Ethical Dimensions in the Health Professions

by Purtilo

• ISBN13: 9780721602431
• ISBN10: 0721602436
• Edition: 4th
• Format: Paperback
• Copyright: 2005-01-21
• Publisher: Saunders

Summary

Carefully written to ensure successful use by all health care professionals, Ethical Dimensions in the Health Professions is still the only cross-disciplinary ethics book available. The new 4th edition of this bestselling title helps readers think critically and thoughtfully about ethical decisions they face in practice. Utilizing a unique 6-step decision making process designed by the author, this text provides an expert framework for making for making effective decisions. Questions and answers are positioned throughout the text to encourage critical thinking and enforce the interactive approach. Presents Western and non-Western sources of ethical thought, and case studies reflect a diversity of practitioners, settings, and cultures Discusses traditional normative theories in additional to newer approaches Features in every chapter include: objectives, new terms and ideas presented in the chapter; a list of topics in the chapter that were introduced in earlier chapters; case stories with diverse practice settings and practitioner types to appeal to a broad audience; summary boxes that synthesize key ideas; reflection boxes with answer blanks to indicate important concepts and encourage students to think critically about the material presented; fill in the blank questions in the text to further knowledge acquisition and retention; a summary paragraph at the end of the chapter; and questions for thought and discussion Weaves the 6-step ethical decision-making process more consistently throughout the text Reflects recent changes in health care, society, and ethics, and provides information on ethical issues based on new medical and high-tech discoveries Features expanded and updated case studies, with several new cases presented, further enforcing the interactive and dynamic approach Provides new information on the law-ethics relationship, showing how ethics are interdependent with legal issues

Table of Contents

Section One Introduction to Ethical Dimensions in the Health Professions	1	(92)
Morality and Ethics: What Are They and Why Do They Matter?	3	(26)
Objectives	3	(1)
The Story of the Harvey Family	4	(4)
Morality and Moral Values	8	(6)
Personal Morality	9	(1)
Societal Morality	10	(1)
Group Morality: The Health Professions and Their Institutions	11	(3)
From the ``Moral'' to the ``Ethical''	14	(1)
Ethics: Studying and Reflecting on Morality	15	(5)
Ethical Issues and Ethical Problems	16	(1)
The Moral and Ethical Thing to Do	17	(1)
Using Ethics in Practical Situations Involving Morality	18	(1)
Ethics Research	19	(1)
Morality: Ethics and Following Your Own Conscience	20	(4)
The Principle of Material Cooperation	21	(1)
Protection Through Laws and Policies	22	(1)
Limits of Protection	23	(1)
Becoming a Part of the Ethics Conversation	24	(2)
Deductive and Inductive Theories and Approaches	24	(1)
To Do and to Be	24	(1)
Individuals and Communities as Units of Concern	24	(1)
Reason and Emotion for Reliable Moral Judgment	25	(1)
Summary	26	(1)
Questions for Thought and Discussion	27	(2)
The Ethical Goal of Professional Practice and Prototypes of Ethical Problems	29	(17)
Objectives	29	(1)
The Story of Beulah Watson and Tiffany Bryant	30	(2)
The Goal: A Caring Response	32	(3)
Components of Ethical Problems	35	(1)
The Moral Agent---A	35	(1)
The Course of Action---C	35	(1)
The Desired Outcome---O	36	(1)
