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Ethics and Morals
Torts
Negligence/Malpractice
Consent
Patient Records and Privacy
100
A branch of philosophy that can be defined as a systematic reflection on morality.
What is ETHICS Personal morality is based on the lessons of right and wrong that we are taught at an early age. Kohlberg's theory discusses the stages of moral development. Societal morality refers to the beliefs shared within our community about values and duties. (ex. The concepts stated in the Declaration of Independence) Group morality refers to the moral principles that apply specifically to certain groups of people. For example, the moral duties of physicians were defined in ancient Greece by the Hippocratic Oath.
100
A civil wrong committed by one individual against the person or property of another.
What is TORT There are two types of torts, intentional and unintentional. Intentional torts in a hospital setting could include assault, battery, false imprisonment, invasion of privacy, or defamation (libel & slander). Unintentional torts would include negligence or malpractice.
100
Two patient identifiers were not checked prior to the beginning of a procedure and the wrong patient was x-rayed.
What is NEGLIGENCE Negligence is defined as neglect or omission of reasonable care or caution. The radiographer is held to the standard of care and skill or the "reasonable and prudent radiographer" in similar circumstances. Negligence is an unintentional tort. Gross negligence: Negligent act that involves "reckless disregard for life or limb". Contributory negligence: The behavior of the injured party contributed to the negligence. Corporate negligence: When the hospital as an entity is negligent.
100
Permission obtained from a patient to perform a specific test or procedure.
What is INFORMED CONSENT Informed consent is required before performing most invasive procedures or admitting a patient into a research study. The patient must be made aware of the risks and benefits of the procedure. The document must be in a language understood by the patient, and it must be signed and dated by the patient and a witness prior to the start of the procedure/study.
100
A law enacted under the U.S. Department of Health and Human Services (HHS) to protect the privacy rights of patients.
What is HIPAA (Health Insurance Portability Act)
200
Correct moral behavior in the context of performing professional duties.
What is PROFESSIONAL ETHICS Morals, ethics, and law are all separately defined standards. Morals instill a sense of right and wrong. Professional ethics define what the correct moral behavior is when we are performing our professional duties. Laws are the means used by government to enforce commonly accepted moral standards. If an injured patient believes that we have caused him/her harm by not fulfilling our moral or professional responsibilities, laws ensure that their rights are protected by the courts.
200
Threatening a patient to remain still during an exam.
What is ASSAULT Assault is the threat of touching in an injurious way. (Intentional tort/misconduct)
200
"Res ipsa loquitur"
What is THE THING SPEAKS FOR ITSELF The patient is injured through no fault of his/her own while under complete control of another. Negligence and loss are so apparent that they would be obvious to anyone. Example: A patient has a surgical instrument inside his/her body at the surgical site after the procedure is completed. (The presence of the instrument establishes negligence of the surgeon).
200
A person’s agreement to allow something to happen, not expressly given but referred from a person’s actions or inactions.
What is IMPLIED CONSENT Most common type of consent in medical imaging. Does not require a signed consent form, but the patient has the right to ask questions/refuse the exam.
200
The term for noting data in a patient's medical record.
What is CHARTING In most imaging departments, the majority of record keeping is done with requisition forms or within a computerized radiology-specific ordering system. The both have a limited area for documentation. A chart usually refers to a more extensive compilation of patient information. Examples: Emergency department record, inpatient chart, electronic medical record.
300
Mandatory, specific, and enforceable standards of minimally acceptable professional conduct for all registered technologists.
What is RULES OF ETHICS The Standards of Ethics for Radiologic Technologists is a two-part document, consisting of the Code of Ethics and the Rules of Ethics. The ASRT Code of Ethics establishes broad principles of professional conduct. It serves as an aspirational document. The ARRT Rules of Ethics are a more specific list of standards, and are enforceable by the ARRT.
300
Speaking negatively about a patient.
