights Charter, and the Pfulandlela Pledge. This quiz delves into the ethical responsibilities of physicians and the rights of patients within the healthcare system.