What are the principles of ethics in home health care?
There are four commonly accepted principles of health care ethics that providers follow to ensure optimal patient safety: autonomy, beneficence, non-maleficence, and justice. Let’s take a closer look at the definition of each of these principles and how they are put into practice in the home health care environment.
Why are there so many ethical issues in nursing home care?
Because nursing home care is complicated by numerous regulations and because nursing home residents have complex medical and social problems, some issues are unique to the long-term care sett … Physicians who provide care for nursing home residents are regularly challenged by ethical and legal issues.
Is the Affordable Care Act ethical and effective?
Limited access to coverage has historically been among its most glaring shortcomings. The ACA, which builds on a market-based approach, redresses this century-old concern. The ethical imperative is to implement this and other health care reforms in the most equitable and effective way possible.
What is the ethical imperative of health care reform?
The ethical imperative is to implement this and other health care reforms in the most equitable and effective way possible. Organisation for Economic Co-operation and Development. OECD health data 2012: US health care system from an international perspective.
What is the major ethical issue in home care?
When an elderly couple refuse home care services offered by a family agency, the ethical issues that arise encompass respect for autonomy and dignity, providing beneficence, and justifying paternalism.
What are the legal and ethical considerations for healthcare professionals?
Some examples of common medical ethical issues include:Patient Privacy and Confidentiality. The protection of private patient information is one of the most important ethical and legal issues in the field of healthcare. ... Transmission of Diseases. ... Relationships. ... End-of-Life Issues.
What are some ethical considerations when providing health services?
5 Ethical Issues in HealthcareDo-Not-Resuscitate Orders. ... Doctor and Patient Confidentiality. ... Malpractice and Negligence. ... Access to Care. ... Physician-Assisted Suicide.
What are at least three ethical issues that may be raised concerning managed care?
It is not surprising that ethical concerns about managed care include damage to the physician-patient relationship, and particularly patient trust, by MCOs' financial incentives for the provider to limit 2 Page 3 Managed Care: Some Basic Ethical Issues 3 care, incentives that create serious conflicts of interest, and ...
What are the legal and ethical considerations?
Legal standards are those standards that are set forth in governmental laws. Ethical standards are based on the human principles of right and wrong. The differences between them are these: Legal standards are based on written law, while ethical standards are based on human rights and wrongs.
What are legal and ethical responsibilities?
Definition. Legal compliance refers to acting in accordance with the laws of a particular organization, company etc. while ethical responsibility is the choice to comply with the code of ethics of the particular organization, company etc.
What are ethical considerations?
Ethical considerations in research are a set of principles that guide your research designs and practices. These principles include voluntary participation, informed consent, anonymity, confidentiality, potential for harm, and results communication.
What are the top 5 ethical issues in healthcare?
Five Top Ethical Issues in HealthcareBalancing Care Quality and Efficiency. ... Improving Access to Care. ... Building and Sustaining the Healthcare Workforce of the Future. ... Addressing End-of Life Issues. ... Allocating Limited Medications and Donor Organs.
What are the 8 ethical issues related to healthcare?
The major 10 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, (7) Informed Consent, (8) Dealing with the opposite sex, (9) ...
What are some of the ethical and legal issues related to patient sensitive health information?
[8] There are four major ethical priorities for EHRS: Privacy and confidentiality, security breaches, system implementation, and data inaccuracies.
What are the 4 ethical principles in healthcare?
The four principles of Beauchamp and Childress - autonomy, non-maleficence, beneficence and justice - have been extremely influential in the field of medical ethics, and are fundamental for understanding the current approach to ethical assessment in health care.
What are 3 legal and ethical issues that occur with end of life patient?
These issues include patients' decision-making capacity and right to refuse treatment; withholding and withdrawing life-sustaining treatment, including nutrition and hydration; "no code" decisions; medical futility; and assisted suicide.
What are the ACA provisions?
The ACA’s central provisions—the individual mandate, insurance exchanges, guaranteed coverage for those with pre-existing conditions, and Medicaid expansion— took effect in 2014, and they are widely credited as the driving force behind a substantial reduction in the percentage of Americans who lack health insurance [10]. However, the newly insured are not the ACA’s only winners. By relying on private companies to broaden access to coverage, the law also brought insurance companies substantial new business opportunities. Private insurers now serve more than ten million customers, most of them new buyers of individual policies on the ACA’s marketplace exchanges [11], and many of these companies also administer benefits for seven million new Medicaid enrollees brought in by the law’s expansion of that program [12].
What was the mandate of the individual market?
The individual market proposals included a mandate that all Americans maintain health coverage to avoid the risk—known as adverse selection—that only the sick would buy in. One or both of these approaches formed the basis for President Bill Clinton’s proposed Health Security Act of 1993 and the ACA [9].
