Health Care Ethics

(Bioethics)

Module #10 Student Activity Sheet

Anthony Badili
Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Lesson Title: Role Fidelity Materials:

Learning Targets: Pen, paper, index card, book, and class List
At the end of the module, students will be able to:
1. List rationale for a profession’s creating a code of ethics;
2. Define disparagement, and state why it is a problem that is References:
to be avoided in health care practice; and,
3. State an ethically based rationale for discouraging conflict of Ethics of Health Care: A Guide for Clinical
interest in our practice; Practice Fourth Edition, Raymond S. Edge, J.
4. Explain an ethically based rationale for forbidding sexual Randall Groves
relations between patients and health care providers.

A. LESSON PREVIEW/REVIEW

Brain Teaser: Students will be asked to answer the following questions.

Options:
A. Beverage Model
B. Bismarck Model
C. National Health Insurance

1. This health care model is of nonprofit motive, no need to advertise, no expensive underwriting.
Answer: _________________

2. Payer is government-run insurance program all citizens pay into.

Answer: _________________

3. Private not-for-profit health insurance (“sickness funds”) financed jointly by employees and employers through
payroll deductions
Answer: _________________

4. Health care financed by government and taxed based rather than insurance based
Answer: _________________

5. This health care model is used in Taiwan, Canada and Australia.

Answer: _________________

B. MAIN LESSON

Conflicts of Interest

Joint venturing
 Group of individuals join performing a business venture
 Any commercial relationship between practitioner and a company, in which practitioner has material interest that
could form basis for a conflict of interest, spelled out in a disclosure statement

Self-referral
 To self-refer to an establishment in which you do not provide service but have an economic interest is at least
suspect and perhaps unethical

THIS DOCUMENT IS THE PROPERTY OF PHINMA EDUCATION 1

 Health Care Ethics
(Bioethics)

Module #10 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Sexual Misconduct in Health Care Practice

Sexual Relations
 Between practitioners and patients unethical
 Relationship between practitioner and patient always unequal
 Create emotional factors that interfere with therapeutic relationship and objective judgment
When practitioner feels potential for misunderstanding or mutual feelings of romantic interest, it is time to end
professional relationship

Scope of Practice

Role Fidelity
 Requires we remain within scope of clear legitimate practice
 One does not cross line without willful intention

Nurse-patient Relationship Models

 Bureaucratic model: emphasis on maintenance of social order at expense of individual patient’s welfare
 Physician advocate model: goal is to enhance authority of physician

Impaired Colleagues
 Impaired colleagues place clients at risk
 Behavioral difficulties: absenteeism, illogical decision making, excessive errors
 Question is not whether practitioner has a duty to intervene, but the manner of the intervention
 Health care provider must be confronted
 Made to seek effective assistance
 Treat impaired colleague humanely

Codes of Ethics and Professional Conduct

Codes of conduct and ethics include:

 Appropriate scope of practice
 Conflicts of interests
 Serving best interest of patients
 Obligations to promote patient autonomy and privacy
 Obligations beyond patients to others in society
 Ethics of research
 Informing on unethical or illegal behavior

Common Problems with Professional Codes

 Vagueness as to duties and prohibitions and self-regulation and peer enforcement
 Incompleteness as to duties
 Excessive concern with promotion and prestige of profession and financial and business interests

Gatekeeping
 One looks out for the interests of the profession or of others in a similar practice
 Result of professional obligations and training
 Strong sense of collegiality with others in practice
 Disparaging: talking ill of

THIS DOCUMENT IS THE PROPERTY OF PHINMA EDUCATION 2

 Health Care Ethics
(Bioethics)

Module #10 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Gaming the System

 Practitioner attempting to get around the system
 Willing to lie in the process
 Often done on behalf of patient or at patient’s request
 Health care practitioners’ responsibility to be truthful, keep promises, be fair
 Lying undermines a person’s credibility
 If individual clinician found to be lying, can have harmful effect on entire health care profession
 Gaming can harm other patients

CHECK FOR UNDERSTANDING

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed.

