LESSON 2:

MEDICAL ETHICS AND

TERMINOLOGIES
LEARNING OUTCOMES:
At the end of this lesson, you will be able to:
• Understand what is the Medical Assistants Code of Ethics;
• Know how important medical ethics is;
• Identify the legal and ethical issues in healthcare;
• Determine the considerations for Medical Administrative
Assistants;
• Recognize the different important terms in the medical setting.
The Medical
Assistant Code of
Ethics
 The American Association of Medical Assistants (AAMA) has established
the Medical Assisting Code of Ethics. Its members pledge to:

• Render service with full respect for the dignity of humanity;

• Respect confidential information obtained through employment unless
legally authorized or required by responsible performance of duty to
divulge such information.
• Uphold the honor and high principles of the profession and accept its
disciplines.
• Seek to continually improve the knowledge and skills of medical
assistants for the benefit of patients and professional colleagues.
• Participate in additional service activities aimed toward improving
the health and well-being of the community.
Why are
medical ethics
important?
 Medical ethics guide your decision-making an d your interactions and
conduct with patients. It is an important part of medical professionalism,
which is always expected. Violations of medical ethics can threaten your
job, your medical license, or even constitute a crime.

Ethics provide us a moral compass to use in situations that may not be

straightforward.
Basic Principles
in medical ethics
AUTONOMY

Patient autonomy refers to the patient’s right to make decisions for

themselves according to their own system of morals and beliefs.
 Patient education and informed consent are important elements of
proper autonomy.
 Confidentiality loosely fits under the umbrella of autonomy.
When is autonomy challenged?
• Incompetence – Patients is legally deemed unable to make rational
decisions for themselves. Often due to permanent conditions such as
dementia. Assigned a surrogate by the court.
• Incapacity – Patient is clinically determined to be unable to make a
rational decision for themselves. May be due to transient conditions such
as lack of consciousness, delirium, psychosis, etc.
• Threat to Self or Others – Usually in psychiatric settings.
PATERNALISM is the practice of making decisions for the patient
without seeking their input their input. It is not refusing unnecessary
“care” for the patient (e.g., opioids) even though requested.
BENEFICENCE
Beneficence is a value in which the provider takes actions or recommends
course that are in the patient’s best interest.
 It is not coercing or manipulating the patient into making a decision against
their values, even though it may objectively be the best decision for their
health.
 It is not euthanasia (in most states)
 Keep the individual patient in mind – beneficence is not the same in all
situations.
• When patient autonomy is compromised (e.g., incapacity), beneficence
must be the guiding ethic.
NONMALEFICENCE
Nonmaleficence is closely related to beneficence. It is abstaining from any
action that may bring harm to the patient. “Do no harm.”

• Beneficence is what you do, maleficence is what you don’t do.

• Nonmaleficence and beneficence can conflict: Patient or proxy input can
help
• The principle of double effect – Unintended medical consequences are
acceptable if the intended consequences are legitimate and the harm is
proportionately smaller than the benefit.
VERACITY
Veracity is honesty. The most important part of truth telling is
revealing all pertinent details of a patient’s medical condition(s) to them,
as well as the risk(s) and benefit(s) of a procedure, and their prognosis
(if known). It also includes informing a patient of any mistakes that have
been made in their care.
 
  t iCritical elements of ensuring informed consent
 It is not telling a patient information that they tell you they don’t want to
hear
 It is OK to first ask a patient if they want to hear their prognosis
 Is OK to delay telling a patient their diagnosis until they are ready to hear
it, although it should never be delayed if it may compromise the ability to
provide informed consent.

When is veracity challenged?

 When a patient may be reasonably expected to engage in self-harm with
the disclosure
 It is NEVER OK lie to or deceive a patient, for any reason!
DISTRIBUTIVE JUSTICE

 Distributive justice is the proper allocation of resources in a

manner that is fair and just.
 Triage is a common example of distributive justice.
PROPORTIONALITY
Proportionality is a principle that ensures a medical treatment or plan
is commensurate with the illness and with the goals of treatment.
 Ensuring the benefits outweigh the risks:
 Benefits are maximized (beneficence)
 Risks are minimized (nonmaleficence)
 Often plays a role when an ethic may be legitimately compromised
or when two or more ethics conflict.
Legal and
Ethical Issues in
Healthcare
Informed Consent
The ethical code of health care professionals’ states that patients have
the right to know the truth about their medical condition, and that they
can choose treatment options. Information must be sufficient and
understandable, to enable the patient to make informed decisions that are
in his best interest.
Example:

 A patient’s family asks the doctor not to tell their elderly mother
that her tumor is malignant.
 The doctor disagrees with the patient’s request to forgo treatment.
 A teenager requests medication for a painful condition, but his
parents refuse, based on religious beliefs.
 The patient asks the X-ray technician if her doctor is disclosing
everything he knows about her test results.
Professional Boundaries
Health care professionals must maintain appropriate boundaries.
Patients are vulnerable, and that vulnerability needs to be
acknowledged and respected at all times. Successful treatment
outcomes can give rise to deep feelings of gratitude that may possibly
mistake for physical attraction.
Example:

