Ethics and Law

CikguOnline
CikguOnline

























ETHICS AND LAW












JULIE JAMES ABDULLAH

CikguOnline
CikguOnline


Learning Outcome








1 2 3
















Explain the Identify

concept of Differentiate common
ethics in ethic with law terminology

health care in healthcare used in ethics

CikguOnline
CikguOnline






















INTRODUCTION TO ETHICS IN




HEALTH CARE

CikguOnline
CikguOnline


Introduction to ethics in health care







▪ Health ethics promotes the consideration of values in the prioritization and
justification of actions by health professionals, researchers and policymakers that

may impact the health and well-being of patients, families, and communities.



▪ It is an interdisciplinary field encompassing a broad range of domains: public health,

health research and clinical care.



▪ With competing interests under limited resources, a health ethics framework
provides for a systematic analysis and resolution of conflicts through the evidence-

based application of general ethical principles, such as respect for personal

autonomy, beneficence, justice, utility and solidarity.

CikguOnline
CikguOnline


Introduction to ethics in health care







▪ The core principles of health ethics

o respect for persons, beneficence, justice, utility, solidarity

o essential to achieving the Sustainable Development Goals

(https://www.my.undp.org/content/malaysia/en/home/sustainable-

development-goals/background.html)

CikguOnline
CikguOnline






















DEFINITION AND CONCEPT OF




ETHICS, VALUES AND MORAL

CikguOnline
CikguOnline


What is ‘ethics’?







▪ The word ethics derives from the Greek ethikos and the Latin moralitas, both
meaning custom or habit.



▪ The words ‘ethics’ and ‘morality’ are commonly used interchangeably, but ethics

appears to be more of a system of thinking about moral issues and can be

distinguished from the personal morals an individual may have about particular
matters.








Simply put, ethics involves thinking not just about what we see as being right or wrong,

identifying what we value and deciding upon how we should treat others or behave, it

also involves systematising, defending and recommending concepts of ‘right’ and
‘wrong’ behaviour.

CikguOnline
CikguOnline


Definition of Ethics in Healthcare







Health care ethics at its simplest, is a set of moral principles, beliefs and values that
guide healthcare provider in making choices about medical care.








▪ At the core of health care ethics is the sense of right and wrong and beliefs about

rights healthcare provider possess and duties healthcare provider owe others.








▪ Thinking carefully about the ethical aspects of health care decisions helps

healthcare provider make choices that are right, good, fair and just.

CikguOnline
CikguOnline


Concept of Ethics in Healthcare







▪ Ethical responsibilities in a given situation depend in part on the nature of the
decision and in part on the roles healthcare provider play.








▪ The Core Principles of Health Care Ethics


1. Autonomy: to honour the patients right to make their own decision

2. Beneficence: to help the patient advance his/her own good


3. Nonmaleficence: to do no harm

4. Justice: to be fair and treat like cases alike

CikguOnline
CikguOnline






















DIFFERENTIATE ETHIC WITH LAW




IN HEALTHCARE

CikguOnline
CikguOnline


Ethics and Law







▪ Ethics and law may overlap but they are distinct from one another.








▪ Law may require a given action while ethics might demand something else.








▪ Example, in many jurisdictions there is no legal duty to rescue.

o One may see a drowning person but have no legal obligation to rescue them. A

moral duty may, however, be seen to exist.

o Ethical decision making then comes into play; for example, a person may decide

their moral duty does not involve jumping into the water (particularly if the
observer cannot swim) but may involve calling for help.

CikguOnline
CikguOnline


Ethics and Law in Healthcare







▪ Distinction between law and ethics is also important because ethics allows
judgments about the law itself.








▪ A law may be valid and enforceable because it has been enacted by a certain

government, it may not be ethically acceptable.








▪ Example, laws supporting apartheid were once valid but were contrary to the values

and ethics of many.

CikguOnline
CikguOnline


Distinguishing Features of Law and Ethics

CikguOnline
CikguOnline


Ethics and Law in Healthcare







▪ Health practitioners don't routinely face ethical dilemmas in every decision they
make, requiring them to stop and engage in a detailed ethical analysis.








▪ Health practitioners take for granted that they should help patients in need and that

good health is valuable.








▪ The ethical ground of health care is often therefore invisible to practitioners because

they are so accustomed to doing the right thing in terms of assisting patients.

CikguOnline
CikguOnline


Ethics and Law in Healthcare







▪ However, sometimes it is necessary to have to stop and ask about the right thing to
do.


o This may occur because the treatment is unlikely to be successful or because
the patient does not want to receive a potentially beneficial treatment;

sometimes there are competing pressures so that helping one patient comes at

a cost to others.

o As health practitioners become more experienced, the ethical issues often seem

to loom larger. This may be because those who are experienced no longer worry

about how to do things and are able to consider whether or not they should do

them.




