This document provides an overview of key concepts in health care ethics, including basic ethical principles like autonomy, beneficence, nonmaleficence, and justice. It discusses the historical background of rights reasoning, from natural rights to human rights and contractarian theories. The main lesson covers universal principles like autonomy and informed consent, as well as veracity, confidentiality, and role fidelity. It also addresses debates around whether health care should be considered a human right.
This document provides an overview of key concepts in health care ethics, including basic ethical principles like autonomy, beneficence, nonmaleficence, and justice. It discusses the historical background of rights reasoning, from natural rights to human rights and contractarian theories. The main lesson covers universal principles like autonomy and informed consent, as well as veracity, confidentiality, and role fidelity. It also addresses debates around whether health care should be considered a human right.
This document provides an overview of key concepts in health care ethics, including basic ethical principles like autonomy, beneficence, nonmaleficence, and justice. It discusses the historical background of rights reasoning, from natural rights to human rights and contractarian theories. The main lesson covers universal principles like autonomy and informed consent, as well as veracity, confidentiality, and role fidelity. It also addresses debates around whether health care should be considered a human right.
This document provides an overview of key concepts in health care ethics, including basic ethical principles like autonomy, beneficence, nonmaleficence, and justice. It discusses the historical background of rights reasoning, from natural rights to human rights and contractarian theories. The main lesson covers universal principles like autonomy and informed consent, as well as veracity, confidentiality, and role fidelity. It also addresses debates around whether health care should be considered a human right.
Lesson Title: Basic Principles of Health Care and the Nature of Materials: Rights in Ethical Discourse Pen, paper, index card, book, and class List Learning Targets: At the end of the module, students will be able to: 1. Identify the applications of the basic principles of health care References: ethics in our ethical codes; 2. Define the basic principle found in health care ethics; Ethics of Health Care: A Guide for Clinical 3. Understand the historical background of rights; Practice Fourth Edition, Raymond S. Edge, J. 4. Explain how rights and their attendant correlative obligations Randall Groves are grounded in the same overarching principles and rules.
A. LESSON PREVIEW/REVIEW
Brain Teaser: Answer the questions below:
1. A competent elderly tells you,” I want to go home.” You respond with, “We won’t let you go home; you’re not capable of taking care of yourself.” You may have just created the elements for what tort? ANSWER: :_______________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _
2. The patient tells you, “I don’t want the treatment.” You respond with, “Your doctor ordered the treatment and told me to make sure you take it, even If I have to hold you down.” You may have just created the elements of what tort?
UNIVERSAL PRINCIPLES Autonomy Form of personal liberty Ability to decide Power to act on your decisions
Respect for the individual autonomy of other
--- Self-determination often used synonymously with autonomy
Informed consent- derived from basic principles of autonomy
o Legal exceptions: under therapeutic privilege and implied consent Paternalism: intentional limitation of autonomy of one person by another Health care professionals fiduciary relationship with patients
1. Veracity - Binds both health practitioner and patient in an association of truth - Harm to patient autonomy and potential loss of practitioner credibility makes lying to patients a practice to be avoided
2. Beneficence - Acts of mercy and charity - Any action that benefits another Hippocratic Oath: physician will “apply measures for the benefit of the sick”
3. Non-malefiecnce - One ought not to inflict evil or harm Beneficence - One ought to prevent evil or harm - One ought to remove evil or harm - One ought to do or promote good
Nonmaleficence - Principle of double effect: secondary effects may be foreseen but can never be intended outcomes. E.g., administering morphine for pain, ethically prescribe but the analgesics suppresses respiration - Under what circumstances can one act morally when some of the foreseeable effects of that action are harmful?
Principles of Double Effect (Guiding Elements)
Course chosen must be good or at least morally neutral Good must not follow because of secondary harmful effects Harm must never be intended but merely tolerated as casually connected with good intended Good must outweigh harm
4. Confidentiality - American Hospital Association’s The Patient Care Partnership: Understanding Expectations, Rights and Responsibilities - Outline of current state of practice with regard to individual’s right to privacy in health care
THIS DOCUMENT IS THE PROPERTY OF PHINMA EDUCATION 2
Health Care Ethics (Bioethics)
Module #6 Student Activity Sheet
Name: _________________________________________________________________ Class number: _______
5. Justice - Procedural justice or due process: disputes between individuals - Distributive justice: distribution of scarce resources - Compensatory justice: individuals seek compensation for a wrong that has been done
6. Role Fidelity - Modern health care is the practice of a team - Allied health over 100 individual professions - Ethics of health care require practitioner practice faithfully within constraints of role - Prescribed by scope of practice of state legislation
Rights - Entitlements, interests, powers, claims, needs - If one possesses a right, one need not feel gratitude to others for its possession - In moral philosophy and political theory thought of as justified claims - A right creates obligation in others to behave in a certain way - Symbolic language of covenants, charters, manifestos, and conventions - Expressions of hope for future of humanity - Not meant to outline a reality grounded in law or claims that can be enforced
Right to Health Care?
