Case Studies in Allied Health Ethics

Georgetown University, Washington, D.C. Case studies exploring ethical decision making, for allied health professionals. Presents and discusses actual cases and scenarios requiring ethical consideration in nine major allied health fields. Topics include euthanasia, reproductive rights, privacy issues, genetics, and more.

Preface

xi

Introduction: Four Questions of Ethics

xvii

What Makes Right Acts Right?

xviii

Distinguish Between Evaluative Statements and Statements Presenting Nonevaluative Facts

xviii

Distinguish Between Moral and Nonmoral Evaluations

xix

Determine Who Ought to Decide

xxi

What Kinds of Acts Are Right?

xxiii

How Do Rules Apply To Specific Situations?

xxvii

What Ought To Be Done in Specific Cases?

xxviii

PART I: ETHICS AND VALUES IN ALLIED HEALTH

1

(26)

Values in Health and Illness

3

(8)

Recognizing Evaluative Judgments

3

(3)

Distinguishing Moral From Nonmoral Evaluations

6

(5)

What Is the Source of Moral Judgments?

11

(16)

Grounding Ethics in The Professional Code

12

(3)

Grounding Ethics in The Physician's Orders

15

(3)

Grounding Ethics in Hospital Policy

18

(2)

Grounding Ethics in The Patient's Values

20

(2)

Grounding Ethics in Religious or Philosophical Perspectives

22

(5)

PART II: ETHICAL PRINCIPLES IN ALLIED HEALTH

27

(112)

Benefiting the Client and Others

29

(20)

The Duty To Do Good And Avoid Harm

29

(1)

Benefiting The Patient

30

(8)

Health in Conflict with Other Goods

30

(3)

Relating Benefits and Harms

33

(3)

Benefits of Rules and Benefits in Specific Cases

36

(2)

Benefiting Society And Those Who Are Not Patients

38

(11)

Benefits to Society

39

(2)

Benefits to Specific Nonpatients

41

(2)

Benefit to the Profession

43

(1)

Benefit to the Allied Health Professional and His or Her Family

44

(5)

Justice

49

(16)

The Allocation of Health Resources

49

(1)

Justice Among Clients

50

(3)

Justice Between Clients and Others

53

(4)

Justice and Life-Style Health Risks

57

(2)

Justice in Public Policy

59

(2)

Justice and Other Ethical Principles

61

(4)

Autonomy

65

(18)

Determining Whether A Patient is Autonomous

68

(4)

Autonomy in Adolescents

69

(1)

Autonomy and the Mentally Impaired Adult

70

(2)

External Constraints on Autonomy

72

(3)

Overriding the Choices of Autonomous Persons

75

(3)

Provider Autonomy

78

(5)

Veracity

83

(18)

Dealing Honestly with Clients

83

(2)

The Condition of Doubut

85

(2)

Lying in Order to Benefit

87

(8)

Protecting the Patient by Lying

88

(2)

Protecting the Welfare of Others

90

(5)

Special Cases of Truth-Telling

95

(3)

Patients Who Don't Want to be Told

95

(1)

Family Members Who Insist the Patient Not be Told

96

(2)

The Right of Access to Medical Records

98

(3)

Fidelity

101

(18)

Promise-Keeping and Confidentiality

101

(1)

The Ethics of Promises: Explicit and Implicit

102

(4)

The Limits on the Promise of Confidentiality

106

(9)

Breaking Confidence to Benefit the Patient

106

(5)

Breaking Confidence to Benefit Others

111

(4)

Incompetent and Dishonest Colleagues

115

(4)

Avoidance of Killing

119

(20)

Active Killing Versus Letting Die

121

(5)

Withholding Versus Withdrawing Treatment

126

(2)

Direct Versus Indirect Killing

128

(4)

Justifiable Omissions

132

(2)

Voluntary and Involuntary Killing

134

(5)

PART III: SPECIAL PROBLEM AREAS

139

(104)

Abortion, Sterilization, and Contraception

141

(18)

Abortion

141

(11)

Abortion for Genetic Reasons

143

(2)

Abortion Following Maternal Trauma

145

(2)

Abortion Following a Rape

147

(3)

Abortion for Socioeconomic Reasons

150

(2)

Sterilization

152

(2)

Contraception

154

(5)

Genetics, Birth, and the Biological Revolution

159

(16)

Genetic Counseling

160

(6)

Genetic Screening

166

(2)

In Vitro Fertilization, Sperm Donation, and Aid

168

(7)

Mental Health and Behavior Control

175

(20)

The Concept of Mental Health

176

(3)

Mental Illness and Autonomous Behavior

179

(5)

Mental Illness and Third-Party Interests

184

(5)

Other Behavior-Controlling Therapies

189

(6)

Experimentation on Human Subjects

195

(18)

Calculating Risks and Benefits

198

(3)

Privacy and Confidentiality

201

(4)

Equity in Research

205

(3)

Informed Consent in Research

208

(5)

Consent and the Right to Refuse Treatment

213

(14)

The Elements of a Consent

214

(6)

The Standards for Consent

220

(3)

Comprehension and Voluntariness

223

(4)

Death and Dying

227

(16)

The Definition of Death

228

(4)

Formerly Competent Patients

232

(4)

Never Competent Patients

236

(4)

Limits Based on Interests of Others

240

(3)

INDIVIDUAL CONTRIBUTERS TO CASE STUDIES

243

(4)

APPENDIX: ALLIED HEALTH CODES OF ETHICS

247

(30)

American Dietetics Association

247

(10)

American Health Information Management Association

257

(1)

American Society for Medical Technology

258

(1)

American Occupational Therapy Association

259

(3)

American Academy of Physician Assistants

262

(2)

American Physical Therapy Association

264

(6)

American Society of Radiologic Technologists

270

(2)

American Association for Respiratory Care

272

(1)

American Speech-Language-Hearing Association

273

(4)

Glossary of Terms

277

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Case Studies in Allied Health Ethics

Summary

Table of Contents

Supplemental Materials