Recognize ethical dilemmas in nursing informatics.
Examine ethical implications of nursing informatics.
Evaluate professional responsibilities for the ethical use of healthcare informatics technology.
Slide 3: Introduction
The Knowledge Age is changing healthcare in ways that will not be fully recognized and understood for years.
The change is paradigmatic, and every expert who addresses this change reminds healthcare professionals of the need to “go with the flow” of rapid change or be left behind.
(Is it so horrible to be left behind?)
Slide 4: Introduction (cont.)
As with any paradigm shift, a new way of viewing the world brings with it some of
the enduring values of the previous worldview.
Ethical decision-making frameworks will remain constant, but the context for examining these moral issues or ethical dilemmas will become increasingly complex.
Slide 5: Ethics
Ethics is a process of systematically examining varying viewpoints related to moral questions of right and wrong.
Regardless of the theoretical definition, a common characteristic regarding ethics is its dialectical, goal-oriented approach to answering questions that have the potential of multiple acceptable (or unacceptable) answers.
Slide 6: Bioethics
Bioethics is defined as the study and formulation of healthcare ethics.
Bioethics takes on relevant ethical problems experienced by healthcare providers in the provision of care to individuals and groups.
As technological advances have increased, recognition and acknowledgment of rights and the needs of individuals and groups receiving this high-tech care have also increased.
Smartphone apps to direct, interact with, and monitor patient status and behaviors.
Google glass for ‘secretive’ photos and videos.
Social media such as Facebook, Twitter, LinkedIn, and YouTube.
(And the sharing that goes on)
Mobile device use by healthcare providers.
Slide 8: Ethical Dilemmas and Morals
Ethical dilemmas arise when moral issues raise questions that cannot be answered with a simple, clearly defined rule, fact, or authoritative view.
Moral dilemmas occur when some evidence indicates that an act is morally right and some evidence indicates the act is morally wrong; yet the evidence on both sides is inconclusive; or an individual believes that on moral grounds, he or she cannot commit an act (Beauchamp and Childress, p. 11).
Slide 9: Ethical Decision Making
The process of making informed choices about ethical dilemmas based on a set of standards differentiating right from wrong.
The changing meaning of “communication” alone will bring with it new concerns by healthcare professionals for protecting patients’ rights of confidentiality, privacy, and autonomy.
Slide 10: Theoretical Approaches to Healthcare Ethics
Theoretical approaches to healthcare ethics have evolved in response to societal changes.
The Hippocratic tradition emerged from relatively homogenous societies where beliefs were similar and the majority of societal members shared common values.
Slide 11: Principlism
Principlism arose as societies became more heterogeneous and members began experiencing a diversity of incompatible beliefs and values.
Principles were expansive enough to be shared by all rational individuals, regardless of their background and individual beliefs.
Slide 12: Principlism is based on:
Autonomy—free-will or agency;
Beneficence—to do good;
Nonmaleficence—not to harm; and
Justice—social distribution of benefits and burdens.
Slide 13: Antiprinciplism
Prompted by expansive technological changes and associated ethical dilemmas.
Opponents of principlism claim principles:
are too conceptual, intangible or abstract.
disregard or do not take into account a person’s psychological factors, personality, life history, sexual orientation, religious, ethnic and cultural background.
Slide 14: Casuistry
The casuistry approach to ethical decision making grew out of the concern for more concrete methods of examining ethical dilemmas.
Casuistry is a case-based ethical reasoning method that analyzes the facts of a case in a sound, logical, and ordered or structured manner.
The facts are compared to the decisions arising out of consensus in previous paradigmatic or model cases.
Slide 15: Bioethical Decision Making (Husted)
The Husted Bioethical Decision-Making Model centers on the healthcare professional’s implicit agreement with patient/client (Husted and Husted, 1995, p. 19).
Based on six contemporary bioethical standards: autonomy, freedom, veracity, privacy, beneficence, and fidelity.
Slide 16: Contemporary Bioethical Standards
Autonomy—right of individual to choose for her/himself.
Freedom—ability and right to make choices.
Veracity—right to truth/truthfulness.
Slide 17: New Challenges
Consider that patients and healthcare providers no longer have to be in the same place for a quality interaction.
How, then, does one deal with licensing issues if the electronic consultation takes place across a state line?
Slide 18: New Challenges (cont.)
Consider the ethical issues created by genomic databases or by sharing information in a health information exchange to promote population health.
Does public good outweigh individual interests in data collection and data mining?
Slide 19: Conclusion
As science and technology advances and policy makers and healthcare providers continue to shape healthcare practices including information management, it is paramount that ethical decisions are made.
The healthcare professional cannot allow conflicting loyalties to interfere with judicious, ethical decision making.
Slide 20: Conclusion (cont.)
In an ideal world, healthcare professionals must not be affected by conflicting loyalties; nothing should interfere with judicious, ethical decision making. As the technologically charged waters of healthcare are navigated, one must hone a solid foundation of ethical decision making and practice it consistently.
Slide 21: Thought-Provoking Problems
Identify moral dilemmas in healthcare informatics that would best be approached with the use of an ethical decision making framework.
Discuss the evolving healthcare ethics traditions within their social and historical context.
Slide 22: Thought-Provoking Problems (cont.)
Differentiate among the theoretical approaches to healthcare ethics as they relate to the theorists’ perspectives of individuals and their relationships.
Select one of the healthcare ethics theories and support its use in examining ethical issues in healthcare informatics.
Slide 23: Thought-Provoking Problems (cont.)
Select one of the healthcare ethics theories and argue against its use in examining ethical issues in healthcare informatics.