Ethics In Health Care Essay
Nr 602: nurse practitioner core competencies.
It examines and evaluates the decision making process integrating ethical principals. Advance practice nurses must be aware there are ethical consequences for decisions that are made. This core competency addresses the need for ethically sound solutions to be applied to complex issues. During this course ethical principles of decision making was addressed in the case studies. For example, a patient became pregnant and contracted a sexually transmitted infection from her estranged spouse.
Autonomy In Health And Social Care
Ethics of healthcare depends on 4 moral standards and how they are utilised; autonomy, non-maleficence, beneficence, and justice. Autonomy, which means self-governance, is the rule for regarding the privileges of a person to settle on a choice for them self, and respecting that decision. In healthcare this implies regarding a patient's choice on treatments, regardless of the possibility that it could bring about damage or demise to themselves. Autonomy is about self-rule, control free, without impact or influence from any other person, and is tied in with making an educated and un-forced choice about their care and medicines, based from their qualities and inclinations. Alongside autonomy is the principle of justice, which incorporates reasonableness
Why Is Physician Assisted Suicide Morally Wrong
Life is a story full of chapters where we experience trials and tribulations in so many ways. As we may already be aware of, humans do not live forever. Life comes to an ending that is inevitable. Death is a difficult part of life to grasp. Furthermore, people have no control of how the end of life will take place.
Amelia Wilkerson Ethical Dilemmas
Nurses are faced with ethical dilemmas related to clinical issues, and disease and treatment decisions daily (Kangasniemi,
Ethical Issues In Human Services
All human service workers have their own particular inward esteem framework and set of ethics. Conflicts occur within the helping field on an external and internal level. Everybody who works in a human service field, or who manages other individuals in an expert or paraprofessional limit is liable to a code of morals. There are various formal moral codes normally set around expert associations, however now and again by law that apply to individuals’ specifically professional positions. This paper attempts to address issues of consent, conflict of interest, unethical behavior and confidentiality on an internal and external level.
Atul Gawande Whose Body Is It Anyway Analysis
Atul Gawande in his article “Whose body is it, anyway?” introduced couple of cases, which discussed a controversial topic, doctors dealing with patients and making important medical decisions. These are difficult decisions in which people might have life or death choices. Who should make the important decisions, patients or doctors? Patients don’t usually know what is better for their health and while making their decisions, they might ignore or don’t know the possible side effects and consequences of these decisions.
A Death Of One's Own Movie Analysis
The ethical principle of autonomy provides for respect for the patient’s autonomy to make decisions and choices concerning their life and death. Respecting the patient’s autonomy goes against the principles of beneficence and non-maleficence. There also exists the issue of religious beliefs the patient, family, or the caretaker holds, with which the caretaker has to grapple. The caretaker thus faces issues of fidelity to patient welfare by not abandoning the patient or their family, compassionate provision of pain relief methods, and the moral precept to neither hasten death nor prolong life.
Medical Assisting Code Of Ethics
CMA (AAMA) Core Values, American Medical Association Assistants maintains this living code of ethics document in order to help medical assistants best evolve with the changing landscape of healthcare. Medical Assisting Code of Ethics of the AAMA sets forth principles of ethical and moral conduct as they relate to the medical profession and the particular practice of medical assisting. The Medical Assisting Creed of the AAMA sets forth medical assisting statements of belief. Medical Codes of Ethics Numerous other professional organizations catering to healthcare workers also promote ethical behavior in the workplace by publishing standards of behavior.”
Ethical Dilemmas In Health And Social Care
* Risk to self or others * Rights of service-users and safety consequence * Differing priorities between stakeholders Health and social care workers as well as care takers can fall into different dilemma related to health and social care decision. One of the dilemmas is ethical dilemma. In this context dilemma must be encountered by health and social care providers and takers.
Ethical Principles In The Film 'Miss Evers Boys'
The four core ethical principles that are called into question in the movie “Miss Evers’ Boys” are autonomy, beneficence, nonmaleficence, and justice. Autonomy refers to the right of the patient to function independently and the ability to self-direct. This means that patients are entitled to decide what will happen to them, and if deemed competent, they have the right to either consent to or refuse treatment. All nurses and healthcare personal would be required to respect the patient’s wishes, even if they do not agree with them. Beneficence is the core principle that refers to the act of ‘doing good’ and advocating for the patient.