Understanding what ethics is, and having an ethical framework within which to

think about what one should do, and why, when faced with moral dilemmas may

assist in answering such questions.

CikguOnline
CikguOnline

What are the ethical issues in healthcare?








The major ethical issues, as perceived by the
participants in order of their importance,
were:

1. Patients' Rights


2. Equity of resources

3. Confidentiality of the patients


4. Patient Safety

5. Conflict of Interests


6. Ethics of privatization-cost, quality etc

7. Informed Consent, has the right to get
information and ask questions before
procedures and treatments


8. Dealing with the opposite sex, e.g.,
requesting personnel of the same
gender

CikguOnline
CikguOnline

























TERMINOLOGY USED IN ETHICS

CikguOnline
CikguOnline


Terminology used in ethics







▪ Autonomy: to honour the patients right to make their own decision



▪ Beneficence: to help the patient advance his/her own good



▪ Nonmaleficence: to do no harm


▪ Justice: to be fair and treat like cases alike

CikguOnline
CikguOnline


Autonomy







▪ Patient autonomy, in the clinical context, is the moral right on the part of the patient
to self-determination concerning one’s own health care.


o whenever a health care professional restricts, or otherwise impedes, a patient’s
freedom to determine what is done, by way of therapeutic measures, to oneself,

and attempts to justify such an intrusion by reasons exclusively related to the

well-being, or needs, of that patient, that health care professional can be

construed to have acted paternalistically.

CikguOnline
CikguOnline


Beneficence







▪ To act beneficently toward others is to behave in such a way as to “do good” on
behalf of, or to benefit, someone other than oneself.


o which health care professionals serve their patients by helping them to maintain
or improve their health status, health care professionals can be said, to the

same extent, to be acting beneficently toward the patients they serve.








▪ Respect for patient autonomy and the practice of beneficent medical care can be

considered to be mutually complementary.

o despite the complementary nature of the ethical principle of autonomy and that

of beneficence, it is not uncommon for these two ethical principles to conflict

one with the other

CikguOnline
CikguOnline


Nonmaleficence







An ethical principle that is typically traced back to the Oath of Hippocrates is to “first,
do no harm,” or to refrain from engaging in any acts of maleficence in the clinical

context, that is, acts that would result in harm to the patient.








▪ Acts of maleficence can be intentional or unintentional, and a large percentage of

the latter kind happen as a result of either negligence or ignorance on the part of
the health care professional.



▪ Example of the former would be a surgeon who fails to exercise due diligence in

scrubbing prior to surgery, the result of such negligence being that the surgical

patient contracts an infection.

CikguOnline
CikguOnline


Justice







▪ Justice is a complex ethical principle, with meanings that range from the fair
treatment of individuals to the equitable allocation of healthcare money and

resources.








▪ Justice is concerned with the equitable distribution of benefits and burdens to

individuals in social institutions, and how the rights of various individuals are
realized.

CikguOnline
CikguOnline


Justice







▪ Common definitions for Justice are often problematic for clinicians, as the
explanations leave many questions unanswered.







o If Justice is a concept about treating people fairly, then it is prudent to wonder

what it means to be “fair.”

o In discussing a different aspect of Justice, distributive Justice, the concern

focuses on who gets what treatment in healthcare, and who decides what
treatments are administered.


o Is the decision based on need? Age? Prognosis?

o These concepts leave clinicians with many unanswered questions as to what is

fair and equitable in the treatment of individuals.

CikguOnline
CikguOnline


Further Reading






▪ A Person’s Right as a Patient from https://www.thomasphilip.com.my/articles/a-personrs-right-as-a-
patient/






▪ General Hospital Operational Policy from
https://www.moh.gov.my/moh/resources/Penerbitan/Garis%20Panduan/Garis%20Panduan%20Umum(
KKM)/GHOP_2013.pdf






▪ Patient And Family Right from https://hbtu.moh.gov.my/bm/wp-content/uploads/2019/08/Patients-
Family-Right.pdf






▪ Person Management System from
https://www.moh.gov.my/moh/resources/auto%20download%20images/589d72ec82adb.pdf






▪ Disclosures Required By Law from https://mmc.gov.my/wp-content/uploads/2019/11/Confidentiality-
guidelines.pdf

CikguOnline
CikguOnline



SEQ





1. Explain the 7 principles of healthcare ethics



2. Define:



▪ Ethics

▪ Moral


▪ Values




3. State the common ethical issues in healthcare setting




4. Find the meaning of terminology










Submit your work individually to Unit 2.1 Assignment in GC.