Chapter 2

Ethical, Legal, and

Economic
Foundations of the
Educational Process
 Differentiated View of Ethics,
Morality, and Law

1. Deontological (Golden Rule)

2. Teleological (greatest good for the greatest
number)
 Evolution of Ethical/Legal
Principles in Health Care

Charitable Immunity
Cardozo Decision of 1914

Informed Consent
Right to Self-Determination
 Cardozo Decision

Informed Consent: the right to full disclosure; the

right to make one's own decisions

Right to self-determination; the right to protect

one's own body and to determine how it shall be
treated
Joyce

Application of Ethical and

Legal Principles
1. AUTONOMY
2. VERACITY
3. CONFIDENTIALITY
4. NONMALFEASANCE
NEGLIGANCE
MALPRACTICE
DUTY
5. BENEFICENCE
6. JUSTICE
 Definition of Ethical Principles
1. Autonomy: the right of a client to self
determination
2. Veracity: truth telling; the honesty by a
professional in providing full disclosure
to a client of the risks and benefits of
Elaborate on what you want to discuss.
any invasive medical procedure
 Definition of Ethical Principles

3. Confidentiality: a binding social

contract or covenant to protect another's
privacy; a professional obligation to
respect privileged information between
health professional and client.
 Definition of Ethical Principles

4. Nonmalfeasance: the principle of doing no harm

A. Negligence: the doing or nondoing of an act, pursuant

to a duty, that a reasonable person to a duty, that a
reasonable person in the same circumstances would or
would not do, with these actions or nonactions leading to
injury of another person or his/her property.
 Definition of Ethical Principles (cont'd)
B. Malpractice: refers to limited class of negligent
activities that fall within the scope of performance by
those pursuing a particular profession involving highly
skilled and technical services.

C. Duty: a standard of behavior; a behavioral expectation

relevant to one's personal or professional status in life.
 Definition of Ethical Principles
5. Benificence: The principle of doing good; acting is the
best interest pf a client through adherence to professional
performance standards and procedural protocols.

6. Justice: Equal distribution of goods, services, benefits,

and burdens regardless of client diagnosis, culture,
national origin, religious orientation, sexual preference
and the like.
 The Ethics of Education in Classroom and
Practice Settings

The Student-Teacher Relationship

Many of the foundational principles and concepts of ethics that apply to patient
care also apply to questions of what ought to be done or how health professionals
ought to behave in the education of students for the health professions. Students
and teachers have their own perspectives, visions, values, and preferences that
are unknown to each other.

The Patient-Provider Relationship

Nurses as well as other healthcare providers and the patients they care
for also have their own worldwives that come together in the practice
setting. These Perspectives must be negotiated and understood by each
party for the process of patient education to occur with a sense of trust.
Legality of Patient Education and
Information
Patients of Bill of Rights
Joint Commission on Accreditation of
Healthcare Organizations
State Regulations
Federal Regulations
Documentation of Patient Education....
''...probably the most undocumented skilled
service....'' (Casey, 1995)
Documentation is required by:
JCAHO
Third-Party Reimbursement: insurance
companies, Medicare and Medicaid programs, or
''payment pay''
Respondent Superior: The employer may be held
liable for the negligence or other unlawful acts of
the employee during the performance of his or her
job-related responsibilities.
Economic Factors of Patient Education:
Justice and Duty Revisited

Challenge for health care providers:

efficient & cost-effective patient
education
Legal responsibility of all nurses
little preparation on pre licensure level
Deither

Financial Terminology

Direct Costs
-Fixed Costs
Add a main point Add a main point

-Variable Costs
Indirect Costs
Cost Savings, Benefit, and Recovery
 Financial Terminology

Direct Costs: those that are tangible and predictable,

such as rent, food, heating, etc.
Fixed Costs: those that are stable and ongoing such
as salaries, mortgage, utilities, durable, equipment,
etc.
Variable Costs: those related to fluctuation in
volume, program attendance, occupancy rate, etc.
 Financial Terminology (cont'd)

Indirect Costs: those that may be fixed but necessarily

directly related to a particular activity, such as as
expenses of heating, lighting, housekeeping,
maintenance, etc.
 Financial Terminology (cont'd)
4. Cost Savings: money realized through decreased use of costly
services, shortened length of stay, or fewer complications
resulting from preventive services or patient education.

5. Cost Benefit: occurs when the institution realizes an

economic gain resulting from the educational program, such as
a drop in readmission rates.

6. Cost Recovery: occurs when revenues generated are equal to

or greater than expenditures.
Program Planning and Implementation

1. Revenue Generation
2. Relationships of Costs and Outcomes
a.) Cost-Effectiveness Analysis
b.) Cost-Benefit Analysis
 Program Planning and
Implementation (cont'd)
Revenue Generation: profit realized when fees for an educational
program exceed the aggregate costs of program preparation and
delivery.
Cost- Effectiveness Analysis: refers to determining the economic
value of an educational offering by making a comparison
between two or more programs, based on reliable measures of
positive changes in the behaviors of participants as well as
evidence of maintenance of these behaviors, when a real
monetary value cannot be assigned to the achievement of
program outcomes.
 Program Planning and
Implementation (cont'd)

Cost-Benefit Analysis: the relationship between actual program

costs and actual program benefits, as measured in monetary

terms, to determine if revenue generation was realized.

Deither

State of the Evidence

1. Legal and Ethical Issues

2. Documentation of Practice
3. New Technologies
4. Health Related Outcomes
5. Economic Implications
Thank you!

Reporters:
Arroyo, Jan Diether
Alvarado, Joyce Clea
Baeta, Ann Kathlyn

Reference:
https://slideplayer.com/slide/8785977/