What is utilitarianism in healthcare?
The principle of utilitarianism emphasizes the breadth of the benefits of expanding coverage in any form. The ACA affords millions of people access to care they might otherwise have been denied, while bolstering an industry that is a mainstay of the economy.
What is the ACA?
The ACA culminates a century-long effort to guarantee health coverage to all Americans that began with Theodore Roosevelt’s call for such a plan in 1912 [8].
Why is the ACA important?
The ACA’s model of government support for private industry also raises a fundamental long-term concern. The strength and resources that private firms gain from their public foundation affords them substantial political influence. They use it to lobby legislators to retain and expand the programs on which they rely.
What is the common thread in health insurance plans?
A common thread in these plans is their reliance on a government-run and publicly funded payment mechanism to expand coverage. In the 1970s, the quest to broaden coverage continued, but the premise behind policy proposals underwent an important shift.
Does Medicare replace private insurance?
Similarly, Medicare does not replace private insurance for the elderly, which was never widely available, but instead grants private insurers new business opportunities to serve key roles in administering the program. However, this intertwined relationship creates an ethical minefield.
What are the legal aspects of patient care?
The legal aspects of patient care are determined by country-specific regulations, which in turn are governed by medical ethics. For instance, when an Indian psychiatrist is alleged of “wrongdoing,” it is determined whether he acted contrary to “medical ethics,”[6] or to the pertaining laws in the country.[1] .
What is ethical issue?
ETHICAL ISSUES. Ethic is defined as “a set of moral principles, especially ones relating to or affirming a specified group, field, or form of conduct.” [5] Technically, ethics talk about morality and desirable way of behaving but may not be binding on an individual.
How many cases were acquitted of mental illness?
The 18 (17.65%) cases out of a total of 102 cases were acquitted on the grounds of mental illness. The Honorable High Courts’ judgment was mostly in line with the judgment of the lower Court and heavily relied on the documentary evidence of mental illness.
Is there a need for judicial policy in India?
In recent times, in India, there is an increased focus on training of judiciary and prison medical officers which is a welcome step. There is also a dire need to have a judicial policy that mandates caregiver's and/or family member's presence while referring such individuals to psychiatry hospitals.
Do faculty members have to be involved in legal aspects of patient care?
Third, the faculty members may not involve them in legal aspects of patient care, believing it is not their responsibility. In my place of work, which is a tertiary level teaching public hospital, the psychiatry residents are routinely involved in legal aspects of patient care.
Is PWMI disclosed to caregivers?
In India, PWMI are mostly accompanied by caregivers. Few PWMI wants their information and diagnosis to be disclosed to such caregivers. Considering this as implied consent, till some time back, such disclosure was done in the absence of an explicit written informed consent.
Do psychiatrists have to be concerned about mental health?
Psychiatrists should only be concerned about mental illness and the resulting disability . Thus, even a rich person who has a disability due to mental illness should get disability benefits. The disability benefits must be independent of the financial status of PWMI.
What are the principles of Medicare reform?
The conservative idea of Medicare reform is rooted in three basic principles: First, government control over medical pricing and inadequate incentives for individuals to control their own health-care costs lead to waste and inefficiencies.
What percentage of Medicare beneficiaries are under cost sharing?
The permanent drug benefit, which includes substantial out-of-pocket “cost-sharing” for middle-income and high-income seniors, requires only minimal cost-sharing for those below 150 percent of the poverty level. This includes roughly a third of all Medicare beneficiaries.
How many days of skilled nursing care is covered by Medicare?
If someone suffers a stroke, for example, Medicare covers the expenses incurred in its immediate aftermath — hospital care, 21 days of skilled nursing care with no deductible, and 79 additional days of skilled nursing care for a subsidized rate of $109.50 per day.
What is Medicare Part A?
In March 2004, the Medicare Board of Trustees issued its annual report on the financial health of Medicare Part A, which funds primarily hospital expenses, and Medicare Part B, which funds outpatient care.
When was the Medicare Modernization Act signed into law?
The Medicare Modernization Act (MMA), signed into law in December 2003, has no doubt made this financial crisis even worse.
Does Medicare have a fiat rate?
The government sets the prices by fiat for all the medical services covered under Medicare — with different physician groups lobbying constantly for increases to the reimbursement rate for their own specialties, and the government trying constantly to keep up with ongoing changes in the nature of medical care.
Is Medicare a federally funded program?
This is no easy task, but a few salient points are worth noting. First, Medicare is primarily a federally funded, third-party payer, fee-for-service program. In other words, when seniors get sick, they go to the doctor and the government pays most of the bill.
