Unit 4- Role in Ehtics

What is ethics?

• Systems of valued behaviors and beliefs that govern proper conduct and character to ensure protection of individuals’ rights.

• Discipline dealing with what is good and bad and with moral duty and obligation.

What is the definition of autonomy?

• A person’s capacity to formulate, express, and carry out value-based preferences.

• The right to make one’s own decisions and to be independent and self-governing.

Sonographers will perform as agents of who?

The physician

What is Nonmaleficence?

Do no harm

What is Beneficence?

Do good

What are the guidelines for the sonography professional?

• The goal of this code of ethics is to promote excellence in patient care by fostering responsibility and accountability among diagnostic medical sonographers. In so doing, the integrity of the profession of diagnostic medical sonography will be maintained. 

What is the definition of informed consent?

Requires that permission be obtained from the patient to have a test or procedure performed after the patient has been fully informed about the test or procedure.

The patient has the right to consent or refuse any service/medical care?

True

What is the most wanted/ legal document of informed consent?

Written

What are the different types of informed consent?

• Written

• Oral

• Implied

What are the valid qualifications of consent?

• Patient is of legal age

• Is mentally competent

• Gives consent voluntarily

• Is adequately informed

  • Type of care

  • Risks

What is the definition of professionalism?

Being involved in and worthy of the high standards of a profession

What are the standards of professionalism?

• Integrity

• Honesty

• Compassion

• Devoid of self-interest

• Psychosocial well-being of patients

What are the Obstetrical Sonography Obligations for the Pregnant Patient and Fetus?

• Pregnant Patient(Mom)

  • Autonomy

  • Beneficence

• Fetus(Baby)

  • Beneficence

What are the moral obligations owed to fetus by physician and sonographer as physicians agent?

• Continuing pregnancy to term

• Protect and promote fetal/child interests

• Prevention of premature death

• Prevention of disease or disability

• Prevention of unnecessary pain and suffering

Until the fetus is born, where are the legal records obligation of the fetal patient stored?

Stored under moms record until fetal patient reaches age of majority

What is the moral status of the fetus as a patient?

• Mom has a beneficence-based obligation to fetal patient also

  • Moral fiduciary for fetus

  • Protection of fetal/child interest

As a sonographer, the autonomy of the patient’s decision with abortion should remain ______

Neutrility

With an abortion, what are the sonographers rights?

May withdraw from involvement

What is the definition of competence?

Providing accurate and reliable information from sonographic examination

• Rigorous standard of training

• Skill proficiency

• Continuing education

What can result from a failure of competency?

• Mistaken Diagnosis

• Incomplete or inaccurate information

• Creates lack of beneficence/nonmaleficence

What are the two ethical clinical challenges related to referral issues?

• Maintain standards of general competence

• Disclosure of inadequate exams/practices

  • Any issues should be dealt with in a professional and ethical manner

What is the informed consent role?

• What exam can and cannot define

• Uncertain interpretation

• Timing relevant to desired information

What images can and cannot be disclosed?

• Normal anatomy may be disclosed by sonographer

• Any anomalies need to be disclosed and discussed by physicians

With the disclosure of images, how does it help with the bonding of a mother and child?

• Prenatal care

• Preparation

With disclosure of images, gender identification must have:

• Viable reason

• Autonomy

• Inherent risk of uncertainty

  • Always document gender, but don’t show if patient doesn’t want to knoe

What are the proponents of disclosing images?

• Enhances bonding

• Educates patients and family

• Increases patient’s compliance

• Increases patient’s acceptance of sonography

What are the opponents of disclosing images?

• extends scanning time

• Distracts sonographer

• Commercialization

When disclosing pictures/videos what must occur?

• Written policy per institution

• Specific time- after completion of regular exam

• Mirror diagnostic images

  • Reviewed by physician

What is nondiagnostic use?

Not using ultrasound for healthcare purposes

Why is nondiagnostic use common?

• Availability of equipment

• Lack of legal regulation

Where is confidentiality derived from?

• Autonomy

• Beneficence

What is disclosed to outside parties only with patient’s explicit permission?

• Pregnancy

• Due dates

• Number & gender

What are the 4 C’s of medical malpractice prevention?

• Caring

• Communication

• Competence

• Charting

What is Caring of the 4C’s

• Do no harm, work to improve condition

• Sincerity

What is Communication of the 4C’s

• Listen attentively (don’t assume)

• Speak calmly and clearly

What is Competence of the 4C’s

• Professionalism - Credentialed

• Continuing Education

What is Charting of the 4C’s

• As though the patient will read his or her own medical record