Mary Shelley's Frankenstein Is Ethical
Ethics are emplaced in us as adolescences. Ethics are a set of moral principles a person lives by. Ethics can be set by the environment around a person. Things can factor in such as their family, culture, and friends etc. Everybody has their different opinions of what ethic codes that are most important for one to follow.
Drug Testing Ethical Dilemmas
Not only do the professionals have to decide on the immediate needs of their patients but also on their future. Ethics has increasingly become a required component of clinical practice. According to Ulrich et al. (2013) , many healthcare professionals suffer from stress-related disorders which originate in job duties like protection of patients’ rights, respect to autonomy, informed consent for treatment, and staffing patterns which are impacted by the increasing demand for clear ethical standards in their decision making process.
Explain The Five Skills Or Competencies You Have Acquired Through Participation In General Education
When faced with an ethical problem or issue in any career affecting societal concerns, I would use moral reasoning and the knowledge about ethical principles I learned in my assignments and courses to make an informed and moral decision when presented with an issue. In my courses at Ashford, I learned a great deal about ethics in the SOC 120: Introduction to Ethics and Social Responsibility course. From the academic knowledge I’ve gained through this course, I am able to apply the four ethical principles, autonomy, beneficence, nonmaleficence, and justice, as guidelines when faced with clinical decisions working in the medical field. In SOC 120, I was able to learn and research how ethics applies to healthcare, health professionals, and hospitals, which is essential for my career in health informatics, and as a pharmacy
Ethical Issues In Health Care Essay
Ethical Issues in Healthcare There are many ethical issues facing health care at any time and it is impossible to say definitively which is the most pressing or the most important. Health care professionals are expected to base their practice on a set of ethical principles, including truthfulness, beneficence, nonmaleficence, justice, and confidentiality. Ethical issues can arise, however, when a l professional is called upon to act in opposition to personal values or in cases where the values of patient, health care worker, and sponsoring institution conflict. The following issues are presented in no order. Neonatal Ethics Neonates are babies within their first twenty-eight days of life.
Nursing Ethics Case Study
As a nurse, it is our duty and obligation to give the best optimal care to our patients. Therefore, it is also our duty to protect our patients from being harmed by sub-optimal care done by our fellow healthcare professionals. Therefore, ethical dilemmas arise when an ethical principle is breached, especially when there is potential harm to patients. CASE STUDY:
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Importance Of Ethics In Health Care
In the health care industry, patients’ have a legal right when making decisions pertaining to their health and medical needs. Did you know, it is the responsibility of medical professionals to promote responsible business practices at every level of the organization and the business should be conducted ethically and honestly? Ethics are the values and moral principles that govern and guide the decisions and actions of a group or an individual. Ethics give direction on how to act right from wrong when faced with moral issues and dilemmas. In addition, there are three ways ethics are used within the health care aspect; 1. Philosophical ethics-involves inquiry about ways of life and rules of conduct 2. Way of life-religious ethics 3. Moral conduct-involves …show more content…
Having respect is the basic essential of treating people ethically and meeting the complete needs of patients and their families across the continuum of care. Yet, the key component from the staffing levels of the medical professionals is to keep the patients best interest at heart and in mind. On the other hand, there will always be those who stand up for the morally right thing; but you will also have some that will try to go against the rules and regulations and do their own medical …show more content…
Patients want the highest quality of care with reasonable measures of caution. When dealing with individual’s lives relating to health, most people take pride in seeking professional and certified medical personnel. USA Community Hospital takes all employees and patients concerns seriously and if any issues arise among anyone, then they will be addressed promptly. Individuals will be held accountable for their actions, so there is no tolerance for unethical behavior. The ultimate legal ramification to the professional personnel regarding the ethical treatment of USA Community Hospital HIV/AIDS patients is to make sure every need has been met to the best of our ability and no patient feels uncomfortable with the services that we have to offer. Employees are to be professional at all times and give the patient their utmost respect, integrity, and trust while keeping the patient’s personal information and medical file
In this essay, the author
- Explains that it is the responsibility of medical professionals to promote responsible business practices at every level of the organization and the business should be conducted ethically and honestly.
- Concludes that it can be challenging for any organization to implement changes and sustain the professional quality of services, but usa community hospital is willing to remain professional in the community.
