Assignment in Ethics Health

Assignment in Ethics Health ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Assignment in Ethics Health I have assignment every week in ethics health and each assignment is answering quotations or case study. And i have the pages of the book that u could help u. This file have the objective and Quotations. Assignment in Ethics Health Thanks chapter_5.doc chapter_5.doc chapter_5.doc Chapter 5 Individual Student Learning Outcomes At the end of this unit, the student will be able to: 1. Write a defense for the principle of confidentiality within health care form a utilitarian, duty-oriented and virtue ethics point of view. 2. Explain the rationale for “the Harm principle” as it relates to the Tarasoff case. 3. List the two basic principles in conflict in the Tarasoff case. 4. Give five instances in which the practitioner would have legal requirement to report confidential matters that relate to health care. 5. Explain how vulnerability guides the decision-making process when confidentiality is overridden by the duty to warn. 6. List five groups not involved in direct patient care that have a legitimate interest in the medical record. 7. Explain why confidentiality is considered a principle with qualifications. 8. Identify the major purposes if the Health Insurance Portability and Accountability Act (HIPAA) of 1996. 9. List three patient rights in regard to control over patient information that has been provided for or strengthened by the HIPAA legislation. 10. List rights that patients receive from the Privacy Rule. 11. List two measures that are not required of health providers in regard to providing security got health care information. 12. List the basic ethical principles that are foundational to the conduct of research using human subjects. Introduction Patients have two major expectations when they visit a physician’s office of other medical facilities: quality of care and confidentiality. They have a right to expect both. However, with the advent of modern technology, including the Internet, e-mail, fax machines, and computers, the number of people who have access to patient information has increased rapidly. In order to address this concern for confidentiality, Congress mandated that the Health Insurance Portability and Accountability Act of 1996 (HIPAA) enforce its privacy provision by April 14, 2003. This law is somewhat complicated and expensive to implement, but it does mean that more careful attention is being paid to issues of patient privacy. 1 Confidentiality • • • • • • • Respecting a patient’s confidence is an ethical duty Confidentiality is the ethical principle that requires nondisclosure of private or secret information with which one is entrusted. Support for this principle is found in codes and oaths in nursing and medicine dating back many centuries. Assignment in Ethics Health The Hippocratic oath is very clear: o “Whatever, in connection with my professional practice, or not in connection with it, I see or hear, in the life of men, which ought to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. The requirement that we respect a patient’s privacy is a legal obligation. American common law provides sanctions against the unwarranted disclosure of a patient’s private affairs. The principle of confidentiality can be defended using any of the decision making formats: o Utilitarian defense ? The breach of confidence, except under very rare and controlled circumstances, has very low utility. ? This breach of confidence would have a chilling effect on the patient/practitioner relationship. o Duty defense ? Personal privacy is a basic right with foundations not only in long standing codes of professional practice, but also common law. o Virtue ethics defense ? The practice of patient confidentiality has been a mainstay if healthcare practice and forms one of the virtues expected of “good practitioners.” Confidentiality – A Principle with Qualifications • Consider the Classic Tarasoff /Prosenjit Poddar case: o To whom did the practitioners owe a duty, to their real patient, or to the potential victim? o Harm principle ? Was the court decision right? PLEASE POST YOUR RESPONSES ON THE DISCUSSION BOARD • Legal reporting requirements o Child abuse o Drug abuse o Communicable diseases o Injuries with guns and knives 2 o Blood transfusion reactions o Poison and industrial accidents o Misadministration of radioactive materials Groups that are not involved in direct patient care that have a legitimate interest in the medical record include those involved in: 1. 2. 3. 4. 5. 6. Education Data collection for research Administrative functions Authorized representatives of the patient Public health reporting Auditing functions Safeguards for Confidential Information 1. Patients should be given an opportunity at registration to restrict what information can be given out and to whom. 2. Providers should provide the patient with a clear written explanation of the conditions of use and disclosure of health information. 