Midterm: Bioethics

Professional Ethics

“How ethical are you?”

 Experts agree that professional success depends on not only on the quality of your work but also
on your relationships with others.
 These relationships begin the minute you make a contact with an employer, a colleague, or a
prospective client (Ferrara et.al).

Professionalism

 The concept professionalism refers first to all to whatever counts as proper conduct oon the
part of members of a profession.
 “Professionalism is someone’s inherent ability to do what is expected of them and deliver
quality work because they are driven to do so.” (Brooks 2019)

Why is Professionalism important?

Attributes of a Professional

 Self-respect
 Self-transcendence
 Service-oriented
 Simplicity
 Sense of personal responsibility and accountability
 Risk taking personality
 Patience

Calling of the Health Care Provider

 The Health Care Profession

- An occupation requiring advanced, specialized, and systematic study and training in the
knowledge of health care designed.
- To provide service to society in that particular field.
 The Client – Patient
 The Health Care Provider
- The person who is authorized to practice the profession.
 The Health Care Provider-Client Relationship
- As a social being, the human person tends to relate with others.
- In establishing relationships, he or she uses language which may take variety of forms
such as spoken or written words, gestures, signs and others.

Major Components of the Therapeutic Interaction

1. The health care practitioners

2. The client/patient
3. Health care and the contents of the interaction
4. Environment
5. The outcome

Health Care Provider-Client Relationship

 Privacy
 Veracity
 Confidentiality
 Unavoidable Trust
 Personal Dignity
 Patient Advocacy

Qualities of a Good Health Care Provider

1. Goodwill
 2. A recognition of acceptance of their personal power
3. The knowledge that they have found their own way
4. Self-respect and appreciation
5. A willingness to serve as models for their patients
6. A willingness to risk making mistakes and to admit having made them.
7. Virtues, Vices, ad Habits of a Health Care Profession

Focal Virtues

a. Compassion
b. Discernment
c. Trustworthiness
d. Integrity

Intellectual Virtues (Mind over Matter)

a. Understanding the First Principe

b. Science
c. Wisdom
d. Art
e. Prudence

Moral Virtues

a. Justice
b. Fortitude
- It’s both a gift of the Holy Spirit and cardinal virtue.
- It gives us strength to follow through.
- Also referred to as courage.
c. Temperance
- Temperance is moderation in the things that are good and total abstinence from the
things that are foul.

Other Virtues

a. Fidelity
b. Honesty
c. Humility
d. Respect

Undesired Virtues

a. Fraud
b. Pride
c. Greed
“Fraud is the daughter of greed”

Good Habits

 Be proactive
 Put first things first
 Think win-win solution
 Seek first to understand then to be understood
 Sharpen one’s saw
 Begin with an end in mind
 Synergize

“The only way to do great work is to love what you do. If you haven’t found it yet, keep looking. Don’t
settle. As with all matters of the heart, you’ll know when you find it.”

- Steve Jobs

Informed Consent
As an ethical doctrine, informed consent is a process of communication whereby a patient is enabled to
make informed and voluntary decision about accepting or declining medical care.

Major Legal Elements of Informed Consent

1. Information
- What is being offered, the alternatives and their risks, benefits, and consequences
2. Consent
- Must be voluntary, without coercion, force, or manipulation from health care providers
or family

Key Aspects of informed Consent

 Nature of Treatment
 Alternatives
 Risks
 Benefits
 Opportunity for Questions

Content of Informed Consent

When educating clients about informed consent, the following information should be provided
in writing and discussed:
 The therapeutic process
 Background of therapist
 Costs involved in therapy
 The length of therapy and termination
 Consultation with colleagues
 Interruptions in therapy

Basic Elements of Informed Consent

 Description of Clinical Investigation/ Medical Procedure

 Risks and Discomforts
 Benefits
 Alternative Procedures or Treatments
 Confidentiality
 Compensation and Medical Treatment in Event of Injury
 Contacts
 Voluntary Participation

Patient’s Rights

 A patient’s bill of rights is a list of guarantees for those receiving medical care.
 It may take the form of a law or a non-binding declaration
  Typically a patient’s bill of rights guarantees patient’s information, fair treatment, and
autonomy over medical decisions, among other rights.