- Explains that the patient's rights are the concept of participating in their treatment options and promoting their own safety. usa community hospital will implement the following policy and procedures.
- Opines that patients should be the top priority in the healthcare industry because they have an obligation to serve the needs of our community according to the code of ethics and the american medical society.
- Opines that usa community hospital will continue to display professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of each individual.
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Ethical Issues In Healthcare Administration
In conclusion, healthcare administrators must provide high quality care through ethically sound policy. Processes must be clear and fair and ongoing ethics training must be provided for all levels of staff responsible for patient care. They must follow their code of ethics and be self-regulating. In doing so, actions and decisions made will be reflective of a good steward of
The clinical standards state, “All decisions made and actions taken on behalf of the patient adhere to ethical standards” (“Scope of Practice,” n.d.). I think that adhering to a professional code of ethics helps healthcare providers establish important decision making skills. Having a Code of Ethics is a vital guideline to have in the work place so we have a grasp on what is expected of a professional healthcare provider. It is crucial for the best quality of care being given to patients with equal care provided for all. The clinical standards also state, “All patients expect and deserve optimal care” (“Scope of Practice,” n.d.). Quality of care is important so that patients are given safe, respectable care. The overall objective is to achieve a high degree of patient satisfaction. By providing patients with more information and instruction, minimalized wait times, affordable costs, properly trained staff, maintained equipment, and compassionate attitudes we can give them the quality care they deserve. I think it is important to provide an excellent quality of care so that your patients want to keep coming back to the
Four Ethical Principles In Health Care
The four major ethical principles in health care are: Autonomy – to honor the patient’s right to make their own decision (the opposite is paternalism - the health care provider knows best for the patient), Beneficence – to help the patient advance his/her own good, Nonmaleficence – to do no harm (many bioethical controversies involves this principle), and Justice – to be fair and treat like cases alike. All 4 principles are considered to be in effect at all times. In theory, each is of equal weight or importance. Ethical responsibilities in a given situation depend in part on the nature of the decision and in part on the roles everyone involved play.
Code Of Medical Ethics
Ethics in the medical field are very important and should be taken seriously. As a medical professional you will tested daily on making the best choices, using good judgment and being morally responsible for your actions. There are nine principles in the Code of Medical Ethics that in general make up the primary code. As a medical professional you must always consider what is in the best interest of the patient. Code of medical ethics of the American Medical Association, (2012). When determining the proper “Patient-Physician Relationship, the relationship between the patient and physician is based on trust and gives rise to the physicians’ ethical obligations to place a patients’ welfare above their own self-interest” Code of medical ethics of the American Medical Association, (2012).
Not-for-Profit Healthcare, For-profit Healthcare and Physician Incentives
Some medical facilities are not-for-profit organizations. They can be a charitable organization or an educational organization or both. There are other not-for-profit medical and public health programs that provide health care to many communities in this country. Some of the best hospitals in America are educational not-for-profit facilities. They work with some of the newest technology and some perform experimental procedures. Most public health programs are ran as not-for-profit organizations and operated for charitable and educational purposes. The not-for-profit organization is not liable to pay taxes under IRS code 501 (c)(3) (.org). This allows the organization to put its revenues back into the organization versus having to pay investors or owners. Unfortunately, over the past 20 years the amount of for-profit organizations has increased (Santa). The growing commercialization of health care has ethical implications and has become a matter of heated controversy (Santa). It’s becoming more difficult despite all the laws and regulations to protect patient’s privacy and confidentiality. An ethical implication that for-profits face is physicians receiving incentives for keeping cost down to increase profits. Some for-profits will encourage doctors to promote profit producing drugs, surgeries, tests and treatments. (Santa). Some of these same physicians may own the facility they operate which creates a huge conflict. On the other hand, financial incentives can cause physicians to delay important tests and treatments or to not perform them at all. In some cases patients are being discharged from hospitals before they are ready to go home (Orentlicher). On an ethical standpoint, the patient’s well being is put in jeopardy and the...
