Ethics Review: Radiologic Technology

Legal responsibility

the employer is responsible for employees’ negligent acts that occur during the course of their work

Respondeat superior

“let the master respond”

Vicarious liability

“borrowed servant”

-liability by one person or agency for the actions of another

Vicarious liability

physicians may be liable for wrongful acts committed by hospital employees under the physician’s order

Laws

legal requirements for behavior

Ofenses against the state or society at large

Felony and misdemeanors

Examples of RT criminal acts

1. drug theft (felonies)

2. violations of laws that regulate practice or scope of practice limitations (misdemeanors)

   1. Fraud or misrepresentation with respect to one’s credentials or qualifications (felony or misdemeanor)

Felony

serious crime, violent or nonviolent

Examples of felony

murder, arson, fraud, manslaughter, grand theft

Misdemeanor

less significant crime

Examples of misdemeanor

trespassing, petty theft, vandalism, public intoxication, reckless driving, simple assault

Punishment for misdemeanor

fine or imprisonment for less than 1 year, jail time, probation, community service

Punishment for felony

death or imprisonment longer than 1 year

Civil Law

deals with the rights and duties of individuals with respect to one another, seeks damage rather than punishment

Civil law

compensation to be paid to individuals who have been injured in a noncriminal act

Tort

a civil wrong committed by one individual against the person or property of another

Plaintiff

suing party

Defendant

party being sued

Torts

lawsuits pursued under tort law claim that the plaintiff has been injured in some way by the defendant

Negligence

occurs when a medical professional causes harm to a patient unknowingly, either through simple ignorance or failing to take action when needed

Res Ipsa Loquitur

“the thing speaks for itself”

‘Res Ipsa Loquitur’ meaning

sometimes applied when negligence and loss are so apparent that they would be obvious to anyone

Tort

intentional misconductt

types of torts

assault, battery, false imprisonment, invasion of privacy, libel, slander

Assault

the threat of touching in an injurious way

assault in healthcare

threatening a patient during a study. IE': “if you don’t follow the instructions…”

Battery

unlawful touching of a person without his or her consent

Battery in healthcare

an image taken against the patient’s will or the wrong patient, wrong part, wrong marker, wrong side

false imprisonment

unjustifiable detention of a person without his or her consent

false imprisonment in healthcare

preventing a patient from leaving

invasion of privacy

intrusion into a patient’s private affairs, disclosure of private information, use of the patient’s name falsely or for personal gain

invasion of privacy in healthcare

confidentiality has not been maintained when a patient’s body has been improperly and unnecessarily exposed or touched

Libel

written malicious spreading of information that causes defamation of character, or loss of reputation

Libel in healthcare

documenting a negative comment about the patient in the chart

Slander

verbal malicious spreading of information that causes defamation of character, or loss of reputation

slander in healthcare

speaking negatively about a patient

Negligence

neglect or omission of reasonable care or cautionG

Gross negligence

reckless disregard for life or limb

Contributory negligence

act in which the behavior of the injured party contributed to the injury

Corporate negligence

hospital as an entity is negligent

contributory negligence in healthcare

a patient falling off the table because the tech was not watching

malpractice

improper, illegal or negligent professional activity or treatment by a medical practitioner

example of malpractice in healthcare

the medical professional is aware of the potential consequences of their actions or non-actions and proceeds anyway

The four conditions to establish a claim of malpractice

1. the defendant had a duty to provide reasonable care to the patient

2. the plaintiff sustained some loss or injury

3. the defendant is the party responsible for the loss

   1. the loss is attributable to negligence or improper practice

rule of personal responsibility

each person is liable for his or her own negligent conduct, the law does not allow the wrongdoer to escape responsibility even though someone else may be legally liable as well

Empathetic care

understanding and compassion with an objective detachment

Burnout

response to chronic strain of dealing with constant demands and problems of people under our care. causes apathy, dissatisfaction, exhaustion, depersonalization

Personal morality

right vs. wrong

group morality

certain groups of people, morals provide an internal motive that governs our relationships w/ others and permits us to live in harmony

Hippocratic Oath

moral duties of physicians

Examples of Hippocratic oath in healthcare

maintain professional competence, maintain confidentiality, provide care

societal morality

set of beliefs that we share with our community about values and duties. Influences laws, customs and moral components

Ethics

a branch of philosophy that may be defined as a systemic reflection on morality

Applied morality

the application of ethical principals to specific human activities

Lawrence Kohlberg theory of moral development

Lawrence Kohlberg's theory of moral development outlines six stages of ethical reasoning, grouped into three levels: Preconventional, Conventional, and Postconventional

Preconventional stage

younger than 6 years old, punishment vs. reward

Conventional Stage

6-11 years old, conforms to avoid disapproval and censure

Postconventional Stage

11 years +, conforms to maintain communities, and individual principals of conciousness

Moral Principals

Instill a sense of right and wrong and a desire to do the right thing

Professional Ethics

defined correct moral behaviors in the context of a professional setting/professional duties

Laws

the means used by a government to enforce commonly accepted moral standards in the interest of society

Code of ethics

hallmark of profession. It defines high principals of professional behavior and signifies a willingness by the profession to control it’s own conduct

ARRT standard of ethics

list of behaviors, includes the rules of ethics

Code of Ethics

aspirational documents 

Nonconsequentialism

judgement of right/wrong based on essential nature of an action

Consequentialism

judgement of right/wrong based on it’s consequencesE

Ethics of care

situational ethics, kindness, respect, patience

virtue based ethics

theory places a value on virtues/admirable character traits, ie- compassion, caring, trustworthiness

rights-based ethics

shielding from undue restriction of harm, protecting the rights of people

conflict

what is one person’s rights vs. the other person’s duty

justice-based ethics

‘justice is blind’ all individuals should be treated with impartiality, no individual should have advantages or disadvantages relative to other individuals, recognizes ones own bias 

Teleology

Utilitarianism, end justifies the means. greatest good for the greatest number. looks beyond the individual benefit to overall benefit

Deontology

duty-based ethics, a duty of an individual to a society, group or organization. absolute rules that should be obeyed, adheres to universal rules and regulations

Principlism example

a framework in ethics, especially bioethics, that uses four widely accepted moral principles—autonomy, non-maleficence, beneficence, and justice—to guide decision-making in complex situations

nonmaleficence 

no evil

veracity

truth

fidelity

faithfulnessj

justice

fairness

automony

self-determination, respecting independence of a patient

ethical analysis (created by michael davis)

the process of evaluating situations in which correct action is in question by 1. identifying the problem, 2. develop solutions, 3. selecting the solutions 4. defend solutionmo

moral agent

responsible for implementing the ethical decision

HIPPA

Health Insurance Portability and Accountability Act of 1996

Beneficence

Do good