PA Quiz 2 Professionalism & Ethics

Seattle 1960s

Seattle 1960s

Dr. Belding H. Scribner and Team were located here. They saw kidney failure a major issue and developed hemodialysis.

They were at Swedish hospital

Urology

Structure of kidney and nephrology; Function of kidney

Kidney Failure

Renal failure, heart may be affected, edema: swelling

High blood pressure

leading cause of kidney failure

John Myers

Kidney dialysis patient, 1962 the story was published. 37 years old

Seattle Artificial Kidney Center Medical Advisory Committee

This board review cases to decide who goes on dialysis

• Local physicians

• Induced a psychiatrist

• Appointed by King County Medical Society

• Referred potential candidates to Admissions Advisory Committee

Composition of Committee

• A surgeon, not involved in the care of dialysis patients

• Lawyer

• A housewife

• A banker

• A labor leader

• A minister

• An official of state government

these people choose who gets to be on dialysis

Criteria for Kidney Center (part 1)

• A stable, emotionally mature, responsible citizen disabled by the symptoms or uremia

• Absence of long-standing hypertension and its permanent complications, particularly coronary artery disease and cerebrovascular disease

• Demonstrated willingness to cooperate in carrying out the prescribed treatment, especially the dietary restrictions

• Show deterioration of renal function, since any therapeutic problem

Criteria for Kidney Center (part 2)

• Age 25-45 years

• Six months residence in the area (WA, AK, ID, MT, OR)

• Financial support

• Value to community

• Potential for rehabilitation

• Psychological and psychiatric compatibility

• Children and young adults who were not potentially self-supporting were excluded

Professionalism

the conduct, aims, or qualities that characterize or mark a profession or a professional person

Six Elements of Professionalism

1. altruism

2. accountability

3. excellence

4. duty

5. honor and integrity

6. respect for others

Altruism

Strive to do the right thing at all time

Accountability

providers, patients, family of the patient, collegues

Duty

bound to the high excellence

Respect for Others

How we act and the approach of how we act is important

Seven challenges to elements of professionalism

• Abuse of power

• Arrogance

• Greed

• Misrepresentation

• Impairment

• Lack of conscientiousness

• Conflict of interest

Key components of professionalism

• Trust

• Community Service

• Specialized body of medical knowledge

• Ability to self-regulate

One of the Six components for the PA profession

Professionalism

Professional Behavior toward the patient

• PAs must prioritize the interests of those being served above their own

• PAs must demonstrate a high level of ethical practice

• PAs must demonstrate a high level of sensitivity and responsiveness to a diverse patient population, including culture, age, gender, and disabilities

• PAs are expected to demonstrate respect, compassion, and integrity

Professional Behavior toward other professionals

PAs are expected to demonstrate professional relationships with physician supervisors and other health care providers

Professional Behavior toward the Public

• PAs are expected to demonstrate responsiveness to the needs of patients and society

•PAs are expected to demonstrate commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices

• PAs are expected to demonstrate accountability to patients, society, and the profession

• PAs must demonstrate adherence to legal and regulatory requirements, including the appropriate role of the PA

Professional Behavior Toward Oneself

• PAs are expected to demonstrate commitment to excellence and ongoing professional development

• PAs must know their professional and personal limitations

• PAs must practice without impairment from substance abuse, cognitive deficiency, or mental illness

• PAs are expected to demonstrate self-reflection, critical curiosity, and initiative

Key components that have diminished professionalism in medicine

• More focus on science and less on service

• More focus on the business of medicine

• Increasing cost associated with medicine due to increased demand

What's at stake with professionalism?

May lead to loss or lack of professionalism

• we require vitals demographics etc during office visits

Ethics

the discipline dealing with what is good and bad and with moral duty and obligation

Ethos(greek), Moralis (latin) - custom

Four Major Principles of Biomedical Ethics according to James Childress and Thomas Beauchamp

• Autonomy—right to make one's own choices

• Beneficence—Do good to the patient, avoid evil

• Nonmaleficence—Do no harm

• Justice—Fairness

Autonomy

• Ensuring the informed patient's rights to participate in medical decision making

• Informed Consent

• Competent patient

• Privacy

• Freedom of Choice

• Self-determination

• Self-governing person with informed goals

• idea that I get to make decisions for myself assuming im in my right mind*

Nonmaleficence

First do no harm

Maximizing possible benefits while minimizing possible harms

Ex: chemotherapy can kill you while trying to help you

Beneficence

• Do good

• Providers act in the best interest of their patients

• Actively make safe the well-being of persons

• Inclusive of physical and mental health of persons

Justice

• All persons treated well and fairly

• Equal access to health resources