Beruflich Dokumente
Kultur Dokumente
Week 6
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Lecture Overview
Ethical Dilemmas in Healthcare and Interprofessional Teams Professional Codes of Ethics
Learning Objectives
1. Identify the distinction between moral and ethical dilemmas 2. Understand ethical reasoning and ethics frameworks as they relate to teams 3. Apply ethical reasoning skills to scenarios
Real-Life Stories
A nurse who is married to a police officer is asked to provide care to a gun-shot patient who is under guard and has been charged with the murder of a cop
The colleague of a lab technician, a fellow technician who performs phlebotomy, reveals she is HIV positive
A health care professional who is a devout practitioner of a faith that condemns abortion is asked to care for a patient undergoing an abortion A drug seeking patient has lost a prescription for narcotics and is seeking a replacement and is in obvious pain
What morals might be in conflict with ethical codes? How might individuals vs. teams react in these scenarios?
Ethics
Ethics is, simply put, the study of what is good and bad, right and wrong, and of moral duty and obligation. It also includes the values and principles of conduct governing an individual or a group.
In health care ethical issues are usually conceptualized as standards of practice linked to the dyadic responsibilities of individual providers toward their patients and each other as professionals (Clark, Cott & Drinka, 2007, p. 591)
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The agent thus seems condemned to moral failure; no matter what she does, she will do something wrong (or fail to do something that she ought to do)* When two or more ethical values apply to a situation, but these values support diverging courses of action, an ethical conflict or dilemma exists. (CNO, 2009)
*Source: http://plato.stanford.edu/entries/moral-dilemmas/#ConMorDil
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A nurse has explained to his client the benefits of taking medication and firmly believes that the medication is in the clients best interest. The client understands Normans explanation, but refuses to take the medication. The client states that the side effects of the medication cancel out any benefits. (CNO, 2009)
*Source: http://plato.stanford.edu/entries/moral-dilemmas/#ConMorDil
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Practice #1
In your group, discuss the case Keeping Tabs on Mom Identify the practical considerations and ethical principles (slide 8) that are relevant to this case.
Bruce, C. (2011). Keeping tabs on mom: The ethics of motion sensor based monitoring of the elderly. Retrieved from http://www.scu.edu/ethics/practicing/focusareas/medical/sensor-basedmonitoring.html For more case studies, visit: Markkula Centre for Applied Ethics, Santa Clara University, http://www.scu.edu/ethics/practicing/focusareas/medical/
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Unique moral & ethic dilemmas are arising from collaborative team work
New questions have to be asked and answered as expanded teamwork practice grows
Lessons from the Bacteria: How Good Culture Trumps Bad Leadership (podcast)
http://www.globalethics.org/lessonsbacteria.php
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Ethical Framework
A framework aids in thinking about & understanding the ethical dimensions of interprofessional teamwork Clark, Cott and Drinka propose three elements:
1.
2.
3.
(2007, p. 593)
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Team
the responsibility of each member for promoting and protecting the team as a distinct structure, and
Organization
i. respect the unique relationship between the team and the patient as a part of the team approach to providing care,
ii.
To develop knowledge i. of oneself and competency in ones own discipline as the basis for mutual respect among the professions on the team, ii. To understand the norms and practice standards of the other professions on the team, and
the shared accountability of each member for the teams decisions and outcomes.
ii.
iii.
iii.
To master the basic knowledge and skills required for effective teamwork.
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Team
Integrate professional knowledge with other team members Develop integrated patient problem definitions and a structure for assessment and care planning
Organization
i. Provide sufficient resource foundation for team Establish evaluative structures for assessment of teams work
ii.
Develop standards i. of professional practice for personal relationships with other team members ii. Acquire insights into basis for practice of other professions on team
ii.
iii. Establish a personal structure for iii. Promote and teaching new protect team as members about distinct structure ones profession and roleCott on team (Clark, & Drinka, 2007, p. 594)
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Team
i. Develop ethic of open communication and dialogue Arrive on time for team meetings
Organization
i. Support team development and function Appoint facilitator to address communication and ethics issues and mediate team conflicts
ii.
ii.
ii.
iii. Get to know and assimilate new members into teamwork processes
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Post an example of a alternate ethical framework to your Group Work Discussion forum
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Related Readings
Community Ethics Toolkit : http://www.jointcentreforbioethics.ca/partners/doc uments/cen_toolkit2008.pdf Meadus, J. & Wahl, J. (2008) Transfer from hospital to long-term care: reframing the ethical debate from the patients Perspective. Retreived from www.acelaw.ca Meadus, J. (2010). First available bed policies & discharge to a long-term care home from hospital. Retrieved from www.acelaw.ca
Meadus, J. (2009). The role of community care access centres in admission to long term care from Hospital. Retrieved from www.acelaw.ca
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References
Beauchamp, T. L., & Childress. J. F. (2001). Principles of Biomedical Ethics (5th ed.). New York, NY: Oxford University Press. Bruce, C. (2011). Keeping tabs on mom: The ethics of motion sensor based monitoring of the elderly. Retrieved from http://www.scu.edu/ethics/practicing/focusareas/medical/sensorbased-monitoring.html Clairmont, S. (2011, November 1). Forced apart after nearly 70 years. The Hamilton Spectator. Retrieved February 12, 2012 from http://www.thespec.com/news/local/article/617797-forced-apart-after-nearly-70-years Clark, P., Cott, C., & Drinka, T. (2007). Theory and practice in interprofessional ethics: A framework for understanding ethical issues in health care teams. Journal of Interprofessional Care, 21(6): 591 603. Retrieved from http://www.cihc.ca:8180/library/bitstream/10296/382/1/ClarkEtAl_InterprofessionalEthics_Dec 2007.pdf College of Nurses of Ontario (2009). Ethics. Retrieved from http://www.cno.org/Global/docs/prac/41034_Ethics.pdf Frey, W. (2012). New Ethics of Teamwork (presentation). In Ethics of Team Work (on-line course module). Retrieved February 12, 2012 from http://cnx.org/content/m13760/latest/?collection=col10491/1.9 Hamilton Health Science Centre. (2010). Ethics framework. Retrieved from http://hamiltonhealthsciences.ca/workfiles/CLINICAL_ETHICS/HHSEthicsFramework.pdf McConnell, T. (2010). Moral Dilemmas. In E. N. Zalta (Ed.), The Stanford encyclopedia of philosophy (Summer 2010 ed.). Retrieved from http://plato.stanford.edu/archives/sum2010/entries/moral-dilemmas
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