Medical Ethics in the PA Profession

  • Medical Ethics Overview

    • Focus on the moral principles guiding the PA profession.

  • 4 Bioethical Principles

    • Autonomy:

    • Defined as "self-rule"; patients have the right to make their own decisions and choices regarding their healthcare.

    • Beneficence:

    • PAs should act in the best interest of the patients, promoting their well-being.

    • Nonmaleficence:

    • The principle of doing no harm; ensuring no unnecessary or unacceptable burdens are placed upon patients.

    • Justice:

    • Ensures that patients in similar circumstances receive the same level of care.

  • Legal vs. Ethics

    • PAs must navigate both legal and moral responsibilities in their practice.

    • Knowledge of laws governing their practice is crucial.

    • Understanding ethical responsibilities as a healthcare provider is essential.

  • Resources for Ethical Questions

    • Supervising physician

    • Trusted colleagues

    • Hospital ethics committee

    • An ethicist

    • AAPA policy

    • Legal counsel

  • Statements of Values for the PA Profession

    • Primary responsibility for the health, safety, welfare, and dignity of human beings.

    • Uphold patient autonomy, beneficence, nonmaleficence, and justice.

    • Recognize and promote diversity, treating all patients equally.

    • Maintain confidentiality of information shared during medical practice.

    • Strive for continuous improvement in medical practice and expand knowledge and skills.

    • Collaborate with healthcare teams to provide compassionate, effective patient care.

    • Respect professional relationships with physicians and share knowledge within the profession.

  • PAs Role and Responsibility

    • PAs practice medicine under the supervision of a physician, making the patient-PA relationship a shared responsibility.

    • The foundation is built on respect for health, safety, welfare, and dignity.

    • Ethical obligation to ensure each patient receives appropriate care, respecting their individuality and right to self-determination.

    • Advocating for patients' best interests is paramount.

  • Diversity in Care

    • PAs should respect the cultural values, beliefs, and expectations of diverse patients.

  • Nondiscrimination in Care

    • PAs must not discriminate on the basis of gender, race, religion, age, or any other characteristic when providing healthcare.

  • Initiation and Discontinuation of Care

    • No ethical obligation to care for someone without a preexisting relationship unless no other provider is available.

    • Morally bound to provide care in emergencies and arrange for follow-ups.

    • Can discontinue professional relationships with patients following appropriate procedures.

  • Informed Consent

    • Duty to support and protect a patient’s informed choices.

    • Provide understandable information to patients or their surrogates.

    • Encourage shared decision-making, especially involving family in adolescent healthcare choices.

    • Ensure surrogates make decisions reflective of the patient’s preferences.

  • Confidentiality

    • PAs must maintain strict confidentiality to foster an open relationship with patients.

    • Awareness of safeguarding against unauthorized interception of communications.

  • Patient and Medical Records

    • Medical records must remain confidential and can only be released with patient consent.

    • Patients have rights to understand the information in their records; institutions own the chart, but the info belongs to the patient.

  • Family and Friends

    • Treating self, co-workers, or family members may lead to ethical conflicts of interest.

  • Genetic Testing

    • PAs should understand the risks and benefits of genetic testing; informed consent is essential.

    • Pre and post-test counseling must be provided.

  • Reproductive Decision Making

    • Patients should have access to a range of reproductive services.

    • PAs have a responsibility to provide balanced information and refer patients when personal values conflict.

  • End of Life Care

    • Acknowledgment that dying is a personal experience; discussions about end-of-life care should happen routinely.

    • Advanced directives and organ donation should be covered.

    • Ensuring dignity and relief from suffering is a priority for terminally ill patients.

  • Professionalism in PAs

    • Importance of managing conflicts of interest, maintaining professional identity and competency.

    • Awareness of issues like sexual relationships and discrimination within the professional environment.

  • Collaboration with Other Professionals

    • Team practice is fundamental to providing comprehensive care.

    • Awareness of illegal/unethical conduct and issues of impairment.

    • Emphasis on the PA-physician relationship and approaches to complementary and alternative medicine.