3. Consent is required before sharing information for treatment, payments, and health care operations. 4. Health care institutions should adopt clear policies regarding privacy procedures, including encryption where necessary. 5. The institution must provide training to all those involved. Confidentiality in Modern Health Care • • • • Modern health care creates a “right to know” and a legitimate interest” situation for many outside the direct patient care service. Modern health information data systems threatened to undermine the principle of confidentiality. Modern information technology creates multiple avenues for information acquisition, making security a real problem. Has modern health care made the principle of confidentiality a “decrepit concept? Confidentiality of Electronic Communications • • • Assignment in Ethics Health Any information transmitted over wire, cable, or like connection are subject to federal wiretap statues. These statutes prohibit intercepting and recording of information and preclude its use in legal proceedings. Health care information can be legally disclosed if there is valid authorization. o Authorization must be written, dated, and signed by the patient o Specify the type and nature if information to be disclosed o Identify the person to whom the health care information will be disclosed 3 Maintaining Patient Confidentiality with Technology Fax Machines • Make sure the intended receiver us there before sending confidential records by fax. • Shred confidential papers that are no longer needed. Do not place them in the trash. • Use a fax cover sheet that states “confidential material.” • Send patient information via fax only when absolutely necessary only fax the specific documentation requested, not the entire medical record. • The fax machine should be located in a restricted access area. Copy Machines • Never leave medical records unattended on a copy machine where others may read them. • Shred all discarded copies. E-Mail and the Computer • Avoid using e-mail to send confidential information. • Do not allow patients or other unauthorized staff members to view the computer screen with confidential patient information. HIPAA Legislation and Requirements • • • • • • • • Health Insurance Portability and Accountability Act Signed into law on August 21, 1996 All entities must be in compliance with the privacy, security, and electronic data provisions by April 14, 2003. Regulates the privacy of patient health information. This law was an effort to reduce costs of healthcare and streamline the fragmented and complicated U.S. healthcare system. Objectives of HIPAA o Improve the portability of health insurance o Combat fraud, abuse and waste un health care o Promote the expanded use of medical savings accounts o Simplify the administration of health insurance Five major categories are covered under HIPAA o Title I – Insurance portability o Title II – Administrative Simplification o Title III- Medical Savings and Tax Deduction o Title IV – Group Health Plan Provisions o Title V – Revenue Offset Provisions Refer to the Patient Bill of Rights (Unit 4) o The patient has the right to every consideration of privacy (#5) 4 • o The patient has the right to expect that all communications and records pertaining to his/her own care will be treated as confidential (#6) Highlights of legislation o Consumer control over health information o Rules for medical record release and use of medical records o Increased security of personal health information oAssignment in Ethics Health The use of electronic transmission of health information (for reasons of cost containment) and to provide additional safeguards to protect the security and confidentiality of the information Who is affected by HIPAA? o o o o o o o o o o Physicians Hospitals Skilled nursing facilities Comprehensive outpatient rehabilitation facilities Home health agencies Hospice programs Ambulance companies Clinical laboratories Pharmaceutical companies Medical device companies Ethical Considerations with Information Technology (Informatics) o Wireless local area networks (WLAN’s) o WLAN’s are used by physicians, nurses and other health care providers to access patient records from central databases while they are conducting patient rounds, adding observations and patient assessments to the databases, checking medications and completing a variety of functions. o The use of wireless networks presents ethical dilemmas. o HIPPA requires there must be safeguards in place to protect the privacy of electronic information. o Medical informatics o Is the application of communication and information to medical practice, research, and education? o Areas that may be linked together are the pharmacy, laboratory, administrative, medical records. o Telemedcine o The use of communication and information technologies to provide health care services to people at a distance is seen in the future of medicine. o Health care is provided to home bound and rural patients via fax, telephone, Internet and even television. 