Beneficence - ANSWER-The obligation to help the patient. Remove harm, prevent harm, promote good. ("do no harm"). Acting in the patient's best interest.
... [Show More] Compassionate patient care.
What ethical principle
Educating an obese patient on the harmful effects of obesity and recommending weight loss. - ANSWER-Beneficence
What ethical principle
Encouraging a patient to stop smoking and enroll in smoking cessation programs. - ANSWER-Beneficence
What ethical principle
: Calling the surgeon to get a prescription for stronger pain med - ANSWER-Beneficence
Nonmaleficence - ANSWER-Nonmaleficence The obligation to avoid harm. Protecting a patient from harm.
What ethical principle
A new nurse practitioner (NP) is told to suture a laceration on a patient's face. The NP tells the physician that she has not been trained to suture facial area lacerations and therefore is unable to do it. - ANSWER-Nonmaleficence
What ethical principle
The NP discusses a new anticancer drug that may be more effective in treating a patient's cancer. The NP discusses the known risk versus the benefits of the new drug. The patient declines the treatment - ANSWER-Nonmaleficence
Utilitarianism - ANSWER-The outcome of the action is what matters with utilitarianism. It also means to use a resource for the benefit of most (e.g., tax money). It may resemble justice, but it is not the same concept (see below).
What ethical principle
The Women, Infants, and Children food (WIC) program - ANSWER-Not only for pregnancy
and children.
It is not open to adults and elderly males. The reason may be that it would cost society more if women (and their fetuses), infants, and children are harmed by inadequate food intake (affects the brain growth, etc.).
Justice - ANSWER-The lack of bias. The right to fair and equitable treatment. The fair and equitable distribution of societal resources.
What ethical principle
Low-income individuals do not pay some types of taxes to the government, but they still have equal access to the postal service and other public services that are supported by taxes. - ANSWER-Justice
What ethical principle
A homeless alcoholic male without health insurance presents to the ED for abdominal pain. The patient is triaged and treated in the same manner as the other patients who have health insurance. - ANSWER-Justice
Dignity - ANSWER-Respect for human dignity is an important aspect of medical ethics. A person's religious, personal, and cultural beliefs can influence greatly what a person considers "dignified" treatmaent.
What with all principle : Hospital gowns should be secured correctly so that when patients get up to walk with their backs not visible - ANSWER-Dignity
Fidelity - ANSWER-Dedication and loyalty to one's patients. Keeping one's promise.
What ethical principle
Example: A woman with terminal breast cancer does not want the NP to reveal her poor prognosis to her mother. The patient explains to the NP that her mother is very anxious and she wants to wait until the next week before she tells her mother news. If the NP keeps the prognosis in confidence from the patient's mother, she is exercising the concept of fidelity. - ANSWER-Fidelity
Confidentiality - ANSWER-Confidentiality The obligation to protect the patient's identity, personal information, test results, and medical records.
What ethical principle
This "right" is also protected by the Health Insurance Portability and Accountability Act (HIPAA) (release of patient information for electronic billing purposes). - ANSWER-Confidentiality
What ethical principle
Psychiatric and mental health medical records are protected information and require separate consent. - ANSWER-Confidentiality
Paternalism - ANSWER-Making decisions for a patient (or for others) because you "believe" that it is for their best interest. The opinion (or desires) of the patient is minimized or ignored. The patient is "powerless."
What ethical principle
Example: A 92-year-old male does not want to be on a ventilator if he codes. The son disagrees and quietly tells the NP and physician that he wants this father to be aggressively treated with life support, if it is necessary. - ANSWER-Paternalism
Autonomy - ANSWER-Mentally competent adult patients have the right to make their own health decisions and express treatment preferences. If the patient is mentally incapacitated (dementia, coma), the designated surrogate's choices are respected. A patient can decline or refuse treatment.
What ethical principle
Examples: An alert elderly female with periods of forgetfulness and who has breast cancer decides to have a mastectomy after discussing the treatment options with her oncologist.
The woman's daughter tells the NP that she does not want her mother to have a mastectomy because she thinks her mother is too old and confused. The NP has the duty to respect the patient's forgetfulness and who has breast cancer decides to have a mastectomy after discussing the treatment options with her oncologist. - ANSWER-Autonomy
Accountability - ANSWER-Health care providers are responsible for their own choices and actions and do not blame others for their mistakes.