Prototypes of Ethical Problems	36	(7)
Ethical Distress: Barriers to Agency	36	(2)
Ethical Dilemma: Two Courses Diverging	38	(3)
Locus of Authority Problem	41	(2)
Summary	43	(1)
Questions for Thought and Discussion	44	(2)
Ethics Theories and Approaches: All You Need to Know	46	(33)
Objectives	46	(2)
The Story of Ronald Rachels, Pam Faden, and Metsui Hasagawa	48	(2)
Parts of Ethical Study	50	(3)
What Is Metaethics?	50	(2)
What Is Normative Ethics?	52	(1)
The Caring Response: Five Theories and Approaches to Help You	53	(1)
Varieties of Story or Case Approaches	54	(7)
Narrative Approaches	55	(1)
Approaches Emphasizing Relationships	56	(1)
Approaches Emphasizing Deep Diversity and Social Structures	57	(2)
Ethics of Care Approaches	59	(1)
Story or Case Approaches and a Caring Response	60	(1)
Virtue Theory	61	(3)
Character Traits and Moral Character	61	(2)
Character Traits and a Caring Response	63	(1)
Principles as Guides	64	(7)
Nonmaleficence and Beneficence	65	(1)
Autonomy	66	(2)
Fidelity	68	(1)
Veracity	69	(1)
Justice	70	(1)
Principles and a Caring Response	70	(1)
Deontologic and Teleologic Theories	71	(3)
Taking Duties Seriously	71	(1)
Absolute, Prima Facie, and Conditional Duties	72	(1)
Paying Attention to Outcomes	73	(1)
Duties, Consequences, and a Caring Response	74	(1)
Summary	74	(1)
Questions for Thought and Discussion	75	(4)
A Six-Step Process of Ethical Decision Making in Arriving at a Caring Response	79	(14)
Objectives	79	(1)
The Story of Anthony Carnavello and Alexia Eliopoulos	80	(1)
The Six-Step Process	81	(9)
Step 1: Get the Story Straight---Gather Relevant Information	82	(2)
Step 2: Identify the Type of Ethical Problem	84	(2)
Step 3: Use Ethics Theories or Approaches to Analyze the Problem(s)	86	(1)
Step 4: Explore the Practical Alternatives	87	(2)
Step 5: Complete the Action	89	(1)
Step 6: Evaluate the Process and Outcome	89	(1)
Summary	90	(1)
Questions for Thought and Discussion	91	(2)
Section Two Ethical Dimensions of Professional Roles	93	(76)
Surviving Student Life Ethically	95	(17)
Objectives	95	(1)
Special Challenges of Student Life	96	(1)
The Story of Matt and the Botched Home Visit	96	(2)
The Goal: A Caring Response	98	(1)
The Six-Step Process as a Student	99	(8)
Step 1: Gather Relevant Information	100	(1)
Step 2: Identify the Type of Ethical Problem	100	(3)
Step 3: Use Ethics Theories or Approaches to Analyze the Problem	103	(1)
Step 4: Explore the Practical Alternatives	104	(1)
Step 5: Complete the Action	105	(1)
Step 6: Evaluate the Process and Outcome	106	(1)
Strategies for Success as a Moral Agent	107	(1)
Summary	108	(1)
Questions for Thought and Discussion	108	(4)
Surviving Professional Life Ethically	112	(17)
Objectives	112	(1)
The Story of Janice K. and the Policies of Her Workplace	113	(1)
The Goal: A Caring Response	114	(1)
You Owe It to Yourself	115	(2)
The Responsibility to Maintain Personal Integrity	117	(7)
Integrity and Personal Values Systems	118	(1)
Opportunities to Strengthen Your Personal Integrity	119	(3)
Societal Safeguards Revisited	122	(1)
Personal Integrity and Personal Vigilance	123	(1)
The Responsibility to Improve Yourself	124	(2)
The Charge to Remain Competent Professionally	124	(1)
The Charge to Improve Yourself Personally	124	(1)
Challenges Regarding Personal Integrity: Vigilance Revisited	125	(1)
Summary	126	(1)
Questions for Thought and Discussion	126	(3)
Living Ethically within Health Care Organizations	129	(17)
Objectives	129	(2)
The Story of Angelica Gomez and the Management Discussion Group	131	(1)
The Goal: A Caring Response	132	(1)