5 Penalties for Noncompliance with HIPAA • • • • • • The penalties for violating HIPAA range from civil penalties of up to $100 per person per incident for minor improper disclosures if health information and up to $25,000 for multiple violations of the same standard in a calendar year. Federal criminal liability for improper disclosure of information or for obtaining information under false pretenses carries sanctions or fines of $50,000 and one year in prison. The liability for obtaining health information under false pretenses with the intent to selling transfer or use the information for personal gain or for a malicious action (Medicare fraud) carries penalties of $250,000. The establishment of the Healthcare Integrity and Protection Data Bank (HIPDB). This is a national data bank that collects reports and disclosures if actions taken against health care practitioners for non compliance and fraudulent activities. The agency that investigates HIPPA violations is the Office of Civil Rights (OCR). Assignment in Ethics Health Patient Rights under HIPAA o Patients have the right to the following: • A copy of the privacy notice from the health care provider. • Access to their medical records, and the right to restrict access by others, request changes, and learn how their records have be accessed. • Ask the provider to limit the way in which health care information is shared and to keep disclosures to the minimum needed for treatment and business operations. • Ask for an accounting of to whom the health care information was given. • Ask to be contacted in a special way as by mail or at work. • Examine and copy the health information the provider has recorded. • Complain to the covered entity and the Department of Health and Human Services if the patient believes there is an invasion of his or her privacy. Misconceptions about HIPAA • • The Department of Health and Human Services (HHS) states that the law requires “reasonable safeguards” to be taken to protect patient privacy. The privacy law: o Does not prevent physicians and hospitals from sharing patient information with other physicians or hospitals in order to treat patients. o Does not prevent hospitals from disclosing names of patients to clergy it from keeping patient directories, It does not require that patients sign in to 6 be included in the directory of patients, only that they can opt out and not be included. o Allows hospitals or physicians to share information with the patient’s spouse, family members, friends, or anyone whom the patient has identified as involved in their care. o Does not apply to most police or fire departments. The hospital may release names and information about homicides, accident victims, and other incidents. However, HIPAA does limit the amount of information that emergency medical technicians (EMT’s) may disclose. Human Subject Research • Basic principles involved: o Protection of human rights, a prime focus of research ethics, is based on principles of beneficence, respect for human dignity, and justice. o These principles imply protection for physical, emotional, spiritual, economic, and social harm; voluntary participation in research; and assurance of privacy and equitable treatment of all research participants. • Patient benefit/risk calculations o Sound design minimizes risk o Risks are reasonable in relation to benefit o Subject selection equitable • Patient benefit/risk calculations o Informed consent o Appropriate monitoring o Privacy and confidentiality protections Human Subject’s Rights • As a human subject, you have the following rights.Assignment in Ethics Health These rights include, but are not limited to, the subject’s right to: o Be informed of the nature and purpose of the experiment; o Be given an explanation of the procedures to be followed in the medical experiment, and any drug or device to be utilized; o Be given a description of any attendant discomforts and risks reasonably to be expected; o Be given any explanation of any benefits to the subject reasonably to be expected; o Be given a disclosure of any appropriate alternatives, drugs, or devices that may be advantageous to the subject, their relative risks and benefits; o Be informed of the avenues of medical treatment, if any, available to the subject after the experiment if complications should arise; o Be given an opportunity to ask questions concerning the experiment or the procedures involved; o Be instructed that consent to participate in the medical experiment may be withdrawn at any time and the subject may discontinue participation without prejudice; o Be given a copy of the signed and dated consent form; and 7 o Be given the opportunity to decide to consent or not to consent to a medical experiment without the intervention of any element of force, fraud, deceit, duress, coercion, or undue influence in the subject’s decision. • (Source Pozgar, George, Legal and ethical issues, p.57-58) • Institutional Review Boards (IRB) • • • • Each organization conducting medical research must have a mechanism in place for approving and overseeing the use of investigational protocols. This