Legal Aspects of Health Information and Health Care Statistics

Week 1

Robyn Korn, MBA, RHIA, CPHQ

General Information

Discussion BoardEnter first post by Saturday and a total of 3 posts

by Tuesday

AssignmentsMake sure your name is on the assignment

attachments when they are submitted

General Information

Late work will not be accepted unless there are clear and compelling extenuating circumstances.

If you have extenuating circumstances that prevent you from completing course assignments/exams you must contact your instructor immediately—prior to the assignment/exam/quiz due-date unless prevented from doing so by emergency circumstances.

Ethical Standards

Key Terms Ethics - the formal study of moral choices that conform to

standards of conduct

Morals - the principles or fundamental standards of right conduct that an individual internalizes.

Values - concepts that give meaning to an individual’s life and serve as the framework for decision making

Code of Ethics - written lists of a profession’s values and standards of conduct.

Ethical Standards

Eugenics - efforts to improve the human species through control of hereditary factors in mating.

Human Genome Project - designed to map the genes found in the human DNA and determine the sequences of the chemical base pairs that make up human DNA.

Etiquette – the principles of how human beings relate to one another under certain circumstances

Law – A body of rules of action or conduct prescribed by a controlling authority that has a binding legal force

Ethical Models

Ethics - based on philosophy

Morals - based on traditional religious beliefs and personal choices

Etiquette - based on society

Law - based on controlling authority

Values - based on society, religion and family

Ethical Concepts

Autonomy Ability to Decide

Power to Actualize or implement a decision

Respect for the Autonomy of others

Example: Informed Consent

Ethical Concepts

Beneficence Qualities of kindness, goodness and mercy

Obligation to do good in all circumstances

Example – Hippocratic Oath

Ethical Concepts

Nonmaleficence Prohibition against doing harm

Obligation to prevent evil or harm

Example – Hippocratic Oath

Ethical Concepts

Double-effect principle – recognizes that ethical choices may result in untoward outcomes.

Examples – nosocomial infections or adverse drug reactions

Ethical Concepts

Best Interest Standard Determining what is in the best interest of the patient

when they are unable to make the decision alone

Decision making is usually determined by patient competency

Evidence of patient’s wishes are used (living will, power of attorney, etc)

Ethical Concepts

Fidelity Faithfulness, loyalty and devotion to

obligations or duties

Example – Physician explaining a new diagnosis to a patient

Ethical Concepts

Justice To be fair to all people

Includes fairness, honesty, and impartiality

Comparative Justice – balancing competing interests against one another (no independent standard)

Distributive Justice – fair distribution of benefits (an independent standard)

Ethical Concepts

Criteria When Resources are Limited

1. Need – required not elective procedures

2. Equity – trying to provide to all who need

3. Contribution – future contributions to society

4. Ability to pay

5. Effort – willingness to comply with instructions

6. Merit – potential for benefit after initial investment

Ethical Concepts

Rights Just claim or entitlement

Derived from the concept of justice

Rights vary according to moral values of a given culture

Ethical Concepts

Patient Rights– Confidentiality – obligation of the provider to

maintain information in a confidential manner

– Privacy – right to be left alone or control personal

information

Ethical Concepts

Veracity Habitual truthfulness and honesty Special relationship between the patient and

health-care provider

Example – human research

Ethical Theories

Principles used to deal with ethical dilemmas

Utilitarianism – promote good over harm– Cost benefit analysis

Deontology – duty orientation (follow the letter of the law and not the spirit)– Human research

Ethical Decision Making

Code of Ethics – professions values and standards

Ethic Committees Patient Rights

– PDSA – advance directives – HIPAA – rights granted to patients– ARRA – rights regarding electronic PHI

Ethical Decision Making

1. Define the issue

2. Get the facts

3. Know who is involved

4. Evaluate options

5. Make decision and implement

6. Evaluate outcome

7. Process to prevent again

Ethical Challenges

Conflict of Interest– Potential and actual

Impaired colleagues

Disparagement– Criticize skills, knowledge or qualifications

Ethics In Supervision

Role model

Encourage ethical behavior

Monitor employee conduct

Health Information Challenges

Coding – Reimbursement

Information Security

Data Resource Management

Protection of Sensitive Information

Bioethic Issues

Ethical issues related to advancements in technology and science, especially biology

and medicine

Beginning of Life Issues

Family Planning– Contraception– Adoption/Infertility treatment

Abortion Perinatal ethics

– Testing, screening, surgery

Eugenics

Quality of Life

HIV/AIDS– Treatment/confidentiality

Organ Transplants– Travel medicine/xenografts

Genetic Science– GINA confidentiality of genetic information– Gene therapy/stem cell research

Death and Dying

Planning for end of life– Advance directives, living will, power of attorney

Euthanasia– Passive and active

Withdrawing/Withholding treatment

Access by the Researcher

Ethical Approach– Declaration of Helsinki– National Research Act– Belmont Report

Respect for persons Beneficence Justice

Access by the Researcher

Regulatory Approach– Institutional Review Board (IRB)

HIPAA – data collection and usage GINA – informed consents

Questions