Ethical, Legal, and Economic Foundations of the Educational Process

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ethics guiding principles
ethical norms accepted by a society
1. Deontology
2 types of ethics
2. Teleology
•based on the "golden rule"
Deontology
•Kant believed each person should be treated for his or her indi-
vidual good and not for the good of others
•based on the "greatest good (Mill)
Teleology
•sacrifice of individuals is acceptable if the larger population ben-
efits
•Moral conflict in which two or more ethical principles apply, but
each one supports a different course of action. This puts the
Ethical Dilemma
person in charge of making a decision in a conflicted state as they
decide which principle to choose.
1. did not inform or ask her or her parents for permission (deon-
tology)
Henrietta Lacks case was an ethical dilemma, why?
2. She had a right to know that she was going to be reimbursed
for the work being done
•This system of belief is what a person believes to be right or
Morality - Internal Belief System
wrong and is expressed through external behavior.
Legal Principles: Hospitals, doctors, and nurses were viewed
as performing a "___________ _________" (who acted in good good samaritan
faith) type service and largely exempt from legal recourse.
•Current views of medical practitioners is different due to stories
Legal Principles
of abuse/mistreatment that have been revealed.
Legal trumps _________ because you can be held responsible
ethics
for it
- 1914
- Cardozo determined that every adult of sound mind has a right
Legal Principle Example: Justice Benjamin Cardozo
to protect his or her own body and to determine how it shall be
treated
1. autonomy
2. veracity
3. confidentiality
Ethics in Patient Education
4. justice
5. nonmaleficence
6. beneficence
autonomy •Refers to the right of self determination
veracity •Truth telling
justice •fairness
confidentiality •Personal info that is protected
nonmaleficence •Do no harm
beneficence •Doing good for the benefit for others
- student-teacher
ethics in the classroom and practice
- patient-provider
ethics in the classroom and practice: risk of harm to the student
student-teacher
or to the _____________-_____________ relationsgip
ethics in the classroom and practice: presence of _____________
coercion or exploitation
or ______________

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 Ethical, Legal, and Economic Foundations of the Educational Process
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ethics in the classroom and practice: potential benefit to the 1. student
_____________ or to the ___________-_________ relationship 2. student-teacher
ethics in the classroom and practice: balance of students 1. interests
____________ and teachers ________________ 2. interests
ethics in the classroom and practice: presence of
professional
___________________ ideals
ethics in the classroom and practice: Coercion patient have rights to refuse treatment
ethics in the classroom and practice: a balance of power exist
1. expert
between the teacher (____________)
2. novice
and the student (______________)
ethics in the classroom and practice: can assist the teacher in
being fully ______________ with her or him self regarding the 1. honest
appropriateness of _________________ the student and can 2. counseling
serve as an extremely useful guide in uncertain situations
ethics in the classroom and practice: students are
autonomous
____________________ agents
•Master-servant rule
•Let the master answer
•Provides that the employer may be held liable for negligence,
Documentation: Respondeat Superior
assault and battery, false imprisonment, slander, libel, or any other
tort committed by an employee
•OTA, as an OT we are responsible for everything they do
•If it isn't documented, it didn't occur!
•Documentation can be the deciding factor in legal actions
Documentation: Laxity in Documentation
•All records can be subpoenaed
•Electronic and hard copies carry equal legal weight
Documentation: a legal doctrine, most commonly used in
__________, that hold a _______________ or ______________ 1. court
legally responsible for the wrongful acts of an _____________ or 2. employer or principle
__________ , if such acts occur within the scope of the employ- 3. employee or agent
ment or agency
Direct Costs •Predictable expenses tied to providing service/education
•Labor
examples of direct cost •Time
•Equipment
•those expenses that are predictable, remain the same over time,
Equipment: Fixed Cost
and can be controlled (salaries)
•in the case of healthcare organizations, depend on volume
Equipment: Variable Cost
(meals prepared)
Time as a ____________ cost is a major factor included in a 1. direct
___________-___________ analysis 2. cost-benefit
Indirect Cost •Expenses not directly related to delivery of services
•Overhead expenses (utilities, mortgage, maintenance)
examples of indirect cost
•These expenses occur whether services are delivered or not
•Indirect cost that cannot be anticipated, but only recognized after
the fact.
HIdden Cost
Examples include low productivity, staff turnover, and unpaid ser-
vices.
•Realized through shortened patient stays, education that pre-
cost savings
vents disease and/or readmission
patients who have fewer complaints and use less expensive ser-
vices yield a cost savings for the institution. If an ambulatory set-

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 Ethical, Legal, and Economic Foundations of the Educational Process
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examples of cost savings
Cost Benefit
cost benefit examples
cost recovery
cost recovery examples
revenue generation
Program Planning and Implementation
Program Planning and Implementation: Considerations
cost-benefit analysis
cost-benefit ratio
cost-effectiveness analysis
State of the Evidence
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ting, cost saving may occur when patient education keeps people
healthy and independent for a longer time, thereby preventing high
use of expensive diagnostic testing or inpatient services
•Occurs when patients are pleased with services, leading to in-
creased use of facilities
includes educational programs such as child birth classes, weight
and stress reductions sessions, and cardiac fitness and rehab
program. Patient satisfaction is CRITICAL
•Occurs when services are paid for, either by patient or third party
offering health education programs for a fee. Reimbursement
(medicare and medicade) may be made for programs and ser-
vices if they are deemed reasonable, appropriate, and necessary
to treat a persons illness or injury. Key to success in obtaining third
party reimbursement is the ability to demonstrate that, because
of education, patients can manage self-care at home and conse-
quently experience fewer hospitalizations
•Occurs when payments collected exceed costs to provide ser-
vices. A large portion of this is attributed to the reputation of a
facility.
Educational programs may be planned to generate revenue -
either through participant charges OR through cost savings to the
institution
Locations costs, publicity, materials, staff time and salaries
•Measures relationship between costs and outcomes achieved.
Outcomes can be the actual amount of revenue generated re-
sulting from an educational offering, or they can be expressed
in terms of shorter patient stays or reduced hospitalizations for
specific diagnostic groups of patients.
•Cost of service per patient/ total savings per patient
•Measures impact of an educational program on patient behavior
If program objectives are achieved, as evidenced by positive and
sustained changes in the behavior of the participants over time,
the program is said to be cost-effective (L. B. Russell, 2015).
Although behavioral changes are highly desirable, in many in-
stances, they are less observable, less tangible, and not easily
measurable. For example, reduction in patient anxiety cannot be
converted into a gain in real dollars. Consequently, it is wise
to analyze the outcome of teaching interventions by comparing
behavioral outcomes between two or more programs to identify
the one that is most effective and efficient when actual costs
cannot be determined.
•Evidence indicate that theory-driven, ethical care is the goal in
the current healthcare setting.
•Providing individualized care, in a multicultural society, is neces-
sary. Practitioners also need to keep the effect of their actions on
the larger community.
•Research needs to be done to assess undocumented patient
education.