- Many claim health care as a human right. Is it? - And if it is, where would such a right come from, and who has obligation to provide it? - Health care as a right difficult to define - Is it a positive or recipient, right?
Historical Background of Rights Reasoning
Natural Rights – Equated to the law of God such as Golden Rule
Natural Liberties – Universal moral rights exist prior to and independent of guarantees of social contract or institutionalized government – Negative rights: obligate others from interference
Human Rights – All humans equally separated from beasts of the field and are unique unto themselves – Positive rights: basic needs we all share, recognize, and respect as a person’s just due – Basic truths understood and known by human reason alone not dependent on outside dictates
Traditions of Natural Law
– Humans possess rational nature as a gift from God – Natural laws are not dependent on social contract – Natural laws are unchangeable and universal – Inability to effect natural rights does not distinguish them – Natural laws discovered even without knowledge of God
THIS DOCUMENT IS THE PROPERTY OF PHINMA EDUCATION 3
Health Care Ethics (Bioethics)
Module #6 Student Activity Sheet
Name: _________________________________________________________________ Class number: _______
John Stuart Mill – Duties of perfect obligation: inherent within them assigned correlative rights – Duties of imperfect obligation: do not give birth to any right – Moral rights: backed up by force of law or public opinion
Contractarian Theory – Force or mechanism for selection of correct principles is agreement or bargain reached by initial agents – Moral agents come to initial situation and bargain to a choice
Hobbesian Model – Those living in the state of nature do not come to the table as equals – Only law of self-preservation existed – World where strong and ruthless armed with force and fraud are only ones allowed to come to bargaining table
John Rawls – Original position: all individuals are free and equal – Veil of ignorance denies each agents’ knowledge of who is to receive rights to goods and services – Seen in the fair opportunity rule
Fair Opportunity Rule
Contractarians – Individual rights grounded in principle of justice and collective choice – Collective choice forms basis of morality
Original Position - Posited concept of moral right to equal concern and respect - Rights existed prior to collective choice procedure
CHECK FOR UNDERSTANDING
You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed.
1.The principle that deals with the need to tell the truth. A. Beneficence B. Veracity C. Confidentiality D. Role fidelity Answer: ________ Rationale:________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________
2. The legal principle of a right to privacy is matched to the ethical principle of .
A. Confidentiality B. Justice C. Veracity D. Nonmaleficence
THIS DOCUMENT IS THE PROPERTY OF PHINMA EDUCATION 4
Health Care Ethics (Bioethics)
Module #6 Student Activity Sheet
Name: _________________________________________________________________ Class number: _______
3. The use of placebos is most problematic when you are considering the principle of . A. Veracity B. Beneficence C. Role fidelity D. Maleficence Answer: ________ Rationale:________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________
4. The famous admonition “If you can’t do the patient good, at least avoid harm,” speaks of the two important principles of beneficence and . A. Confidentiality B. Justice C. Veracity D. Non maleficence Answer: ________ Rationale:________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________
5. “Nurses should practice nursing and allied health specialist should only practice within their specialty areas” is an application of the basic principle of . A. Veracity B. Beneficence C. Role fidelity D. Maleficence Answer: ________ Rationale:________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________
6. When one person has a right, others have obligations to either refrain from hindrance or provide the required goods and services associated with the right. What type of obligation is this? A. Imperfect obligation B. Perfect obligation C. Correlative obligation D. Personal obligation Answer: ________ Rationale:________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________
7. Perhaps the most famous moralized contractarian theory of rights that includes the concept of an original position comes from the work of . A. John Locke
THIS DOCUMENT IS THE PROPERTY OF PHINMA EDUCATION 5
Health Care Ethics (Bioethics)
Module #6 Student Activity Sheet
Name: _________________________________________________________________ Class number: _______
C. John Rawls D. Thomas Aquinas Answer: ________ Rationale:________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________
8. What rights are generally equated to the law of God?
A. Artificial Rights B. Natural Rights C. Legal Rights D. Moral Rights Answer: ________ Rationale:________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________
9. We have different Golden rules across religions, what religion has its golden rule which says “Hurt not others which you would find hurtful?” A. Buddhism B. Brahmanism C. Islam D. Taoism Answer: ________ Rationale:________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________
10. He is an English philosopher where in his model he assumes that the state of nature was a state of social chaos, and that the origins of law, which are simultaneous with those of morality, are in social contract. A. John Rawls B. John Locke C. Thomas Aquinas D. Thomas Hobbes Answer: ________ Rationale:________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________
C. LESSON WRAP-UP
AL Activity: Minute Paper
1) What was the most useful or the most meaningful thing you have learned this session? _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________
2) What question(s) do you have as we end this session?