ANA Code Of Ethics Of Virtue Ethics In Nursing
When the practices in the healthcare delivery system or organization threaten the welfare of the patient, nurses should express their concern to the responsible manager or administrator, or if indicated, to an appropriate higher authority within the institution or agency or to an appropriate external authority” (3.5 protection of patient health and safety by acting on questionable practice, ANA, 2015). The example of the practice is a patient discharge from the rehab facility to the Personal care unit with pending PT/INR results, which turned out to be critical. The admitting nurse demonstrated moral courage by questioning physician who wrote discharge orders and the nurse who completed discharge. Rehab physician refused to address lab results and referred the patient to the PCP. Admitting nurse raised a concern to administration to review discharge protocol and deviation from safe practice. Nurse acted on behalf of the patient and requested readmission to rehab based on patient’s unstable medical
Ethical Principles In Health Care
Ethical principals are extremely important to understand in the healthcare field. Ethical responsibilities in any situation depend on the role of the healthcare worker and the nature of the decision being made. Healthcare administrators and professionals must make ethical decisions that can be an everyday or controversial situation. When making such decisions, it is imperative to consider the four major principles of ethics: autonomy, nonmaleficence, beneficence, and distributive. By using these four principles, ethical decisions can effectively be made. For the purpose of this paper, examined will be the example of the treatment of an uninsured homeless patient. Poor health care be a cause and a result of homelessness.
Ethical Conduct in Healthcare: A Study on ACHE's Code
It is also directed, according to the code of ethics, that Healthcare executives have a fiduciary responsibility to the society and community and should act in such a way that wins their trust, confidence, and respect. Hence, it is needed that the healthcare professionals lead exemplary lives. By acting their role, they are said to be moral advocates. Every decision taken by these professionals leads to an impact on the well-being of the people; therefore, decisions should be balanced and ethical.They should safeguard the interests of every audience that they serve.
Exploring Ethical Principles in Healthcare
Ethical principles in healthcare are significant to the building blocks of mortality. The principles are beneficence, autonomy, justice, and nonmaleficence. Although these principles can be certainly followed they can also be disregarded. Beneficence is a theory that assures each procedure given is entirely beneficial to that patient to help them advance within their own good. For example, There was a young girl, the age of 17. She had been being treated at a small private practice since she was born. She was recently diagnosed with lymphoma and was only given a few more years to live. Her doctors at the private practice who had been seeing her for years were very attached to her and wanted to grant this dying girl her every wish. They promised
The Beneficence Of Ethical Decision Making In Healthcare
Nearly most of the problems that have arisen at the VA are not only bad scheduling practices that resulted in extremely longer wait times, putting certain veterans before others, but also death to veterans who had to wait for care. Also, there is a lack of ethical culture, but beneficence, justice, nonmaleficence, self-sufficiency as well as confidentiality that was forgotten is this case (McWay, 2014). The beneficence and nonmaleficence are the most important of ethics (McWay, 2014). First, beneficence is to make available good and nonmaleficence means to do no harm whatsoever (McWay, 2014). Also, justice can include the responsibility of fairness, honesty, and in essence treating all patients
Ethics And Medicine: The Role Of Ethics In Medicine
Morality plays a huge role in the health care field. This principle of right and wrong behavior is significant to every doctor when evaluating the merits and difficulties of many medical procedures. One may find the advancement of medical technologies hard to endure, however, this increase in medical technology serves as a solution to our human imperfections. For example, using in-vitro fertilization to pick and choose embryos regarding an ideal genetic baby or human cloning. If we screen an embryo for a tissue type, we can then allow certain physical traits for the baby. We can choose their eye color, type of intelligence, athleticism, and talent that could suggest our babies nonetheless, perfect
The Importance Of Medical Ethics In Public Health
There are currently 40 emerging infectious diseases, that are at risk of spreading from country to country, due to the increase of people traveling. Diseases like Ebola and the Zika virus pose a global threat due to the possible rapid rate of transmission from human-to-human, that occurs with exposure to someone who is symptomatic and seropositive (World Health Organization, 2016-a). When there is an infectious disease breakout, public health practitioners and physicians, must make quick decisions regarding isolation of a patient exhibiting symptoms and using quarantine for those who have been exposed to someone symptomatic or seropositive. Although, a public health framework is followed to make the decisions for isolation and
Ethical Issues In Health Care
To save or not to save? That is the question. In the hospital setting, many problems arise and it is the duty of the healthcare workers to ensure, aide, and facilitate the patient’s well being to the best of their ability. Though all problems cannot simply be solved with medicine and therapy, it takes a considerate amount of critical thinking as well. What should happen when a problem like making sure a patient stays alive, backfires and the patient actually wants to die? Also, for a person desiring death, it is not considered righteous and we, as humans will deem them as mentally ill. This is where the ethical and moral issues of promoting health and respecting the patient’s right to autonomy are conflicted.
