Legal Aspects of Health Information and Health Care Statistics Week 1 Robyn Korn, MBA, RHIA, CPHQ
Dec 31, 2015
General Information
Discussion BoardEnter first post by Saturday and a total of 3 posts
by Tuesday
AssignmentsMake sure your name is on the assignment
attachments when they are submitted
General Information
Late work will not be accepted unless there are clear and compelling extenuating circumstances.
If you have extenuating circumstances that prevent you from completing course assignments/exams you must contact your instructor immediately—prior to the assignment/exam/quiz due-date unless prevented from doing so by emergency circumstances.
Ethical Standards
Key Terms Ethics - the formal study of moral choices that conform to
standards of conduct
Morals - the principles or fundamental standards of right conduct that an individual internalizes.
Values - concepts that give meaning to an individual’s life and serve as the framework for decision making
Code of Ethics - written lists of a profession’s values and standards of conduct.
Ethical Standards
Eugenics - efforts to improve the human species through control of hereditary factors in mating.
Human Genome Project - designed to map the genes found in the human DNA and determine the sequences of the chemical base pairs that make up human DNA.
Etiquette – the principles of how human beings relate to one another under certain circumstances
Law – A body of rules of action or conduct prescribed by a controlling authority that has a binding legal force
Ethical Models
Ethics - based on philosophy
Morals - based on traditional religious beliefs and personal choices
Etiquette - based on society
Law - based on controlling authority
Values - based on society, religion and family
Ethical Concepts
Autonomy Ability to Decide
Power to Actualize or implement a decision
Respect for the Autonomy of others
Example: Informed Consent
Ethical Concepts
Beneficence Qualities of kindness, goodness and mercy
Obligation to do good in all circumstances
Example – Hippocratic Oath
Ethical Concepts
Nonmaleficence Prohibition against doing harm
Obligation to prevent evil or harm
Example – Hippocratic Oath
Ethical Concepts
Double-effect principle – recognizes that ethical choices may result in untoward outcomes.
Examples – nosocomial infections or adverse drug reactions
Ethical Concepts
Best Interest Standard Determining what is in the best interest of the patient
when they are unable to make the decision alone
Decision making is usually determined by patient competency
Evidence of patient’s wishes are used (living will, power of attorney, etc)
Ethical Concepts
Fidelity Faithfulness, loyalty and devotion to
obligations or duties
Example – Physician explaining a new diagnosis to a patient
Ethical Concepts
Justice To be fair to all people
Includes fairness, honesty, and impartiality
Comparative Justice – balancing competing interests against one another (no independent standard)
Distributive Justice – fair distribution of benefits (an independent standard)
Ethical Concepts
Criteria When Resources are Limited
1. Need – required not elective procedures
2. Equity – trying to provide to all who need
3. Contribution – future contributions to society
4. Ability to pay
5. Effort – willingness to comply with instructions
6. Merit – potential for benefit after initial investment
Ethical Concepts
Rights Just claim or entitlement
Derived from the concept of justice
Rights vary according to moral values of a given culture
Ethical Concepts
Patient Rights– Confidentiality – obligation of the provider to
maintain information in a confidential manner
– Privacy – right to be left alone or control personal
information
Ethical Concepts
Veracity Habitual truthfulness and honesty Special relationship between the patient and
health-care provider
Example – human research
Ethical Theories
Principles used to deal with ethical dilemmas
Utilitarianism – promote good over harm– Cost benefit analysis
Deontology – duty orientation (follow the letter of the law and not the spirit)– Human research
Ethical Decision Making
Code of Ethics – professions values and standards
Ethic Committees Patient Rights
– PDSA – advance directives – HIPAA – rights granted to patients– ARRA – rights regarding electronic PHI
Ethical Decision Making
1. Define the issue
2. Get the facts
3. Know who is involved
4. Evaluate options
5. Make decision and implement
6. Evaluate outcome
7. Process to prevent again
Ethical Challenges
Conflict of Interest– Potential and actual
Impaired colleagues
Disparagement– Criticize skills, knowledge or qualifications
Health Information Challenges
Coding – Reimbursement
Information Security
Data Resource Management
Protection of Sensitive Information
Bioethic Issues
Ethical issues related to advancements in technology and science, especially biology
and medicine
Beginning of Life Issues
Family Planning– Contraception– Adoption/Infertility treatment
Abortion Perinatal ethics
– Testing, screening, surgery
Eugenics
Quality of Life
HIV/AIDS– Treatment/confidentiality
Organ Transplants– Travel medicine/xenografts
Genetic Science– GINA confidentiality of genetic information– Gene therapy/stem cell research
Death and Dying
Planning for end of life– Advance directives, living will, power of attorney
Euthanasia– Passive and active
Withdrawing/Withholding treatment
Access by the Researcher
Ethical Approach– Declaration of Helsinki– National Research Act– Belmont Report
Respect for persons Beneficence Justice
Access by the Researcher
Regulatory Approach– Institutional Review Board (IRB)
HIPAA – data collection and usage GINA – informed consents