NCM 108

HEALTH CARE ETHICS

ETHICAL PRINCIPLES
Ethics
 Ethos - custom
 Study of moral conduct or behavior
 It deals with making moral judgements about what is right or wrong, good or bad.
 Ethics are principles that guide us in making good decisions and actions
 In healthcare, ethics pertains to making moral behaviors and decisions which affect the
patient's health.
Ethical Principles

 Autonomy
 From the Greek words "autos" (self) and "nomos" (law).
 The quality or state of being self-governing. Especially: the right of self-
government. (Merriam-Webster Dictionary)
 In medical practice, autonomy refers to the right of adults to make an informed
decision regarding their own medical care.
To ensure autonomy, patients have:
 Patient's Rights
o Patient rights refer to a set of ethical and legal principles that ensure
individuals who receive medical care are treated with dignity, respect,
and fairness.
o These rights are designed to empower patients and protect their well-
being while interacting with the healthcare system.
o The list of Patient's Rights varies from country to country, but they
generally enclose similar principles.
 Informed Consent
 Privacy and Confidentiality
 Access to Medical Records
 Respect and Dignity
 Refusal of Treatment
 Pain Management
 Access to Information
 Second Opinions
 Continuity of Care
 Complaints and Grievances
 Advance Directives
 Financial Transparency
 Patient's Bill of Rights
o A patient's bill of rights is a formal document or set of principles that
outlines the rights and responsibilities of individuals receiving medical
care.
o It's intended to ensure that patients are aware of their entitlements
and to promote respectful, ethical, and patient-centered care within
the healthcare system.
  Informed Consent/Legally Acceptable Representative
 Confidentiality
 Privacy

 Confidentiality
 It is the duty to protect privileged information and to share entrusted information
responsibly.
 It requires health care providers to keep a patient's personal health information
private unless consent to release the information is provided by the patient.
 Health Insurance Portability and Accountability Act (HIPAA)

 Veracity
 It is the principle of telling the truth and being honest
 It is the basis of trust in relationship between the patient and healthcare provider
 In healthcare, veracity is important as it demonstrates respect towards the
patients
 Fidelity
 Fidelity refers to the quality of being loyal, trustworthy, and faithful to one's
commitments, obligations, and responsibilities. It encompasses a sense of loyalty to
principles, duties, and relationships
FIDELITY IN HEALTHCARE:
 Patient Trust and Confidentiality
 Truthfulness and Honesty
 Informed Consent
 Justice - Justice refers to the concept of fairness, impartiality, and treating individuals or
groups equitably based on principles of morality, law, and societal norms. It involves the
distribution of benefits, burdens, opportunities, and resources in a way that is consistent
with ethical standards and respects the rights and dignity of all individuals
Types of Justice:
 Distributive Justice - Fair distribution of resources, benefits, and burdens
within a society
 Retributive Justice - Centers on the concept of punishment as a response to
wrongdoing.
 Restorative Justice - Emphasizes repairing harm caused by wrongdoing and
restoring relationships between individuals.
 Procedural Justice - Procedural justice is concerned with the fairness of the
processes and procedures used to determine outcomes
 Social Justice - Focuses on addressing systemic inequalities and promoting
fairness on a broader societal level.
 Global Justice - Extends ethical considerations to the international level,
addressing issues of fairness and equity in interactions between nations and
the treatment of individuals worldwide.
 Environmental Justice - Ensure that environmental benefits and burdens are
distributed fairly among all individuals, regardless of their socio-economic
status or demographic characteristics.
Justice in Healthcare (Key aspects of justice in healthcare ethics):
 Equitable Access to Care - Justice requires that all individuals have equal access to
healthcare services, regardless of their socio-economic status, race, gender, age, or
other demographic factors
 Allocation of Resources - Ethical distribution of limited healthcare resources, such as
organs for transplantation, vaccines during a pandemic, or critical care beds.
 Eliminating Disparities - Ethical distribution of limited healthcare resources, such as
organs for transplantation, vaccines during a pandemic, or critical care beds
 Affordable Care
 Informed Decision-Making - Justice requires that patients are provided with accurate
and complete information about their medical conditions, treatment options, risks,
and benefits.
 Research Ethics - Justice extends to research involving human subjects.
  Healthcare Policy - Justice informs the development of healthcare policies that aim to
address systemic inequalities and provide equitable access to care for all members
of society

 Beneficence
 Non-maleficence