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A Casebook in Interprofessional Ethics: A Succinct Introduction to Ethics for the Health Professions PDF

101 Pages·2016·1.097 MB·English
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SPRINGER BRIEFS IN ETHICS Jeff rey P. Spike Rebecca Lunstroth A Casebook in Interprofessional Ethics A Succinct Introduction to Ethics for the Health Professions 123 SpringerBriefs in Ethics More information about this series at http://www.springer.com/series/10184 Jeffrey P. Spike Rebecca Lunstroth (cid:129) A Casebook in Interprofessional Ethics A Succinct Introduction to Ethics for the Health Professions 123 Jeffrey P. Spike Rebecca Lunstroth McGovern Center McGovern Center TheUniversity of TexasHealth Science TheUniversity of TexasHealth Science Centerat Houston, UTHealth Centerat Houston, UTHealth Houston, TX Houston, TX USA USA ISSN 2211-8101 ISSN 2211-811X (electronic) SpringerBriefs inEthics ISBN978-3-319-23768-8 ISBN978-3-319-23769-5 (eBook) DOI 10.1007/978-3-319-23769-5 LibraryofCongressControlNumber:2015959909 ©TheAuthor(s)2016 Thisworkissubjecttocopyright.AllrightsarereservedbythePublisher,whetherthewholeorpart of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission orinformationstorageandretrieval,electronicadaptation,computersoftware,orbysimilarordissimilar methodologynowknownorhereafterdeveloped. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publicationdoesnotimply,evenintheabsenceofaspecificstatement,thatsuchnamesareexemptfrom therelevantprotectivelawsandregulationsandthereforefreeforgeneraluse. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authorsortheeditorsgiveawarranty,expressorimplied,withrespecttothematerialcontainedhereinor foranyerrorsoromissionsthatmayhavebeenmade. Printedonacid-freepaper ThisSpringerimprintispublishedbySpringerNature TheregisteredcompanyisSpringerInternationalPublishingAGSwitzerland To my wife Elizabeth Spike, and to the lights of my life: Alexander Hume, Perry Spinoza, and Sophia Russell Spike, my three teenage children who are rapidly becoming unique and wonderful individuals. Acknowledgments It is important to acknowledge that this book is the result of a group project. In 2009, the President of The University of Texas Health Science Center-Houston gave financial support to faculty from all six professional schools to develop and enhance the ethics curriculum, the Campus-wide Ethics Program (or CWEP). The first three years were spent identifyingcore ethics topicsessential tobe introduced toallstudents,regardlessofprofessionalschool.TheresultwasabookentitledThe Brewsters,whichisrequiredreadingforfirst-yearstudentsineverydegreeprogram at all six of our schools: Medicine, Nursing, Public Health, Dentistry, Biomedical Sciences,andInformatics.(IfyouwanttoknowmoreaboutTheBrewsters,youcan gototheWebsiteMeetTheBrewsters.com.)AfterthattheCWEPturnedtoworking on the newest challenge in ethics, interprofessional ethics. The cases in this book represent the work of the CWEP from 2012 to 2014. I must particularly acknowledge the work of my colleagues in the McGovern Center for Humanities and Ethics at UT-Houston. First, our administrative assis- tants, Angela Polczynski, who helped arrange rooms, keep records, and maintain thegroup’spaceovertheyearsofmonthlymeetings,andAlmaRosaswhohelped keeptrack ofmany revisions ofthemanuscript,andsecond, Rebecca Lunstroth, J. D., the Assistant Director of the McGovern Center, and the co-director of the medical school and the school of biomedical science’s ethics and professionalism courses. Rebecca took on the task of final editing of the cases in Chap. 6 of the book, making improvements to all of them. I also must acknowledge the support and encouragement of this project by the Director of the McGovern Center, Tom Cole. One member of the Campus-wide faculty, Stephen Linder from the School of PublicHealth,providedsomeconceptualorganizationtothegroupprocessthatwas especiallyhelpfultothegroup.Hiscontributionsledtohiswritingthefirstdraftof chapter two, “Framing Interprofessional Ethics Cases.” He deserves special acknowledgment as a co-author of that chapter. vii viii Acknowledgments I also thank The Hastings Center for hosting me during the process offinishing the first five chapters of the book, and to my wife Elizabeth Spike, my research assistant Jennifer Bulcock, and Laura Haupt at The Hastings Center who read and helped edit those five chapters. Contents 1 A Very Brief History of Health Care Ethics: Four Decades from the Golden Age of Bioethics to the Dawn of Interprofessional Ethics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Suggestions for Further Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 2 Framing Interprofessional Ethics Cases. . . . . . . . . . . . . . . . . . . . . 