Educate the Educator Healthcare Ethics Competencies 3 and 4.

Educate the EducatorHealthcare Ethics

Competencies 3 and 4

• Up to this point, the module has addressed the definition and development of values, personally and professionally. Key health care values were introduced as well. Professional relationships, boundaries, boundary violations and their warning signs were discussed.

• Ethics will be discussed for the remaining of the power point.

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From Values to Ethics in Competency 3

3. Describe aspects of ethical decision making in health care.4. Explain how an individual’s diversity, socioeconomic or religious beliefs could lead to potential ethical differences from other health care employees.

Module Competencies

Competency 3 Describe aspects of ethical

decision making in health care.

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3. Describe aspects of ethical decision making in health care.

Units in this competency include:A. Define ethics.B. Define the code of ethics.C. Explain the purpose of a code of ethics.D. Identify steps/framework for ethical decision making.E. Discuss the difference between legal guidelines and ethical decision-making.

Competency 3

Recommended ContentThe module introduces the student to ethics, this can provide for some lively discussions.The term ethics has several meanings in common use:• A method of inquiry that helps people to understand the morality of human behavior

(study of morality)• The practices or beliefs of a certain group (medical ethics, nursing ethics)• The expected standards of moral behavior of a particular group as described in the

group’s formal code of professional ethics. Ethics: The study of conduct and character; concerned with determining what is good or valuable for individuals, for groups of individuals, professions, and for societies.

Unit 3A: Definition of Ethics

Potter, P.A. & Perry, A.G. (2009); Ramon, P.R. & Niedringhaus, D. M. (2008)

Code of Ethics: a set of guiding principles that all members of a profession accept; a collective statement about the group’s expectations and standards of behavior, reflects the group’s moral judgments over time, and works as a standard for their professional actions.

Codes of Ethics serve as guidelines to assist professional groups when questions arise about correct practice or behavior.

Unit 3B: Code of Ethics

Potter, P.A. & Perry, A.G. (2009)

Ethical behavior of the healthcare worker/nursing assistant includes responsibilities to other caregivers that they work with, as well as ultimately reflecting the care being given. So the patient is a direct recipient of the caregiver’s Code of Ethics.

Many students seem to be unaware of what a ‘Code of Ethics’ is. When asked if their place of employment has a ‘Code of Ethics’ and what is it, they typically will stare straight ahead.

Code of Ethics

Ethical behavior of the healthcare worker/nursing assistant also includes responsibilities to the employer. Some of these behaviors are:• Reporting to work on time• Reliably fulfilling assignments • Notifying supervisor when ill • Working as a team member • Doing one’s job to the best of his/her ability according to JOB DESCRIPTION• Conserving supplies/equipment

Code of Ethics

Establishment of Code of Ethics

International, national, state, and provincial nursing associations have established codes of ethics.

The American Nurses Association (ANA) established the first code of nursing ethics decades ago and reviews and revises the code regularly to reflect changes in practice.

Basic principles remain constant and are responsibility, confidentiality, accountability, advocacy.

Code of Ethics

Origins of Ethical Problems in Healthcare

Ethical problems in healthcare are due to social and technological changes and healthcare workers’ conflicting loyalties and obligations.

Social Changes: Women’s movement, growing consumerism, large number of uninsured , high cost of health care, and workplace redesign under managed care—raise issues about fairness and allocation of resources (justice).

Technology: monitors, ventilators, parenteral feedings, growth of premature infants, prolonging biological lifeSome questions to ask students might be: who should be treated—everyone, only if they can pay, only those who have a chance to improve?

Code of Ethics

Ramon, P.R. & Niedringhaus, D. M. (2008)

Purposes of a Code of Ethics:

• Inform the public about the minimum standards of the profession and help them understand professional healthcare/nursing conduct.

• Provide a sign of the profession’s commitment to the public it serves.• Outline the major ethical considerations of the profession.• Provide general guidelines for professional behavior.• Guide the profession in self-regulation.• Remind healthcare workers of the special responsibility they assume when caring for

the sick.

Purpose of a Code of Ethics

Ramon, P.R. & Niedringhaus, D. M. (2008)

Recommended Learning Activities

Code of Ethics

Assignment Resources Notes

Compare sample Codes of Ethics

from various health

professions

Two samples of codes of ethics

available in Module Outline and Instructor

Resources

Students to research Code of Ethics from a healthcare profession that they are

interested in.

Code of Ethics Students create their own Code of Ethics for a profession that interests them

Unit 3D: Guiding Principles

• Preserve life• Do good (beneficence)• Respect autonomy• Uphold justice

• Be honest (veracity)• Be discreet (confidentiality)• Keep promises (fidelity)• Do no harm (no maleficence)

Recommended ContentThe module addresses 8 guiding principles of ethics and asks the student to identify them. These guiding principles are:


Guiding Principles

Assignment Location Notes

Review vocabulary list On website and in Module Outline and Instructor Resources Document

Class Discussion

Review Oregon’s ‘Death with Dignity Act’

Death with Dignity Act Class Discussion

http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/index.aspx

Recommended Content

This unit helps students to understand a rational and systematic method to make decisions. The key is to identify the ethical principles and code to be used, rather than emotion.

On the following slide, let’s take a brief look at ethical theory, ethical dilemmas and ethical decision-making.

Unit 3E: Framework for Ethical Decision-making

Ethical theory examines the different philosophies, systems, ideas, and principles used to make judgments about what is right and wrong and good and bad. For example:

• A person who believes that life is sacred may not be able to sanction the removal of life support services on a client with a severe head injury.

• A person who believes that life begins as conception may not support the use of birth control methods that prevent implantation (intrauterine devices, morning after pill).