Proposed Magna Carta of Patient’s Rights

Explanatory Note
It is a declared policy of the State to ensure and protect the rights of patients to decent,
humane and quality health care. Further, the State shall adopt an integrated and
comprehensive approach to health and development which shall endeavor to make
essential goods, health and other social services available to the people at affordable
costs. The State shall likewise endeavor to provide free medical care to pauper.
http://legacy.sente.gov.ph/lisdata/50404429!.pdf

1. Rights to informed consent

- Relates to a process by which patients are informed of the possible outcomes.
- Alternatives, risks of treatments, and patients are required to give their consent freely.
- Information, decision, and choice.
Types of Consent
 Admission Agreement
 Blood Transfusion Consent
 Surgical Consent
 Research Consent
 Special Consent
Functions of Informed Consent
 To avoid fraud and duress
 To encourage self-scrutiny by professionals
 To foster rational decision making
 To involve the larger society in the debate
Elements of Informed Consent
1. Competence
A competent individual is a person who:
 Can make decisions
 Able to justify the decision
 Able to justify decision in a reasonable manner
2. Disclosure
3. Comprehension
4. Voluntariness
2. Rights to informed decision
- Refers to the necessary information of and understanding so a genuine deliberation is
carried out before making a moral decision on a medical treatment.
3. Right to informed choice
- The patient has the right to be inform all possible alternative courses of action to be
taken, together with the possible consequences.
- = Moral Choice
4. Right to refuse treatment
- The patient has the right to refuse treatment to the extent permitted by law and to be
informed of the medical consequences of his action.
5. Right to self-determination
- The patient as an autonomous individual has the moral right to determine what is good
for himself, usually upon the advice of a health care provider.

Limitations of Patient’s Rights

 Patient’s rights do not include patient’s rights to be allowed to die.

 Patients in a moribund condition does not possess the necessary mental, physical, or emotional
stability to make decision.
 Patient’s right are not absolute.

Patient’s Bill of Rights from the Department of Health

 1. Right to appropriate Medical care and Humane treatment
2. Right to informed consent
3. Right of privacy and confidentiality
4. Right to information
5. Righto choose health care provider and facility
6. Right of self-determination
7. Right to religious belief
8. Right to medical records
9. Right to leave
10. Right to refuse participation in medical research
11. Right to correspondence and to receive visitors
12. Right to express grievances
13. Right to be informed of his rights and obligations as a patient

Right to Health Care

 Health as a human right creates a legal obligation on states/countries to ensure access to

timely. Acceptable, and affordable health care of appropriate quality.
 To provide for the underlying determinants of health, such as safe and potable water,
sanitation, food, housing, health-related information.

Health Care Claim

 An insurance claim is a formal request by a policyholder to an insurance company for coverage

or compensation for a covered loos or policy event.

Health Care Resources

 Are defined as all materials. Personnel, facilities, funds, and anything else that can be used for
providing health care services.
Types:
Public
Private

Health Care System

 Primary
- Are the rural health units, their sub-centers, chest clinics, malaria eradication units, and
schistosomiasis control units operated by DOH
 Secondary
- Are the smaller, non-departmentalized including emergency and regional hospitals
- Services offered to patients with symptomatic stages of disease, which require
moderately specialized knowledge and technical resources for adequate treatment
 Tertiary
- Are the highly technological and sophisticated services offered by medical centers and
large hospitals
- These are specialized national hospitals.
Resource allocation is the distribution of resources – usually financial – among competing groups of
people or programs.

Level 1: Allocating resources to health care versus other social needs.

Level 2: Allocating resources within the health care sector.
Level 3: Allocating resources among individual patients.

Levels of Allocation

Macro Level
 Health systems policy level
 National Health Authorities
Meso Level
 Health services (hospital, facility managers
Micro Level
 Clinical management (health care providers involved in direct provision of clinical care)