RADS 2050 Professional Ethics and Medical

Autonomy

A person's self-reliance

independence

liberty rights

privacy

individual choice

freedom of the will

self-contained ability to decide

Beneficience

Doing good, active promotion of good, kindness, charity

Code of Ethics

Articulated statement of role morality as seen by the members of a profession

Confidentiality

Belief that health-related information about individual patients should not be revealed to others, maintaining privacy

Consequentialism

Belief that the worth of actions is determined by their ends or consequences, actions are right or wrong

according to the balance of their good and bad consequences

Ethical dilemma

Situation requiring moral judgment between two or more equally problem-fraught alternatives, there are two or more competing moral norms present, creating a challenge about what to do

Ethics

The study of right and wrong of human conduct and character as known by natural reason

Ethics of care

Ethical reflections that emphasize an intimate personal relationship value system that includes such virtues as sympathy, compassion, fidelity, discernment, and love

Fidelity

Strict observance of promises or duties, loyalty and faithfulness to others

Justice

equitable, fair, or just conduct in dealing with others

Laws

Regulations made by government and applicable people within a political subdivision

Legal rights

Rights of individuals or groups that are established and guaranteed by law

Morals

Generally accepted customs, principles, or habits of right living and conduct in a society and the individual's practice to these

Nonconsequentialism

Belief that actions (rather than consequences) determine the worth of actions.

actions are right or wrong according the morality of the actions

Nonmaleficence

Ethical principle that places high value on avoiding harm to others

Principle-based ethics

The use of moral principles for defending an action in resolving an ethical dilemma

Professional ethics

Internal controls of a profession based on human values or moral principles

Rights

Justified claims that a person can make on people, groups, or society, divided into legal and moral rights

Rights-based ethics

Belief that individual rights provide the vital protection of life, liberty, expression, and property

Social contract

two mutual groups in a society recognize certain expectations of one another and conduct their affairs accordingly

Standards of Professional Conduct

Practice behaviors that are defined by members of a profession

Values

Ideals and customs of a society toward which the members of a group have an affective regard

Veracity

Duty to tell the truth

avoid deception

Virtue

Trait of character that is socially valued - ex: courage

Virtue-based ethics

Ethical theory - emphasizes the people/agents who perform actions and make choices, character and virtue form the framework of this ethical theory

ASRT Code of Ethics

Conduct in a professional manner

Responds to patient needs

Supports colleagues

Provides quality patient care

Respect for the dignity of mankind

No discrimination

Employs procedures and techniques appropriately

Assesses situations

Exercises care

Assumes responsibility for professional decisions

Acts in the best interest of the patient

Obtain pertinent information for the physician

Performs services in accordance with an accepted standard of practice

Minimize radiation exposure to patient/self/other members

Practices ethical conduct

Protects the patient's right to quality care

Respects confidences, privacy

Reveals confidential information only as required by law

Continually strives to improve knowledge and skills

ASRT Practice Standards

1. Radiography Clinical Performance Standards

Assessment

Analysis/Determination

Patient Education

Implementation

Evaluation

Implementation

Outcomes Measurement

Documentation

2. Quality Performance Standards

Assessment

Analysis/Determination

Education

Performance

Evaluation

Implementation

Outcomes Measurement

Documentation

3. Professional Performance Standards

Quality

Self-Assessment

Education

Collaboration and Collegiality

Ethics

Exploration and Investigation

Your Rights as a Hospital Patient

Information Disclosure

Choice of Providers and Plans

Access to Emergency Services

Participation in Treatment Decisions

Respect and Nondiscrimination

Confidentiality of Health Information

Complaints and Appeals

List the 4 steps involved in solving ethical dilemmas:

1. Identify the problem

2. Developing alternative solutions

3. Selecting the best solution

4. Defending your selection

what things do medical records must have?

1. Patient Identifiers

2. medical history

3. Reports / Evaluations (diagnostic, treatment, procedures, therapeutic, physical exams)

4. orders

5. clinical observations

6. tests / results

7. informed consent

8. Termination of hospitalization

9. follow-up care

informed consent

patient has been informed of the procedure/operation to be done, the risks and possible consequences.

There must be evidence it for procedures that require it.

Policy is developed by medical staff and hospital governing board.

authorization for treatment

signed at the time of admission or registration

If the informed consent is not filed with the record, the record must indicate that informed consent was obtained for the procedure & treatment and must show where the informed consent is located

incident reports

Information related to patient incidents.

must be completed after an event, put the reports should not be a part of the patient record.