 A patient persists in telling sexist jokes, which offends nursing

home staff.
 A nursing home patient offers cash to a certified nursing assistant
who has money problems.
 A patient asks his oncology nurse to go on a date with him the day
he is discharged.
 A doctor treats her own family members when the family's primary
care doctor is out of town.
Data Privacy

Protecting patient privacy is essential, in accordance with the

Health Insurance Portability and Accountability Act. Health care
professionals must know and follow HIPPA laws, and cannot disclose
patient information.
Example:

 The medical secretary thinks she may have mistakenly mailed

Patient A’s medical records to Patient B.
 A plastic surgeon discloses names of his well-known clients at a
cocktail party.
 A medical coder accidentally put sensitive medical records in a
hallway trash bin, instead of in the shredder.
 Nurses discuss a patient in the hospital cafeteria, where
confidential information is overheard by visitors.
Access to Care
Access to care poses difficult ethical and legal dilemmas for
health care professionals, who sign an oath not to harm their patient.
Striking a balance between quality care and efficiency can be
challenging. Health care professionals struggle to help patients who
lack the resources to cover the treatment they need.
Example:

 An insurance company refuses to pay for a procedure or a drug

that a doctor strongly believes the patient needs.
 Due to staff shortages, a nurse is reassigned to another area, where
the nursing staff lacks sufficient skill or training.
 The doctor wants to see a child for a follow-up visit, but his
parents refuse, because of limited insurance coverage.
 A patient without insurance asks if she can have free samples of
the medicine she needs.
Examples of
Ethical Dilemmas in
Medical Assisting
Accountability
Medical assistants should demonstrate professional
accountability, which means acknowledging mistakes and
immediately taking steps to address them. Some medical conditions
can progress rapidly, which means that all health care workers are
responsible for reporting potential errors to their superiors so that
patient care can be adjusted.
Confidentiality
All health care workers have a responsibility to protect patient
confidentiality. The Health Insurance Portability and Accountability
Act (HIPAA) mandates this is a matter of federal law, but other
regulations, professional codes and office policies also govern how
patient information is handled. Medical assistants may find
themselves in situations where they must maintain confidentiality
even when it is difficult to do so.
Loyalty
It is natural for employees, including health care professionals, to
demonstrate loyalty to their employer. However, no one, particularly
in the health care field, can afford to be absolutely loyal to an
employer or superior who is behaving un ethically or is incompetent.
Considerations
for Medical
Administrative
Assistants
Communications
Confidentiality in communications is a priority. Federal and state
regulations make it clear that all health care employees have a
responsibility to protect patient privacy. Since medical office
assistants often spend a great deal of time communicating with
patients and their families, it is crucial that medical assistants learn
how to provide information clearly, appropriately and in a way that is
compliant with HIPAA and other pertinent regulations.
Hiring contractors
A medical office assistants may be responsible for hiring third-
party contractors such as cleaning services or tradespeople. Third
parties in a healthcare setting may need training in how to minimize
exposure to pathogens, or training in the need for confidentiality, if
they run into patients they know, or if they happen to inadvertently see
patient records. In many cases, office assistants may opt to work with
service providers that specialize in the health care industry to avoid
possible ethical breaches.
Working with Insurers
Medical Assistants may be responsible for working with insurers
to get claims, medications or procedures approved. Ethical issues can
arise when a conflict exists between the insurer and the opinion of a
medical professional. The medical assistant may be responsible for
advocating for the patient and the doctor, while also being truthful in
her dealings with the insurance company.
Important
Medical Terms
you need to know
• Benign: Not cancerous
• Malignant: Cancerous
• Anti-inflammatory: Reduces swelling, pain, and soreness (such as ibuprofen or naproxen)
• Body Mass Index (BMI): Body fat measurement based on height and weight
• Biopsy: A tissue sample for testing purposes
• Hypotension: Low blood pressure
• Hypertension: High blood pressure
• Lesion: Wound, sore, or cut
• Noninvasive: Doesn’t require entering the body with instruments; usually simple
• Outpatient: Check in and check out the same day
• Inpatient: Plan to stay overnight for one or more days
• In remission: Disease is not getting worse; not to be confused with being cured
• Membrane: Thin layer of pliable tissue that serves as a covering or lining or connection
between two structures
• Acute: Sudden but usually short (e.g., acute illness)
• Angina: Pain in the chest related to the heart that comes and goes
• Gastroesophageal Reflux Disease (GERD): Heartburn
• Cellulitis: Inflamed or infected tissue beneath the skin
• Epidermis: Outermost layer of skin
• Neutrophils: Most common type of white blood cell
• Edema: Swelling
• Embolism: Blood clot
• Sutures: Stitches
• Polyp: Mass or growth of thin tissue
• Compound fracture: Broken bone that protrudes through the skin
• Comminuted fracture: Broken bone that shatters into many pieces
THANK YOU ! 