2.5 Ethics and Legal Dilemma

ETHICS AND LEGAL


DILEMMA











JULIE JAMES ABDULLAH

LEARNING OUTCOME












1 Discuss ethical & legal 2 Discuss potential ethical
violation that places
dilemma in healthcare fundamental of autonomy,


beneficence and
nonmaleficence

At stake

Ethical &




Legal



Dilemma In



Healthcare

Introduction










What are legal and ethical dilemmas?





• Ethical issues are based on the difference between right and wrong


• Legal issues are based on laws. Many laws are created with ethical issues in


mind in order to protect individual rights and freedoms. On the other hand,

there are laws that can be used in unethical ways.

Introduction







What constitutes an ethical dilemma and how such


dilemmas arise in health care?





• Ethical dilemmas arise when a difficult problem cannot be solved in a way


that will satisfy everyone who is involved.

• The same dilemma might occur when a situation arises that involves a


choice between equally unsatisfactory alternatives.

Introduction







Some examples of ethical dilemma examples









• Taking credit for others' work.


• Offering a client, a worse product for your own profit.

• Utilizing inside knowledge for your own profit.

Introduction







What is the difference between ethical dilemma


and legal dilemma?





• Ethical issue is anything that a person believes to be right or wrong that


generally comes down based on personal opinion or a person’s belief or

philosophy


• While legal issue is any act done by a person, he/she thinks it is right or


wrong, whether it conforms to the law and needs legal expertise

Examples Of Common Legal And Ethical


I s s u e s I n H e a l t h c a r e




1 Patient Privacy and 2 Transmission of Diseases

Confidentiality.

3 Relationships 4 End-of-Life Issues





5 Advance directives 6 Surrogate decision making




7 Refusal of treatment 8 Conflicts with caregivers




9 Foregoing life-sustaining 10 Do Not Attempt
Resuscitation (DNAR) orders.
treatment.

Ethical Dilemma











Value Attitude

What are the values based ethical dilemma? Work attitude [impact to others]


When we are faced with a dilemma, it is important to stop and Positive 'Can-Do' Attitude. Being ready, available and willing to
consider our choices carefully and recognize how our values get the job done, and done well.
will influence our decision. • Courteous and Friendly.
We must also think about how our decisions will affect others. • Consistently Meets Deadlines.
Values help us determine appropriate standards of behaviour. • Gladly Takes Responsibility.
Ethical behaviour is influenced by societal values. Societal • Good Attendance and Punctuality.
norms tell us it is wrong to engage in certain behaviours.
However, individuals must often determine for themselves
what is proper and what is not.

Attitude







What is wrong with attitude at work?



• Examples of negative attitudes in the workplace can be an employee


consistently coming late

• Carelessly performing tasks


• Laziness, rudeness to other employees or management


• Spreading or creating rumours

• Or anything that you consider threatening to a positive workplace culture


or environment

Ethical Dilemma










Professionalism


What is a professional dilemma?

An ethical problem that requires an individual to choose a particular course of action.
Usually, the choice itself is black and white: one choice is clearly the right answer, while the other choice is unmistakably the wrong answer.
In general, an ethical dilemma is a complex situation a person faces in which a decision must be made about the adequate action to be
taken (Harrison, 2005).

A dilemma may derive from the conflict between the rightness or wrongness of the actions and the goodness or badness of the
consequences of the actions. Example of a common ethical dilemma nurses deal with is establishing boundaries with patients. Nurses and
nurse managers devote their careers to helping patients receive the care they need, so it can often be difficult to establish professional
boundaries.

Legal Dilemma








• A legal dilemma arises when an action is both legal and illegal at the same

time. legal dilemma defined as an irresolvable and unavoidable conflict


between legal norms, where obeying or applying one norm necessarily


entails the undue impairment of another.





What is a legal dilemma in healthcare?

• The main legal issues in the healthcare system relate to medical negligence,


informed consent and confidentiality.

Legal Dilemma












Absolute Pure

The right to consent: Is it absolute? What is a definition of pure?

The patient’s right to autonomy should always be respected Not mixed with anything else.
and steps shall be taken to make consent truly informed.
However, no absolute right to consent based on philosophical, As a pure legal issue:
ethical, legal and practical considerations. • Forcing treatment on an unwilling person
v A harmful or offensive touching without permission
What is the legal basis for informed consent? (is battery, battery is a criminal offense, and it can
Valid informed consent must include three major elements: also be the basis of a civil lawsuit.
disclosure of information, competency of the patient (or v The key element is that the touching be
surrogate) to decide, and voluntary nature of the decision. unauthorized, not that it be intended to harm the
person

Potential ethical


violation that places


fundamental of

autonomy,


beneficence and

nonmaleficence at


stake

Over or Under Treatment









What are some ethical challenges
involved in treatment?


The major ethical issues, in order of their
importance, were:
• Patients' Rights
• Equity of resources
• Confidentiality of the patients
• Patient Safety
Introduction • Conflict of Interests

Potential ethical violation that • Ethics of privatization
• Informed Consent
places fundamental of autonomy,
beneficence and non-maleficence • Dealing with the opposite sex
at stake

Sub Standard Care











Essentially, “substandard care” arises when a

doctor or other medical professional fails to

adhere to the appropriate standard of care when

treating a patient.
In general, the standard of care for those who

provide medical services is higher than a normal

standard of care.

Scope of Professional Practice









What are some ethics expected

of it professional?



For example, among other elements that describe ethical behaviour in

the profession, in general these codes assert that professionals need to

commit to:
• integrity

• competence

• professional responsibilities
• work responsibilities

• societal responsibilities

Impaired Professional





















Typically, the impaired professional is one whose ability to function in his or her professional
capacity has deteriorated because of a physical or mental difficulty.

An incompetent professional lacks the minimally acceptable levels of knowledge and skill

needed to practice within a field.

Fraud





















What constitutes as medical fraud?
Medical fraud is generally defined as the billing of the Medical program for services, drugs,

or supplies that are: Unnecessary; Not performed; More costly than those actually

performed.

Misconduct, Sexual harassment and Abuse







Professional misconduct in health care is defined by the Dutch Health

Care Inspectorate as a (generally) lasting situation in which patients are

at risk or harmed because a healthcare worker lacks competencies or
provides irresponsible care and seems unable or unwilling to change

this situation.

Sexual harassment is a widespread problem in the healthcare
workplace, affecting hospitals, medical practices and other healthcare

facilities. The law defines sexual harassment as an unwelcome sexual

advance, request for a sexual favour, or verbal or physical conduct of a
sexual nature. e.g. slapping the butt, touching, voice, etc.

Violation of Patients Right







Professional misconduct in health care is defined by the Dutch Health

Care Inspectorate as a (generally) lasting situation in which patients are

at risk or harmed because a healthcare worker lacks competencies or
provides irresponsible care and seems unable or unwilling to change

this situation.

Sexual harassment is a widespread problem in the healthcare
workplace, affecting hospitals, medical practices and other healthcare

facilities. The law defines sexual harassment as an unwelcome sexual

advance, request for a sexual favour, or verbal or physical conduct of a
sexual nature. e.g. slapping the butt, touching, voice, etc.

How do you deal with dilemmas at work?






Dealing with dilemmas in the workplace is important to ensure everyone

maintains focus on the company's overall goals.


• Get the facts about the issue.


• Team up to produce a solution.

• Anticipate and counter the impact to any of your clients or customers.


• Take steps to avoid a recurrence of the dilemma in the future.

THANK YOU FOR YOUR


ATTENTION