They are an administrative document, maintained by hospital legal counsel.

Describe health records in the radiology department

1. Before a procedure is performed, an order for service is completed.

2. The order includes patient demographic, specific procedures being requested, ordering physician, diagnosis/sign, or symptom.

3. The results of the procedure are document on a radiology report. The radiologist write or dictates and authenticates a description of what is seen on the radiograph and the implications for the patient

4. The original document should be placed in the patient’s permanent health record.

legal aspects - patient health record

record is an important legal document

used to define what was or was not done to patient

may be submitted in court

correcting or amending the record

Author of the record

Draw a line through the error

Write error, record correct info

Date and sign

confidentiality of records

we must safeguard confidentiality of record

privileged communication

states can have statutes recognizing patient-physician priviledge

consents to release information

In writing and contain:

Whom the info is to be released

Patient's name, address, DOB

Extent of info to be released

Date

Signature of patient

fax of information

have confidentiality issues

Transmitted only in urgent situations

Cover page should include a confidentiality notice

Transmission is sent to right designation

information security

all info must be protected

patient access / HIPAA

Patient / patient representative should have access

should be restricted to extent necessary, hospitals can prohibit access

health record in court

is a legal document, must honor subpoena for record

send copies

Constitution

Supreme law of the land

Protects individual rights

Many areas of health care are defined and regulated by these:

Statues and regulations

Case Law

Case by case basis decided by judge or jury

Each profession has a _________ _____ __________, the degree of skill, proficiency, knowledge, and care ordinarily possessed and employed by members in good standing within the profession

standard of care

what is tort

A patient's claim that he or she has been wronged or had suffered some injury, for which he or she believes there is cause for action for damages

negligent care

Failure to use such care as a reasonably prudent person would use

assault

Patient believes they have been threatened

battery

Unlawful touching

Performs an exam or touches a patient without permission

False Imprisonment (Intentional Tort)

Patient restrained against will

defamation

Information that is leaked to those who do not need to know

Patient is subject to ridicule, scorn or contempt

fraud

Intentional perversion of truth for the purpose of inducing a person to rely on the false information to his or her detriment

describe how privacy of records relates to legal issues

Information in patient record cannot be distributed without patient consent. Only persons who need to know

describe how HIPAA relates to legal issues

Establish guidelines for storage, access, and transmission of individual health information

what 4 elements must be proved for a charge of negligence

1. A duty to the patient by the health care practitioner as defined by the standard of care

2. Breach of this duty by an act of by failing to perform some act

3. A compensable injury

4. A causal relation between injury and the breach of duty

Res ipsa loquitur

Speaks for itself

Describes how a patient is injured through no fault of theirs while in the complete control of another

respondeat superior

The master speaks for the servent

If radiographer is sued, so may be the hospital and MD's

corporate liability

The hospital to be responsible for the quality of care given to patients

what 3 elements are included in corporate liability

1. Duty of reasonable care in the selection and retention of employees and medical staff

2. Duty of reasonable care in the maintenance and use of equipment

3. Availability of equipment and services

implied consent

When an individual appears for a simple procedure. It does not require a signed form. It still allows the patient to ask questions or refuse the procedure.

describe the concept of informed consent

Patient’s trust that procedures are being informed and that

they are receiving the appropriate standard of care. Right to

make their own decisions, only when they have all the

information. Requires a signed form.

what should be included on a consent form

An authorization clause to permit the physician or health care worker to perform the exam

A disclosure clause to explain the procedure, its risks, benefits, and possible alternatives to the procedure

An anesthesia clause if required

A no-guarantee clause for therapeutic procedures

A tissue disposal clause if the removal of tissue may be necessary

A patient understanding clause, which usually states that all the info contained in the consent form has been carefully explained to the patient

A signature clause, which calls for the signature of the patient as well as that of a witness (Witness a disinterested third party not involved in the actual performance of the procedure)

required for invasive procedures

When should a patient sign an informed consent in radiology?

be well informed of illness, outcomes & treatments, be treated respectfully, refuse treatment

Legal rights of a patient include:

slander

- Involves the spoken word

- Releasing information about a patient that causes harm

- Gossiping which causes injury to professional/personal life

libel

A written defamation of a person's character, reputation, business, or property rights.