What are the myths surrounding the Patient Protection and Affordable Care Act?
Part of the controversy surrounding the PPACA is related to misinterpretations of the legislation which distort public opinion. Understanding the myths surrounding the legislation can help us examine the facts from the perspective of what is just for society.
Who said the right to adequate medical care and the opportunity to achieve and enjoy good health?
It is interesting to note that this same mandate for "the right to adequate medical care and the opportunity to achieve and enjoy good health” was articulated already by Franklin Roosevelt in the “Second Bill of Rights” outlined in his 1944 State of the Union address ( USHistory.org, 1944/2012 ).
What do Americans want from their health care system?
First, we want high quality health care that can provide the greatest benefits. Second, we want freedom of choice so that we can decide the “who, when, and where” for our health care . Third, we expect our health care to be affordable so that we have resources for all of the other things we need or want . Fourth, we want our fellow citizens to share in the costs and also benefits of health care ( American College of Emergency Physicians, 2011 ).
How much will Medicare cost in 2019?
Long term financial benefits of the act, according to a report by Health and Human Services, include a reduction of government expenditures on Medicare of approximately $575 billion by 2019 ( Werhane, & Tieman, 2011 ).
When was the Affordable Care Act enacted?
The June 2012 Supreme Court decision that upheld the constitutionality of the Patient Protection and Affordable Care Act (PPACA), first enacted in 2010, provides some guidance to states, insurers, employers, and consumers about what they are required to do by 2014, when much of the law comes into force ( White House, n.d. ).
Does the Affordable Care Act require government control of the health system?
The act does not call for government control of the health system. Instead, it attempts to improve both access and efficiency through a set of mandates to be carried out by states, insurers, and private health care providers.
What are the four principles of ethics in home health care?
There are four commonly accepted principles of health care ethics that providers follow to ensure optimal patient safety: autonomy, beneficence, non-maleficence, and justice . Let’s take a closer look at the definition of each of these principles and how they are put into practice in the home health care environment.
What is home health policy?
For home health providers, it means having a policy in place to provide care, treatment and services to patients without regard to age, race, religion, sex, national origin or disability. It also requires providers to ensure they are in compliance with both federal and state regulations that govern them.
Why is patient autonomy important in home health?
Patient autonomy is also critical when it comes to how home health care agencies handle incapacitated patient and life-sustaining treatment decisions and the procedures providers have in place. Consistent written policies and training are both needed for nurses, aides and other staff to handle such difficult ethical dilemmas.
Why is it important to implement risk management strategies in home health care?
This principle is about “doing no harm”, intended for providers to consider if any decision made may harm another individual or society – even it is made to benefit an individual patient. This is why it’s so important for home health care agencies to implement strong risk management strategies, safety procedures and protocols and best practices for staff to follow. When staff members are well versed in – and understand – a provider’s protocols, there is less room for deviation or exceptions that, while perhaps performed with good intentions, can cause overall harm and liability issues for the provider.
What is the role of beneficence in healthcare?
Health care providers are charged with doing all they can to benefit a patient, with all recommended procedures and treatments intended to do the most good for the patient. In order to do this, a high level of skill and knowledge, including ongoing training is needed.
Why should doctors create their own compliance program?
This means doctors should consider creating their own compliance program to identify what actions might constitute fraud and when medical bills may violate the laws. Part and parcel of a good compliance program should be: Assigning someone to be responsible for compliance.
Do physicians have to have CME?
Physicians must know their state licensure requirements. This includes the duty to comply with your state’s Continuing Medical Education (CME) obligation to take course to keep current with your medical practice and specialty. Physicians must also understand the requirements to keep up their hospital privileges and board certifications.
Can OIG exclude a person from federal health care?
The OIG can also exclude people or entities that have felony convictions for health-related misconduct, financial misconduct, or for offenses involving controlled substances. Your federal healthcare lawyer can also explain what other actions can disqualify a physician from obtaining federal health care funds.
Should physicians consult with attorneys?
Physicians should consult with experienced healthcare attorneys before they conduct business with any vendor. The attorney will inquire about the nature of the medical practice and the scope of the desired business relationship. The attorney will then advise the client about the relevant laws, the legal risks, and legal strategies for minimizing the risks.
Can a physician bill Medicare?
The Stark Law also known as the physician self-referral law. Under Stark, physicians can’t bill Medicare or Medicaid if they make referrals to specific designated health entities in which they (or an immediate family member) has a financial interest.
Code of Medical Ethics Opinion 10.1.1
Physicians’ core professional obligations include acting in and advocating for patients’ best interests. When they take on roles that require them to use their medical knowledge on behalf of third parties, physicians must uphold these core obligations.