1. The physician assistant who certifies that an elderly patient with bunions needs a handicapped parking sticker, when in
fact the severity of the problem does not meet the standard for authorizing the sticker. What moral problem is involved in
this situation?
A. Disparagement
B. Gaming the system
C. Gatekeeping
D. None of the above
B
Answer: ________
In this kind of situation, it involves a gaming system.
Rationale:________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

2. The common problems associated with professional codes are as follows EXCEPT?
A. Incompleteness as to duties
B. Vagueness as to duties and prohibitions
C. Excessive concern with prestige of profession
D. None of the above
D
Answer: ________
Rationale:________________________________________________________________________________________
All of the options above are common problems associated with professional codes.
_________________________________________________________________________________________________
_________________________________________________________________________________________________

3. One looks out for the interest of the profession or of others in a similar practice is known as?
A. Disparagement
B. Gaming the system
C. Gatekeeping
D. Code of conduct
Answer: ________
C
Gatekeeping is one looks out for the interest of the profession or of others in a similar practice
Rationale:________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

4. Code of conducts and ethics include the following EXCEPT?

A. Serving best interest of patients
B. Ethics of research
C. Incompleteness to duties
D. Appropriate scope of practice

THIS DOCUMENT IS THE PROPERTY OF PHINMA EDUCATION 3

 Health Care Ethics
(Bioethics)

Module #10 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

C
Answer: ________
Rationale:________________________________________________________________________________________
Options A, B, and D are codes of conducts and ethics except Incompleteness to duties
_________________________________________________________________________________________________
_________________________________________________________________________________________________

5. What are the ways of a healthcare professional to avoid disparagement?

A. Offer professional courtesy to others
B. Avoid sexual and conflict of interest
C. Look after the welfare of the profession
D. All of the above
D
Answer: ________
Rationale:________________________________________________________________________________________
All of the options are the ways of a healthcare professional to avoid disparagement
_________________________________________________________________________________________________
_________________________________________________________________________________________________

6. Which of the following statements about sexual misconduct is INCORRECT?

A. Between practitioners and patients unethical
B. Relationship between practitioner and patient always equal
C. When practitioner feels potential for misunderstanding or mutual feelings of romantic interest, it is time to end
professional relationship
D. None of the above
B
Answer: ________
Relationship between practitioner and patient always equal is incorrect about sexual misconduct
Rationale:________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

7. Sheryl is a respiratory therapy technician in a small town in Michigan. The town has a small hospital and a small
durable medical supply company. She is known locally as an entrepreneur ball of fire and has managed to become both
the head of the hospital respiratory care department and the owner of the small durable medical supply company. What
code of ethics and professional conduct best describe the scenario?
A. Role fidelity
B. Conflict of interest
C. Moral duty
D. Duty to treat
B
Answer: ________
Rationale:________________________________________________________________________________________
Any commercial relationship between practitioner and a company, in which practitioner has material interest
_________________________________________________________________________________________________
that could form basis for a conflict of interest
_________________________________________________________________________________________________

8. What universal principle requires remaining within the scope of legitimate practice. Scope of practice is clear, and one
does not cross the line without willful intention?
A. Justice
B. Autonomy
C. Role Fidelity
D. Veracity
C
Answer: ________
Rationale:________________________________________________________________________________________
Role Fidelity requires we remain within scope of clear legitimate practice. One does not cross line without
_________________________________________________________________________________________________
willful intention
_________________________________________________________________________________________________

9. The nature substance abuse is such that even fine practitioners begin to experience behavioral difficulties such as

THIS DOCUMENT IS THE PROPERTY OF PHINMA EDUCATION 4

 Health Care Ethics
(Bioethics)

Module #10 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

EXCEPT.
A. Behaves naturally
B. Absenteeism
C. Illogical decision making
D. Excessive error
Answer: ________
A
Rationale:________________________________________________________________________________________
The nature substance abuse is such that even fine practitioners begin to experience behavioral difficulties
_________________________________________________________________________________________________
such as Absenteeism, Illogical decision making, and Excessive error
_________________________________________________________________________________________________

10. An example of conflict of interest where a group of individuals join together to perform a business venture.
A. Self-referral
B. Business partners
C. Joint venturing
D. Stark law
C
Answer: ________
Rationale:________________________________________________________________________________________
Joint venturing is a group of individuals join performing a business venture
_________________________________________________________________________________________________
_________________________________________________________________________________________________

C. LESSON WRAP-UP

AL Activity: Minute Paper

1) What was the most useful or the most meaningful thing you have learned this session?
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

2) What question(s) do you have as we end this session?

_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

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