11 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Interprofessionalism. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Different Levels of Ethical Issues in the Cases . . . . . . . . . . . . . . . . . 14 A Framework to Help Formulate Ethical Judgments. . . . . . . . . . . . . . 14 Suggestions for Further Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 3 Using Ethical Theories as a Tool for Understanding Cases. . . . . . . 19 Introduction: What Ethics Is, What Ethics Isn’t, and When It All Began . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Ethical Theories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 The Two Modern Philosophical Theories of Ethics . . . . . . . . . . . . . . 22 Four Less Rigorous ‘Alternative’ Ethical Theories. . . . . . . . . . . . . . . 24 4 Using Principles as a Tool for Understanding Ethics Cases . . . . . . 31 The Original Four Principles. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Four Additional Mid-Level Principles for Professionalism (and Professional Integrity). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Four Principles for Public Health. . . . . . . . . . . . . . . . . . . . . . . . . . . 41 5 Instructional Materials for Students and Teachers. . . . . . . . . . . . . 45 Instructional Materials for Students: A Case Analysis Method to Write Short-Answer ‘Free-Response’ Questions (FRQs), Essays, and Papers with Valid Ethical Arguments and Sound Conclusions (Including a Grading Matrix for Teachers and Students) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 ix x Contents Instructional Materials for Ethics Facilitators: Can Ethics Be Taught?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 An Excursion in Socratic Pedagogy . . . . . . . . . . . . . . . . . . . . . 48 6 Cases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Outline of Cases by Professions Involved. . . . . . . . . . . . . . . . . . . . . 54 Case 1: The Limitations of Electronic Health Records (EHRs), Decision-Support, and Financial Conflicts of Interest. . . . . . . 55 Relevant Professions: Health Informatics, Medicine, Nursing. . . . 55 Case 2: Preserving Privacy and Confidentiality with Electronic Health Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Relevant Professions: Health Informatics, Medicine, Nursing, Clinical Psychology, Social Work . . . . . . . . . . . . . . . . . . . . . . 56 Case 3: Privacy in the Age of Patient-Driven Websites. . . . . . . . . . . . 57 Relevant Professions: Health Informatics, Medicine, Biomedical Sciences. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Case 4: Workplace Wellness Programs and Health Disparities. . . . . . . 58 Relevant Professions: Medicine, Nursing, Public Health . . . . . . . 58 Case 5: Conducting Human Subject Research Abroad: Whose Standards? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Relevant Professions: Biomedical Science, Translational Science, Medicine, Public Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Case 6: Authorship and Clinical Equipoise . . . . . . . . . . . . . . . . . . . . 60 Relevant Professions: Medicine and Biomedical Science. . . . . . . 60 Case 7: When Professional Identity Conflicts with Research . . . . . . . . 61 Relevant Professions: Medicine, Biomedical Sciences and Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Case 8: When Experimental Therapies Need to Be Tested . . . . . . . . . 62 Relevant Professions: Medicine, Biomedical Science . . . . . . . . . 62 Case 9: When Practice Guidelines Conflict with Professional Authority. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 Relevant Professions: Health Informatics, Medicine . . . . . . . . . . 63 Case 10: Whistleblowing in a Small Town . . . . . . . . . . . . . . . . . . . . 64 Relevant Professions: Nursing, Medicine, Dentistry, Dental Hygiene, Dental Assistant. . . . . . . . . . . . . . . . . . . . . . . 64 Case 11: Managing Patient’s Health Information from the Internet. . . . 66 Relevant Professions: Medicine, Nursing, Social Work, Dentistry. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 Case 12: Sandy’s Case. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Relevant Professions: Clinical Social Work, Nursing, Medicine, Health Informatics. . . . . . . . . . . . . . . . . . . . . . . . . . 67 Case 13: Disasters: Who Gets Priority? . . . . . . . . . . . . . . . . . . . . . . 68 Relevant Professions: Public Health, Medicine, Nursing . . . . . . . 68 Case 14: Planning During a Pandemic: Does Social Worth Count? . . . 69 Relevant Professions: Public Health, Medicine, Nursing . . . . . . . 69

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