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Essay On Code Of Ethics
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Essay On Ethics In Health Care
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It is with no much doubt that the health care industry, above any other shows a high degree of concern for issues encompassing the wellness of their clients (patients). Ethical quandaries in health care are often times enthralling and exacting because it puts the health care worker in a position to come up with decision(s) that attempts to balance two or maybe more diverse opinions, both of which have their own ethical excellence. Every day, doctors, nurses and other health professionals are forced to make ethical decisions that abide by the code of ethics set by ethical committees in the health sector. The purpose of the codes is to guide healthcare givers towards identifying, understanding, and resolving tough ethical decisions that involves patients and their families. However, each ethical quandary demands a tradeoff of…
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- Health care
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The Issue of Ethics in Healthcare
Healthcare ethics is a set of basic principles and values that are applied when making decisions about medical procedures. These ideas include such bioethics notions as autonomy, justice, beneficence, and nonmaleficence. These important factors should be taken into consideration to make recommendations and decide on the best course of action. The most frequently found ethical problems are those that require a simple distinction of what is right and wrong. However, sometimes more challenging issues arise; for example, in the cases when there are two “rights,” when a person needs to decide between different values systems, such as the patient’s against the doctor.
To decide in the healthcare sphere, it is important to understand the medical issues, such as patient’s diagnosis, treatments options, and prognosis, as well as their personal values and preferences. Each of these factors can become a reason for an ethical conflict, as they always involve different interpretations. For example, a family and a physician may have different understandings of the prognosis. According to this, the ethical concerns should focus on identifying an issue and trying to find an agreement in cases with competing values.
This moral approach is usually divided into two categories: micro- and macro-ethics. Micro-ethics is based on the obligations of individuals for their research subjects. It is a science existing in everyday interaction between a physician and a patient. These are the principles of the biggest importance which should be a part of training programs in medical institutions as all the medical personnel encounters the same problems on daily basis. Macro-ethics address the organization of general moral practices which include factors helping the process of healing, such as respect for people, the value of human life, and care for suffering individuals.
From a personal point of view, ethics in healthcare is standard norms telling what one cannot do in the professional sphere. Sometimes, it gives much freedom as well, as it can approve that one is undertaking the right actions. The most important elements of medical ethics are an ability to listen, tactfulness, and respect for the patient, which allow winning their confidence and making the process of treatment easier for both sides.
An overview of the legal and ethical issues in healthcare . (2019). StPatrick. Web.
Western Governors University. (2019). Healthcare Ethics in Modern Medicine . Web.
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Importance of Ethics in Healthcare and Related Legal Ramifications, Essay Example
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Ethics in Healthcare
The healthcare industry is one with great responsibility to the public. Patients rely and depend on healthcare professionals to help them cope with their medical issues and also to help them get well. The healthcare industry constantly deals with these issues and they must do so while remaining in strict compliance with healthcare system regulatory requirements and guidelines. This evolves a high level of ethics in the healthcare industry. According to Morrison (2009), ethics in healthcare is a matter of doing what is right, as well as a matter of ensuring that professionals in this industry are knowledgeable enough about their specialties to make solid, logical, and informed decisions when dealing with ethical issues in the healthcare setting. In this vein, Morrison (2009) categorizes ethics into two separate categories: (1) normative and (2) metaethics.
Normative ethics deals with what is the right and the wrong. It has to do with taking ethical actions. According to the Encylcopaedia Britannica, normative ethics is related to morals and philosophy connected with right and wrong. This refers to implications from people’s actions that affect others. Normative ethics deals with answering the question of what determines how standards are justified, based on deontological and teleological theoretical aspects (nomative ethics).
- Deontological theories dismiss considerations of values when dealing with ethical standards.These theories are based on what is inherently right in ethcial actions.
- Teleological theories definitely consider values when dealing with ethical standards.These theories are based on goodness and what is valued as a criterion for ethics.
Normative ethics deals with issues such as human rights, social equality, and moral actions that pertain to social issues such as scientific research for genetic engineering. In other words, normative ethics deals with practical moral problems and standards for addressing them (nomative ethics).
