1. Unit #4 – Medical Ethics Cecile M. Sanders, M.Ed., MLS(ASCP) CM

2. Unit #4 Medical Ethics  What is “ethics”? –According to the American College Dictionary, “ethics” means: 1. The principles of morality, including both the science of the good and the nature of the right 2. The rules of conduct recognized in respect to a particular class of human actions, as in “medical ethics” 3. Moral principles, as of an individual 4. The science of the human character in its ideal state

3. Unit #4 Medical Ethics  In a nutshell, “ethics” means doing what is right.  So, what is “right”?  “Right” depends on your values  “Values”, in terms of societal interaction, refer to the ideals and customs toward which a person or group of person has a positive regard.

4. Unit #4 Medical Ethics  “Values” can be a positive thing, like cleanliness, freedom, education, etc. or a negative thing, like cruelty, crime, or blasphemy.  What are YOUR values?  One can hardly argue with things like cleanliness, freedom or education, but we all know there are people who don’t value these things.

5. Unit #4 Medical Ethics  In some cultures, freedom is not important.  In some cultures, it is OK to send suicide bombers into a crowd of innocent people just because they are trying to make a point or disagree with others’ values.  So, again, what are YOUR values?

6. Unit #4 Medical Ethics  Here are things that many people value: –Honesty –Integrity –Freedom –Loyalty –Life –Friendship –Family –Timeliness –Hard-work –Truthfulness –Religion –Etc., etc., etc.

7. Unit #4 Medical Ethics  All of us have values even though we may not know it or admit it to ourselves.  Sometimes our values don’t make themselves apparent until we are confronted with a tough issue or decision.

8. Unit #4 Medical Ethics  For instance: –If you value honesty,  Is it OK to keep extra money that a store clerk has returned to you accidentally?  Is it OK to call in sick when you are not?  Is it OK to “fudge” laboratory results when you need to leave work to pick up your children at day care?

9. Unit #4 Medical Ethics  If you value life, –Is it OK to have an abortion? –Is it OK to disconnect a feeding tube from a comatose patient? –Is it OK to bomb innocent people? –Is it OK to have capital punishment?

10. Unit #4 Medical Ethics  If you value friendship, –Is it OK to tell a friend a lie? –Is it OK to turn a friend in to the police if he has committed a crime?  I think you get the idea that although one may say they hold a certain value doesn’t mean that they would always act to hold that value.

11. Unit #4 Medical Ethics  Most professions have established a Code of Conduct or a Code of Ethics for people in the field –Example: Doctors take the Hippocratic Oath, Nurses take the Florence Nightingale Oath –The American Society for Clinical Laboratory Sciences has established a Code of Ethics for clinical laboratory professionals. It can be found at http://www.ascls.org/?page=Code

12. Unit #4 Medical Ethics  The ASCLS Code of Ethics basically states that all laboratory professionals have: –I. Duty to the Patient –II. Duty to Colleagues and the Profession –III. Duty to Society

13. Unit #4 Medical Ethics  ASCLS Pledge to the Profession As a clinical laboratory professional, I strive to: –Maintain and promote standards of excellence in performing and advancing the art and science of my profession –Preserve the dignity and privacy of others –Uphold and maintain the dignity and respect of our profession –Seek to establish cooperative and respectful working relationships with other health professionals –Contribute to the general well being of the community. I will actively demonstrate my commitment to these responsibilities throughout my professional life.

14. Unit #4 Medical Ethics  The ASCLS Code of Ethics and Pledge to the Profession can serve as a “moral compass” to guide clinical laboratory professionals in their jobs and even in their interactions with friends and family.  Decision-making can be tough in any situation, but particularly tough when you are a recent graduate or when you are the only person working in the lab when a decision is needed.

15. Unit #4 Medical Ethics  Here is one of many decision-making models, based on personal and/or professional values: –1. State the problem –2. Determine personal or professional values regarding the problem –3. List the possible alternative solutions to the problem –4. Frame a choice from the possible alternative solutions and compare it with personal or professional values –5. List the short and long term consequences of the choice

16. Unit #4 Medical Ethics  Example of using the Value-Based Decision-Making Model –The Lead MLT is the only staff person left in the lab on a Saturday evening. Two technicians arrive for the midnight shift. One of the technicians seems to be under the influence of something; her gait is unsteady and her speech is slurred. –What to do?

17. Unit #4 Medical Ethics  Example of using the Value-Based Decision- Making Model (cont’d) –Using the Decision-Making Model outlined on slide #15, this is what the Lead MLT decided:  1. The problem is that this midnight tech might be drunk or under the influence of some drug and her ability to function may be impaired.  2. The Lead MLT values excellent patient care and accurate laboratory testing. He also values maintaining a good working relationship with the midnight tech and her friendship. Too, he values his free time and a good night’s sleep.

18. Unit #4 Medical Ethics  Example of using the Value-Based Decision-Making Model (cont’d)  3. The Lead MLT could: –A. Stay for a double shift, assigning the midnight MLT to harmless tasks –B. He could warn the other midnight tech about this possibly impaired MLT, leave, and hope for the best –C. He could call his supervisor for a decision –D. He could ignore the situation and hope for the best

19. Unit #4 Medical Ethics  Example of using the Value-Based Decision-Making Model (cont’d)  4. This Lead MLT chose alternative D (ignored the situation and hoped for the best). He decided that his friendship with this person and maintaining a good working relationship with her, along with wanting his free time and a good night’s sleep, was priority.

20. Unit #4 Medical Ethics  Example of using the Value-Based Decision-Making Model (cont’d)  5. Short-term consequences of his decision include: –A. The Lead MLT could go home and not work a double shift. –B. His supervisor would not have to be disturbed. –C. The impaired employee could work with no reprimands.  6. Long- term consequences are that laboratory errors could affect patient care.

21. Unit #4 Medical Ethics  Example of using the Value-Based Decision-Making Model (cont’d) –Is this the decision you would have made? Maybe, maybe not. It is difficult to know until you are actually in that situation.

22. Unit #4 Medical Ethics  In the Assignment for this Unit, go to http://virtualmentor.ama- assn.org/ http://virtualmentor.ama- assn.org/http://virtualmentor.ama- assn.org/  On the home page for this website, click the “Past Issues” tab at the top of the page.  Scroll down to 2008, April, “Medical Care for US Immigrants” and click.  Take the Poll in the grey box. Click the “Vote” button at the bottom to view the results.  Copy and paste the results of the poll in a Word document AND, using the 5 step decision-making model in this PowerPoint, outline the steps you used to arrive at your voting results ONLY for whether illegal immigrants should be eligible for the following government-subsidized medical interventions.  Send the Assignment to the instructor by the scheduled deadline.