Healthcare Ethics

Ethics in Healthcare

• Accountability refers to answering for one's own actions.
• Confidentiality involves respecting patient privacy.
• Values are deeply held beliefs that affect choices and behaviors, and can change over time due to cultural and social influences.

Approaches to Ethics

• Deontology is based on a "duty" to do what's right simply because it's right, adhering to rules and principles such as fidelity to promises, truthfulness, and justice.
• Utilitarianism focuses on outcomes, aiming for the greater good and best outcomes.
• Casuistry involves bending policies to justify preferred outcomes using one's own facts.
• Feminist ethics emphasize natural caring for others as the basis for moral behavior, focusing on emotions and relationships.
• Ethics of care focus on understanding relationships, personal narratives, and context in which ethical problems arise, with patient advocacy as a top priority.

Ethical Problems

• Ethical dilemma: lying to people, even if it's a white lie.
• Moral distress: being forced to take a specific action that goes against one's beliefs.

Ethics Committee

• An ethics committee is devoted to teaching and processing ethical issues and dilemmas, involving individuals from different disciplines and backgrounds.

Processing an Ethical Problem

• 7 steps: Ask, Gather, Identify problem, Name problem, Possible Action, Take action, Evaluate the plan.

Patient Education

• Goal: help individuals, families, or communities achieve optimal levels of health.
• Education plan starts from day one, focusing on maintenance and promotion of health, restoration of health, and coping with impaired functions.

Effective Communication

• Involves feedback from sender and receiver.
• Effective educator delivers instruction and evaluates success of teaching plan by gaining feedback from receiver.

Domains of Learning

• Cognitive learning: understanding, with 6 levels of understanding (Bloom's taxonomy).
• Affective learning: attitudes.
• Psychomotor learning: motor skills.

Cultural Factors in Patient Education

• ACCESS helps focus on cultural factors influencing patient education outcomes.

Patient-Centered Care

• Four core concepts: respect for patients' values, coordination of care, information sharing, and emotional support.

Case Management

• Coordinates and links health care services across all levels of care for patients and their families, streamlining costs and maintaining quality.

Decision Making

• Shared governance: decentralized structure, allowing decisions to be made at staff level.
• Responsibility: duties and activities employed to perform.
• Autonomy: making independent decisions about patient care.
• Authority: legal ability to perform tasks, assign tasks, and follow up.
• Accountability: assuming responsibility for outcomes of actions, clinical judgments, and omissions.
• Staff involvement: all staff members actively participate in activities.

Interprofessional Collaboration

• Involves collaboration among nurses and health care providers, with a goal of delivering quality, safe patient care and creating a positive work culture.

Critical Thinking and Clinical Judgment

• Clinical judgment is the observed outcome of critical thinking and decision making.
• Clinical decision making: technicians or other assistive personnel cannot make or take immediate action.

Therapeutic Communication

• Techniques encourage the expression of feelings and ideas, conveying acceptance and respect.
• Nontherapeutic techniques discourage further expression of feelings and ideas, leading to negative responses or behaviors.

Sociocultural Considerations

• Culture influences thinking, feeling, behaving, and communicating.
• Speech and language considerations should be adapted based on patient needs.

Patient Outcomes

• Evaluate patient outcomes, identifying factors that influenced outcomes and modifying the plan of care accordingly.