This sub-discipline of ethics deals with moral judgments and ethical theories such as those regarding naturalism, intuitionism, emotivism, and prescriptivism, according to the Encyclopaedia Britannica. This discipline assesses the validity of moral claims to understand whether they are true or false. However, these claims are thought to be reasonably justified in non-moral terms, as some more natural (metaethics).
Types of Ethical Issues in the Healthcare Setting
Ethics is of major importance in the healthcare field, and it is comprised of different types of ethical issues that healthcare professionals face, particularly when dealing with controversies such as physician-assisted death or abortion. Other controversies include dealing with conflicts of interests such as inappropriate patient-doctor relationships or illegal prescription medicine schemes for addicted patients. These are examples of highly unethical and illegal activity. It is important to manage these types of ethical issues in the healthcare setting, and this is something charged to leadership in healthcare. This has much to do with organizational leadership as a component of effective management, which contributes to upholding ethical issues in the healthcare setting (Aarons, 2006).
These facts are true because effective healthcare leadership determines how well the organization operates and how well the healthcare staff adhere to regulatory requirements and standards, especially those dealing with ethical issues in the healthcare setting. This is important because the patients’ welfare depends on the healthcare professionals’ open communication and positive thinking within the organization. It is also good for quality improvement to make sure ethical standards are met and ethical regulatory guidelines are adhered to (Aarons, 2006). These standards and regulations are essential to treating patients with respect, as well as protecting their health information.
Protecting Patient Health Information
According to the U.S. Department of Health & Human Services, federal law stipulates that patients’ health information must be protected under the rules of the Health Insurance Portability and Accountability Act (HIPAA). This ensures that private health information that is individually identifiable is protected and any breach of protected health security must be reported immediately. Authorized disclosure of protected health information (PHI) is allowed as needed for the care of patients and other authorized purposes (Health Information Privacy).
Rules in Place to Punish Violators
HIPAA regulations are very strict and a Security Rule is in place to punish violators of the policy. According to Health Information Privacy, “The Security Rule specifies a series of administrative, physical, and technical safeguards for covered entities and their business associates to use to assure the confidentiality, integrity, and availability of electronic protected health information” (para. 2).
Additionally, it is important that healthcare entities have specific codes of ethics in place to regulate ethical conduct in the workplace. Regarding this, the National Association for Healthcare Quality (2011) is an agency that regulates the code of ethics and practice standards for healthcare professionals. This is something that is necessary for defining a standard of conduct for healthcare professionals. This is an excellent way to promote a standard of ethical commitment to making sure healthcare professionals are honest. Also, it fosters good levels of integrity and accountability. A code of ethics in healthcare is important to maintain the public trust and to ensure guidelines are in place to help professionals respect laws, and free up temptation to engage in fraudulent or deceptive activities. Patients put their trust in the healthcare industry and its professionals, and they have the right to fair and ethical treatment without the threat of intentional or unintentional acts of ethical irresponsibility.
This is one reason that an ethical doctor-patient relationship is essential. Doctor are viewed as a people of authority, and this means they have an obligation not to abuse their authority. Additionally, doctors and all other healthcare professionals must keep patient information confidential in order to protect the privacy and dignity of the patients. This is not only the right thing to do; it is federal law.
Ethics in healthcare is a major issue of concern for patients, healthcare professionals, and the public, in general. However, ethics are also a necessary component of operating healthcare organizations and the business of dealing with patients.
Aarons, G. A. (2006, August). Transformational and Transactional Leadership: Association With Attitudes Toward Evidence-Based Practice. Psychiatric Services, 57(8), 1162-1169.
Metaethics . (n.d.). Retrieved from Encyclopaedia Britannica: http://www.britannica.com/EBchecked/topic/377413/metaethics
Morrison, E. (2009). Health Care Ethics: Critical Issues for the 21st Century: Critical Issues. Jones and Bartlett Publishers, LLC.
Nomative ethics . (n.d.). Retrieved from Encyclopaedia Britannica: http://www.britannica.com/EBchecked/topic/418412/normative-ethics
The National Association for Healthcare Quality. (2011). The Code of Ethics and Standards of Practice for Healthcare Quality Professionals. Retrieved from http://www.nahq.org/uploads/files/about/codestandards.pdf
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