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Weekly Overview: Week Four 1 HCS/335 Version 4 Weekly Overview

Week Four

Overview

Week Four provides you with detailed information regarding biomedical ethical issues. You will be introduced to the historical overview of biomedical ethics and offered theoretical and practical knowledge regarding medical consent, conflict of interest, and advance directives. The discussion will include an array of biomedical issues, such as cloning, euthanasia, ethics of organ donation, and much more. Specifically, important consideration is focused on the role and responsibilities of the managerial or administrative role related to ethical and legal issues.

Many biomedical ethical issues, such as continuing or discontinuing life support and assisted suicide (euthanasia), require tough decisions. Genetic discoveries and drug therapies are often at the forefront of these discussions, including biomedical research using human subjects and animals. Biomedical ethical decisions may be difficult because they raise questions about when life begins and ends. People often have strong moral views based on individual values, religion, and culture. This may lead to differing thoughts about the most appropriate action to take when someone is suffering or has a poor prognosis. As an organizational leader guiding biomedical decision-making, each person’s view must be considered as part of the decision-making process.

What you will cover

.1 Biomedical Ethical issues .a Describe the ethical impact of historical biomedical events on the health care industry. )1 Biomedical ethical issues )a From its beginnings in the late 1960s, bioethics focused attention on the behavior of individuals and the relationships between patients and their doctors. )b In the early 1990s, the role of the institution in patient care was taken more seriously, particularly the institution’s role in educating and supporting patients in exercising their rights. )c Ethicists were compelled to consider how the organization, through its formal policies and culture, affected patient care. ()1 Patient Self-Determination Act ()2 Emergence of managed care ()3 Growth of for-profit health care institutions ()4 The Joint Commission standards in organization ethics )2 Components )a Voluntary: consent must be given without duress that significantly influences the decision )b Competent: means the person understands the nature and consequences of the course of treatment )c Informed: law requires full disclosure of the nature of the patient’s condition and proposed treatment, available alternatives, and likely consequences and difficulties that may result from treatment or nontreatment )3 Advance directives )a Living wills )b Natural death acts statutes )c Do-not-resuscitate orders

)d Power of attorney )4 Euthanasia: means good death in Greek )a Active: terminally ill patient requests to end life; a conscious act )b Passive: terminally ill patient dies naturally without any medical interference or assistance )c Voluntary: occurs at the request of the patient )d Involuntary: terminating patient’s life without consent )5 Assisted suicide )a Oregon is the first state with a law that specifically allows physician-assisted suicide, enacted in 1997. )b Washington adopted a ballot measure based on the Oregon law in November 2008. )c In 1999, Texas adopted a law that allows hospitals and physicians to withdraw life support from terminally ill patients. )d California legislators worked industriously to pass a bill similar to the Oregon law, but it was nullified in June 2007. )e New technology )f Incentives resulting from cost constraints )6 Managed care ethics )a Resource allocation )b Financial interests to providers )c Clinician–patient relationship )d Confidentiality )e Employee trust .b Identify current biomedical ethical issues in health care. )1 Ethics of transplants (e.g., transplant protocol procedures and processes) )2 Ethics of biomedical research (e.g., lack of funding, problems with double-blind testing, ethics of randomized test trails, human genomes, cloning, and stem cell research) )3 Ethics of testing and screening (e.g., health care testing and screening protocols) )4 Ethics of organ donation, obligation of donation, and selling organs (e.g., major delimitations regarding donations and selling organs) )5 Ethics of treating the terminally ill (e.g., quality of life) )6 Experimentation in medicine (e.g., cloning and gene therapy) )7 Caring for compromised newborns (e.g., quality of life) )8 Fetal tissue (e.g., research and transplants became an issue because of its use of fetuses from elective abortions) )9 Artificially provided nutrition and hydration (e.g., quality of life, and ethical and legal issues addressing patient persistent vegetative state) )10 Confidential care of minors )11 Financial incentives for organ donation )12 Allocation of health resources )13 Withholding or withdrawing life-prolonging treatment )14 Euthanasia )15 Assisted suicide )16 Advance directives .c Analyze ethical issues that are related to medical consent. )1 Communication barriers between health care practitioners and patient/family )2 Doctrine of informed consent

)a Definition )b Standards )3 Barriers of informed patient consent )a Substituted Judgment issues ()1 Voluntary Mechanisms of Substituted Judgment ()a Powers of Attorney ()b Nonemergent medical care ()2 Involuntary Substituted Judgment ()a Medical emergency exception ()b Involuntary medication )4 Cultural aspects )a Language differences )b Religious beliefs

DISCUSSION PROMPTS

1. What are some ethical issues related to releasing medical records to third parties?

2. Several biomedical issues, such as cloning, harvesting embryos, in vitro fertilization, stem cells, and organ transplants are major health care and research issues. What are some arising ethical dilemmas and developing initiatives to promote patient safety and maintain confidentiality?

3. What are some ethical dilemmas in selling organs and organ donation?