The Six-Step Process in Organizational Matters	133	(9)
Step 1: Gather Relevant Information	133	(2)
Step 2: Identify the Type of Ethical Problem	135	(1)
Step 3: Use Ethics Theories or Approaches to Analyze the Problem	136	(4)
Step 4: Explore the Practical Alternatives	140	(1)
Steps 5 and 6: Complete the Action and Evaluate the Process and Outcome	141	(1)
Living with the Business Aspects of Health Care	142	(1)
Summary	143	(1)
Questions for Thought and Discussion	143	(3)
Living Ethically as a Member of the Health Care Team	146	(23)
Objectives	146	(1)
The Story of Maureen Sitler and Daniela Green	147	(2)
The Goal: A Caring Response	149	(2)
The Six-Step Process and Team Decisions	151	(6)
Step 1: Gather Relevant Information for the Team Situation	152	(1)
Steps 2 and 3: Identify the Type of Ethical Problem and the Ethics Approach to Analyze It	153	(1)
Step 4: Explore the Practical Alternatives	154	(3)
Step 5: Complete the Action	157	(1)
Step 6: Evaluate the Process and Outcome	157	(1)
Peer Evaluation Issues	157	(3)
Blowing the Whistle on Unethical or Incompetent Colleagues	160	(5)
Summary	165	(1)
Questions for Thought and Discussion	165	(4)
Section Three Ethical Dimensions of the Professional-Patient Relationship	169	(64)
Why Honor Confidentiality?	171	(17)
Objectives	171	(1)
The Story of Chaanda Jiwani and Damian Doucet	172	(2)
The Goal: A Caring Response	174	(4)
Keeping Confidences	176	(1)
Breaking Confidences	177	(1)
The Six-Step Process in Confidentiality Situations	178	(3)
Step 1: Gather Relevant Information	178	(1)
Steps 2 and 3: Identify the Type of Ethical Problem and the Ethics Approach to Analyze It	179	(1)
Step 4: Explore the Practical Alternatives	179	(1)
Step 5: Complete the Action	180	(1)
Step 6: Evaluate the Process and Outcome	181	(1)
Confidentiality, Records, and Patient Care Information Systems	181	(2)
Patient Privacy: Health Insurance Portability and Accountability Act of 1996	183	(2)
Summary	185	(1)
Questions for Thought and Discussion	185	(3)
Why So Much Emphasis on Truth Telling?	188	(20)
Objectives	188	(1)
The Story of Maria Priley and Kim Segard	189	(2)
The Goal: A Caring Response	191	(3)
Arguments Against Disclosure	191	(1)
Arguments Favoring Disclosure	192	(2)
The Six-Step Process Regarding Truthful Disclosures	194	(5)
Step 1: Gather Relevant Information	194	(1)
Step 2: Identify the Type of Ethical Problem	195	(1)
Step 3: Use Ethics Theories or Approaches to Analyze the Problem	196	(1)
Step 4: Explore the Practical Alternatives	197	(1)
Step 5: Complete the Action	198	(1)
Step 6: Evaluate the Process and Outcome	199	(1)
Truth, Truth Telling, and Deceit	199	(2)
Placebos: A Special Case of Information Disclosure	201	(2)
Disclosure of Genetic Information	203	(2)
The Right Not to Know	205	(1)
Summary	205	(1)
Questions for Thought and Discussion	206	(2)
Why Care about Informed Consent?	208	(25)
Objectives	208	(1)
The Story of Jason Fruhling and Faye Nesbitt	209	(1)
The Goal: A Caring Response	210	(2)
The Six-Step Process in Informed Consent Situations	212	(10)
Step 1: Gather Relevant Information	212	(5)
Step 2: Identify the Type of Ethical Problem	217	(2)
Step 3: Use Ethical Theories or Approaches to Analyze the Problem	219	(1)
Step 4: Explore the Practical Alternatives	220	(1)
Steps 5 and 6: Complete the Action and Evaluate the Process and Outcome	221	(1)
The Special Challenge of Incompetence or Incapacity	222	(2)
Informed Consent in Research	224	(4)
Sensitivity to Cultural and Other Differences	228	(1)
Summary	229	(1)
Questions for Thought and Discussion	230	(3)