Veracity - ANSWER-The duty to present information honestly and truthfully.
What ethical principle
Example: An elderly woman is recently diagnosed with advanced pancreatic cancer. The patient thinks that she has a very good chance of being cured. The oncologist explains to the patient her poor prognosis. The oncologist is being truthful and honest to the patient about her prognosis. - ANSWER-Veracity
American Nurses Association (ANA) Code of Ethics for Nurses - ANSWER-The ANA Code of Ethics for Nurses with Interpretive Statements (2001) contains "the goals, values and ethical precepts that direct the profession of nursing." According to the ANA, the Code "is nonnegotiable." Each nurse "has an obligation to uphold and adhere to the code of ethics."
Ombudsman - ANSWER-A person who acts as an intermediary (or as a liaison) between the patient and an organization (long-term care or nursing homes, hospitals, governmental agencies, courts). The ombudsman represents the patient and works in the best interests of the patient.
Guardian ad litem - ANSWER-A court-appointed guardian who is assigned by a court (and has the legal authority) to act in the best interest of the "ward." The ward is usually a person who is a child, frail, or vulnerable.
Living will - ANSWER-Living Will A document that contains the patient's instructions and preferences regarding health care if the patient becomes seriously ill or is dying. It contains the patient's preferences (or not) for aggressive life-support measures. Health care providers should have a copy of the document in the patient's chart.
Durable power of attorney - ANSWER-The patient designates a person (family member or a close friend) who has the legal authority to make future health care decisions for the patient in the event that the patient becomes mentally incompetent or incapacitated (i.e., comatose).
Power of attorney - ANSWER-A person who is designated by the patient, and who has the legal authority to make decisions for the patient. This role is broader and encompasses not only health care decisions but also other areas of the patient's life, such as financial affairs.
Accountability Act (HIPAA) * Also known as the "HIPAA Privacy Rule" - ANSWER-The law was passed by the U.S. Congress and enacted in August, 1996. The law provides protections for: "the use and disclosure of individuals' health information"—called "protected health information" by organizations subject to the Privacy Rule—called "covered entities."
Covered entities - ANSWER-Any health care provider, health insurance company, health care plans, and third-party administrators (TPAs) who "electronically transmit health information" must follow the HIPAA regulations.
TPA - ANSWER-third-party administrator is the organization that does the processing of claims and administrative work for another company (health insurer, health plans, retirement plans).
HIPPA - ANSWER-Health providers are required to provide each patient with a copy of their office's HIPAA policy (patient to sign the form).
The HIPAA form must be reviewed and signed annually by the patient. Patients have the right to review their medical files. A mental health provider has the right to refuse patients' requests to view their psychiatric and mental health records. When patients request to review their medical records, the health provider has up to 30 days to comply. Patients are allowed (under HIPAA) to correct errors in their medical records. Must keep identifying information (name, DOB, address, Social Security number) and any diagnosis/disease or health concerns private except with allowed exceptions (see list below).
When is consent not needed - ANSWER-The health plan/insurance company that is paying for the medical care.
A third party or business associate (e.g., accounting, legal, administrative) that the insurance company or doctor's office hires to assist in payment of their services (e.g., medical billing services).
Health care operations (medical services review, sale of health care plan, audits).
Collection agency for unpaid bills.
Victims of abuse/neglect or domestic violence.
No separate consent is needed to consult with other health care providers.
Claim based policy - ANSWER-A claim is filed in court against an NP in January 2011 for an incident that occurred in January 2009. The NP remains enrolled with the same malpractice insurance company. Therefore, the claim will be covered. But if the NP has changed jobs or is retired (and does not carry tail coverage), the claim will not be covered even if the NP was insured at that time.
What is "tail" insurance or "tail coverage"? When an NP with claims-based malpractice insurance retires or changes to a new job, it is advisable to buy "tail" coverage insurance. The tail coverage insurance will cover the NP for malpractice claims that may be filed against him or her in the future.
Occurrence - ANSWER-This type of malpractice policy is not affected by job changes or retirement. When a claim is filed against the NP in the future, it is covered if he or she had an occurrence-based policy at the time the incident occurred.
What type of malpractice [Show Less]