Ethical dilemmas occur when the choice available include only undesirable alternatives.Ethical decision-making is the use of a systematic approach that enhances decision-making and subsequent satisfaction with the decision.

Framework for Ethical Decision-making

Three characteristics of an ethical problem:The existence of a conflict of valuesObligations, loyalties, interests, orNeeds in a patient care situation, such as:

• Disagreement about treatment between health professionals and patients or health care team members and patients’ families

• Ethical principles or values are at stake, such as respect for patient autonomy, doing the least harm, or the values of caring and patient advocacy; and the situation involves the feelings and values of all key persons involved in the situation.


Following are 10 steps to follow when making an ethical decision:

1. Review the overall situation to identify what is going on.2. Identify significant facts about the client, including the medical, social history,

decision-making capacity, existence of an advance directive for treatment.3. Identify the parties or stakeholders involved in the situation or affected by the

decision(s) that is made.4. Identify relevant legal data5. Identify specific conflicts of ethical principles or values


6. Identify possible choices, their intent, and probable consequences to the welfare of the client/clients as the primary concern.

7. Identify practical constraints, i.e., legal, organizational, political, economic.8. Make recommendations for action that are determined to be ethically supportable,

recognizing that the possible choices often have positive and negative aspects.9. Take action if your are the decision-maker and implementer of the decision(s) made.10. Review and evaluate the situation after action is taken, in order to determine what

was learned that will help in resolution of similar situations in client care and related policy development.




Assignment Resources Notes

HCE Competency 3

Scenarios Ethical Decisions

Worksheet on Website

In this assignment there are 3 scenarios and students answer questions on ethical issues and

professional boundaries. The topics include Home Health Aide, Long Term Care, and Health

Care Worker.

Recommended ContentAs the famous saying goes. “Which came first the chicken or the egg?”. Laws and ethics can be viewed in the same way. For example, there were abortions being performed, ethical dilemma, and then the laws pertaining to abortion came into being.

Unit 3F: Legal Guidelines vs. Ethical Decision-making



Assignment Location NotesHCE

Competency 3 Project Medical Ethics Collage.

Worksheet on

Website

In this assignment the students use their creativity to make a collage that involves ethical situations. The

student explain the pictures and their meaning relating it to the ethical situation.

HCE Competency 3

Project – Presentation

Ethical Situations

Worksheet on

Website

In this assignment, students research an ethical issue and either write a letter to a fictitious editor, develop an

advertisement poster, or give a persuasive speech

Competency 4Explain how an individual’s diversity, socioeconomic or

religious beliefs could lead to potential ethical differencesfrom other health care employees.

Explain how an individual’s diversity, socioeconomic or religious beliefs could lead to potential ethical differences with that of other health care employees.

Units included for this competency include:A. Identify possible factors that may contribute to ethical differences between

employees.

Competency 4

Recommended ContentEthical differences between any two people can be drastically different and can many times cause tension, arguments, broken relationships and be the beginning of an ethical dilemma.

The curriculum address 3 factors in which these differences may develop:1. Personal issues2. Diversity issues3. Status issues

Ethical differences between employees

Ethical differences may come about due to personal issues. Personal issues are broken down into the following.

Lack of knowledge – people often times fear what they don’t understand

Previous experience – if a person’s previous experience is a negative one, why would their next experience be any different

Lack of self confidence – a lack of knowledge in the area

Fear of being misunderstood – if a person is pro-choice does that mean they support abortions? Maybe not.


The second factor that contributes to ethical differences between employees is diversity issues.The 4 areas of diversity that the curriculum addresses are:

1. Ethnic2. Gender3. Political4. Religious

It is safe to say that these areas need no explanation and yet can provide for hot and interesting discussion among the students.


The third and finally factor that may contribute to ethical differences between employees is status issues.

Two part of status issues need to be addressed and they are:Social – everyone desires to be accepted, liked and even lovedFinancial – often times a person’s self worth is directly related to how much money they have or how much money it looks like they have.




Assignment Location Notes

HCE Competency 4

Ethical and Legal Dilemmas

Website This learning activity lists 7 thought provoking ethical and legal questions for

discussion.

Review Oregon’s ‘Death with Dignity Act’

Death with Dignity Act

Class Discussion



College of Registered Nurses of British Columbia (CRNBC). (2011). Practice standard principles. Retrieved from https://www.crnbc.ca/Standards/ClientRelationships/Pages/Default.asp

Hegner, B.R., Acello, B., & Caldwell, E. (2004). Nursing assistant: A nursing process approach (9th ed.). Clifton Park, NY: Thompson Delmar Publishing

Lane, A. (2009). The importance of accountability. Retrieved from http://EzineArticles.com/3471801

Potter, P.A. & Perry, A.G. (2009). Ethics and values. In P.A. Potter & A.G. Perry (Eds.). Fundamentals of nursing (7th ed.) (pp. 313-342). St. Louis, MO: Elsevier, Mosby

References

https://www.crnbc.ca/Standards/ClientRelationships/Pages/Default.asp



http://EzineArticles.com/3471801

http://EzineArticles.com/3471801

Ramon, P.R. & Niedringhaus, D. M. (2008). Legal and ethical issues of nursing. Fundamental nursing care (2nd ed.) (pp. 25-44). Upper Saddle River, NJ: Person Prentice Hall

Weiss, T.C. (2009, July 21). Certified Nursing Assistant Code of Ethics. Retrieved from http://www.disabled-world.com/disability/caregivers/cna-code-ethics.ph

References

http://www.disabled-world.com/disability/caregivers/cna-code-ethics.ph



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Educate the Educator Healthcare Ethics Competencies 3 and 4.

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