Section Four Ethical Dimensions of Chronic and End-of-Life Care	233	(52)
The Growing Ethical Challenges of Chronic and Long-Term Care	235	(20)
Objectives	235	(2)
The Story of the McDonalds, the Experimental Drug, and the Doubters	237	(3)
The Goal: A Caring Response	240	(2)
The Six-Step Process in Chronic and Long-Term Care Situations	242	(10)
Step 1: Gather Relevant Information	242	(3)
Step 2: Identify the Type of Ethical Problem	245	(2)
Step 3: Use Ethics Theories or Approaches to Analyze the Problem	247	(2)
Step 4: Explore the Practical Alternatives	249	(1)
Step 5: Complete the Action	250	(1)
Step 6: Evaluate the Process and Outcome	251	(1)
Summary	252	(1)
Questions for Thought and Discussion	252	(3)
Ethical Issues in End-of-Life Care	255	(30)
Objectives	255	(2)
The Story of Almena Lykes, Jarda Roubal, and Roy Moser	257	(1)
The Goal: A Caring Response	258	(4)
Palliative Care	259	(3)
The Six-Step Process in End-of-Life Situations	262	(14)
Step 1: Gather Relevant Information	263	(2)
Step 2: Identify the Type of Ethical Problem	265	(1)
Step 3: Use Ethics Theories or Approaches to Analyze the Problem	266	(2)
Step 4: Explore the Practical Alternatives	268	(7)
Steps 5 and 6: Complete the Action and Evaluate the Process and Outcome	275	(1)
Advance Directives in End-of-Life Care	276	(1)
Clinically Assisted Suicide and Medical Euthanasia	277	(3)
Summary	280	(1)
Questions for Thought and Discussion	280	(5)
Section Five Ethical Dimensions of the Social Context of Health Care	285	(56)
Distributive Justice: Clinical Sources of Claims for Health Care	287	(19)
Objectives	287	(2)
The Story of Christopher Lacey and Other Contenders for His Bed	289	(2)
The Goal: A Caring Response	291	(1)
The Six-Step Process in Allocation Decisions	291	(8)
Step 1: Gather Relevant Information	292	(3)
Step 2: Identify the Type of Ethical Problem	295	(1)
Step 3: Use Ethics Theories or Approaches to Analyze the Problem	296	(2)
Steps 4 and 5: Explore the Practical Alternatives and Complete the Action	298	(1)
Step 6: Evaluate the Process and Outcome	299	(1)
Rationing: Allocation and Dire Scarcity	299	(3)
Criteria for a Morally Acceptable Approach to Rationing of Health Care Resources	300	(2)
Summary	302	(1)
Questions for Thought and Discussion	303	(3)
Compensatory Justice: Social Sources of Claims for Health Care	306	(21)
Objectives	306	(1)
The Story of the Maki Brothers	307	(3)
The Goal: A Caring Response	310	(1)
The Six-Step Process in Compensation Decisions	310	(10)
Step 1: Gather Relevant Information	310	(1)
Step 2: Identify the Type of Ethical Problem	311	(1)
Step 3: Use Ethics Theories or Approaches to Analyze the Problem	312	(2)
Step 4: Explore the Practical Alternatives	314	(3)
Step 5: Complete the Action	317	(1)
Step 6: Evaluate the Process and Outcome	317	(3)
The Patient's Responsibility for Health Maintenance	320	(1)
The Story of Jane Tyler and Sam Puryo	321	(3)
Summary	324	(1)
Questions for Thought and Discussion	324	(3)
Good Citizenship and Your Professional Role: Life as Opportunity	327	(14)
Objectives	327	(1)
The Story of Michael Merrick and ExRad Corporation	328	(2)
The Goal: A Caring Response	330	(1)
The Six-Step Process in Public Life	330	(8)
Steps 1 and 2: Gather Relevant Information and Identify the Type of Ethical Problem	331	(1)
Step 3: Use Ethics Theories or Approaches to Analyze the Problem	332	(3)
Step 4: Explore the Practical Alternatives	335	(1)
Steps 5 and 6: Complete the Action and Evaluate the Process and Outcome	336	(2)
Summary	338	(1)
Questions for Thought and Discussion	338	(3)
Index	341