board or committee is designated by the institution to provide initial approval and periodic monitoring for biomedical research studies. The IRB should include community representation. Primary responsibilities of an IRB include: o Protecting the rights and welfare of human subjects o Ensuring that protocols are presented by the sponsor(s) o Ensuring sponsor(s) of a protocol discloses o Reviewing, monitoring and approving clinical protocols for investigations of drugs and medical devices involving human subjects o Ensuring that the rights, including the privacy and confidentiality, of each individual are protected o Ensuring that all research is conducted within appropriate state and federal guidelines (e.g. FDA guidelines) • (Source: Pozgar, p.60) • Codes of Ethics to Protect Human Subjects o Nuremberg Code of 1947 • This code was adopted following numerous experiments conducted by the Nazis on prisoners in concentration camps. • Prisoners were exposed to cholera, diphtheria, malaria, mustard gas, yellow fever, typhus, and other horrendous experiments, ultimately claiming thousands of lives. •Assignment in Ethics Health This exploitation of unwilling prisoners as research subjects in Nazi concentration camps was condemned as a particularly flagrant injustice. • The code was developed as a set of principles for the ethical conduct of research against which the experiments in the concentration camps could be judged. o Helsinki Declaration of 1964 • Recommendations guiding medical doctors in biomedical research involving human subjects. • Guides clinical research. • Adopted by the 18th World Medical Assembly, Helsinki, Finland, 1974. • Revised by the 19th World Medical Assembly, Tokyo, Japan, 1975. 8 • Revised by the 35th World Medical Assembly, Venice, Italy, October 1975. • Revised by the 41st World Medical Assembly, Hong Kong, September 1989. • Revised by the 48th General Assembly, Somerset West Republic of South Africa, October 1996. o The Belmont Report of 1979 Unit 5 – Assignments Assignment 1 Review Exercise A Assignment 2 A. Why has patient confidentiality become more difficult in the present heath care environment? B. Should family members or even friends have access to a patient’s medical records? Why or why not? Assignment 3 Review Question C 9 Assignment 4 Review Question D Assignment 5 In the News – page 106 Assignment 6 Please read the New York Times article “HIPAA’S Use as Code of Silence Often Misinterprets the Law”, by Paula Span, July 17, 2015. Please include your comments to this article with the Unit 5 assignments. Assignment 7 Look under the official government website relating to HIPAA, www.hhs.gov/ocr/hipaa to find the answers to frequently asked questions about HIPPA. Describe 10 questions and answers that you believe all healthcare professionals should know. Assignment 9 Please read the Tarasoff Case (p. 99) and respond to the questiom of whether confidentiality is good – regardless of what reasoning you use – but whether it is a moral absolute, or might be overridden by other circumstances. 10 Chapter 5 Individual Student Learning Outcomes At the end of this unit, the student will be able to: 1. Write a defense for the principle of confidentiality within health care form a utilitarian, duty-oriented and virtue ethics point of view. 2. Explain the rationale for “the Harm principle” as it relates to the Tarasoff case. 3. List the two basic principles in conflict in the Tarasoff case. 4. Give five instances in which the practitioner would have legal requirement to report confidential matters that relate to health care.Assignment in Ethics Health 5. Explain how vulnerability guides the decision-making process when confidentiality is overridden by the duty to warn. 6. List five groups not involved in direct patient care that have a legitimate interest in the medical record. 7. Explain why confidentiality is considered a principle with qualifications. 8. Identify the major purposes if the Health Insurance Portability and Accountability Act (HIPAA) of 1996. 9. List three patient rights in regard to control over patient information that has been provided for or strengthened by the HIPAA legislation. 10. List rights that patients receive from the Privacy Rule. 11. List two measures that are not required of health providers in regard to providing security got health care information. 12. List the basic ethical principles that are foundational to the conduct of research using human subjects. Introduction Patients have two major expectations when they visit a physician’s office of other medical facilities: quality of care and confidentiality. They have a right to expect both. However, with the advent of modern technology, including the Internet, e-mail, fax machines, and computers, the number of people who have access to patient information has increased rapidly. In order to address this concern for confidentiality, Congress mandated that the Health Insurance Portability and Accountability Act of 1996 (HIPAA) enforce its … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10