Read more opinions about this topic
Visit the Ethics main page to access additional Opinions, the Principles of Medical Ethics and more information about the Code of Medical Ethics.
How does the equalitarian model of health care affect the health care system?
The equalitarian model of health care has played a major role in reducing class and race/ethnicity based inequalities and inequalities in access to health care . Medicaid has very substantially increased access to care among the poor of all ages who are disproportionally African American and Hispanic.
What is the principle of equal access to health care?
The principle does require, however, that sufficient resources be provided to ensure that everyone, regardless of ability to pay, have equal access to all health services commonly recognized as necessary to maintain normal physical and mental functioning.
How has access to health care increased since the 1960s?
Access to appropriate health care has increased very substantially since the 1960s and the advent of Medicare and Medicaid and the health status of most Americans has improved as measured by increased longevity. At the same time, however, inequalities, especially among racial, ethnic and socio-economic groups persist and in some cases appear ...
What is equalitarianism in health care?
Daniels and others have developed an ethics of health care based on the principle of fair equality of opportunity for individuals to flourish as human beings. This principle is an essential part of the notion that health care, like education, is a fundamental human right and not just a privilege.
What is the purpose of charity in the absence of any biding moral obligations on the state?
In the absence of any biding moral obligations on the state to collectively meet the needs of destitute individuals or families , people are free to respond through individual or organized charity to help needy others on a purely voluntary basis (Nozick, 1974).
Can inequalities be addressed through collective action?
If the inequality is the product of biological differences or any other source that cannot be feasibly addressed and reduced through collective action, then it cannot plausibly be considered an injustice that should be remedied. In point of fact, few if any health inequalities cannot be effectively addressed through collective efforts ...
Does Medicare expansion help low income people?
In this view, Medicare expansion would substantially enhance the chances that low to moderate income individuals would enter old age in better health than they do now and be in a better position to experience an active old age with fewer chronic illnesses and impairments.
The Affordable Care Act and Its Historical Roots
The Affordable Care Act and The Private Market
- The ACA’s central provisions—the individual mandate, insurance exchanges, guaranteed coverage for those with pre-existing conditions, and Medicaid expansion—took effect in 2014, and they are widely credited as the driving force behind a substantial reduction in the percentage of Americans who lack health insurance . However, the newly insured are not the ACA’s only winners. By relyin…
The Ethical Balance Between Private and Public Approaches
- Where should the balance lie between the competing ethical considerations raised by private and public approaches to expanding health care access? A starting point is to bear in mind that proposals to extend health care coverage do not arise in a vacuum. The political environment shapes the nature of any plan that can succeed. In the current environment, a guarantee of unive…
The Ethical Landscape Ahead
- What does this analysis say about the ethical direction of health policy going forward? What kind of health care landscape should we seek to create? It is tempting to answer that question by speculating about the shape America’s health care system might have taken had its historical path led to a smaller role for the private sector. The complex public-private interaction that char…
Goals For An Ethical Health Care System
- What do Americans want from their health care system? Four fundamental goals have shaped our system. First, we want high quality health care that can provide the greatest benefits. Second, we want freedom of choice so that we can decide the “who, when, and where” for our health care. Third, we expect our health care to be affordable so that we have...
Myths of The Patient Protection and Affordable Care Act
- Part of the controversy surrounding the PPACA is related to misinterpretations of the legislation which distort public opinion. Understanding the myths surrounding the legislation can help us examine the facts from the perspective of what is just for society. What control will the government have? The PPACA is often characterized as a move toward socialism with a “govern…
Ethical Responsibilities of Health Care Professionals
- In order to respond to ethical considerations related to the PPACA, it is important to sort out myths from reality. Many health issues are rooted in societal injustices and unless we understand the true intent and anticipated outcomes of the act, we cannot effectively sort out ethical concerns to address. Health professionals have a moral responsibility to pursue actions that su…
Author
- Jeanne Merkle Sorrell, PhD, RN, FAAN E-mail: [email protected] Dr. Sorrell is Senior Nurse Researcher in the Department of Nursing Research and Innovation at the Cleveland Clinic, Cleveland, OH, and Professor Emerita, George Mason University, Fairfax, VA. She earned a BSN from the University of Michigan, a MSN from the University of Wisconsin, and a PhD from Georg…
References
- American College of Emergency Physicians. (2011). Ethics of health care reform: Issues in emergency- medicine- An information paper. Retrieved from www.acep.org/Content.aspx?id=80871 Gable, L. (2011). The Patient Protection and Affordable Care Act, public health, and the elusive target of human rights. Journal of Law, Medicine and Ethi…