What is SLANDER Slander and libel are terms for the malicious spreading of information that causes defamation of character or loss of reputation. Slander (verbal) and libel (written) are types of intentional torts.
300
"Respondeat superior"
What is THE MASTER SPEAKS FOR THE SERVANT AKA "let the master respond". The employer is liable for employees' negligent acts that occur in the course of their work.
300
Type of consent necessary for a hip replacement.
What is INFORMED CONSENT This is an invasive procedure, informed consent is required before proceeding with the surgery.
300
Diagnostic images are the property of...
What is THE HEALTH CARE INSTITUTION Diagnostic images belong to the hospital or facility where they were created, but patients have the right to access them.
400
The four steps of an ethical analysis.
What is 1. IDENTIFY THE PROBLEM 2. DEVELOP ALTERNATIVE SOLUTIONS 3. SELECT THE BEST SOLUTION 4. DEFEND YOUR SELECTION Ethical analysis is a method of evaluating situations (ethical dilemmas) in which the correct action is in question. You must be able to assess the situation objectively and come to a conclusion that you can implement and defend. The person responsible for implementing the ethical decision is known as the MORAL AGENT.
400
Taking an x-ray against a patient's will.
What is BATTERY Battery is defined as the unlawful touching of a person without his/her consent. This is an intentional tort.
400
Complications resulting from a procedure.
What is MALPRACTICE Professional negligence: an act of negligence in the context of a relationship between the professional person and a patient/client. This is an unintentional tort.
400
Type of consent required for a hip x-ray.
What is IMPLIED CONSENT A patient does not need to sign a consent for for this examination. However, the patient can refuse the x-rays.
400
The electronic system in hospitals that allows for the ordering of radiographic examinations.
What is RIS Hospitals will have a RIS (radiology information system) in its medical imaging departments. This system will allow technologists access to pertinent patient information, as well as facilitate ordering and billing of medical imaging examinations. Works with other systems such as HIS, DICOM, HL-7, and PACS. An order must be placed in the system before radiographic examinations may be done. They must be signed by the ordering physician, and include signs, symptoms, and/or diagnosis.
500
Two traditional ethical theories that argue the judgment of right and wrong is based on (1) the nature of an action or (2) its consequences.
What is (1) NONCONSEQUENTIALISM and (2) CONSEQUENTIALISM A consequentialist will argue that an action is right if the outcome is positive. Example: Speeding is okay if you get to work on time. If there is a negative outcome, such as a crash, then speeding is bad. A nonconsequentialist will say that speeding is wrong no matter what, as it is risky and against the law. Modified ethical theories also exist in patient care: -Social contract theory: Certain persons or groups have relationships that contain inherent expectations or duties. Ex. Patients and radiographers (Patients expect minimized radiation exposure from radiographers, and the radiographers expect patients to cooperate and remain still during exams. Unmet expectations could be viewed as a violation of the unwritten contract). -Ethics of care: Right actions for one patient in one situation may be wrong for other patients or circumstances. AKA situational ethics. -Rights-based ethics: Emphasizes the rights of individuals in a democratic society to be shielded from undue restriction or harm (the rights of some individuals place duties on others). -Principle-based ethics: widely accepted standard in health care, based on six moral principles for guidance (beneficence, nonmaleficence, veracity, fidelity, justice, autonomy).
500
Restraining a patient on the exam table so he/she cannot leave.
What is FALSE IMPRISONMENT False imprisonment is unjustifiable detention of a person against his/her will (intentional tort).
500
Requires the hospital or health care provider to be responsible for the quality of care provided.
What is CORPORATE LIABILITY This is the liability by one person or agency for the actions of another, aka vicarious liability. The doctrine of the "borrowed servant" allows for the physician to potentially be liable for wrongful acts committed by hospital employees under the physician's orders. Example: the actions of radiographers may result in lawsuits against their employers or physicians with whom they work. However, the "rule of personal responsibility" has been used more frequently in recent years, where in some cases radiographers have been placed in legal jeopardy. The ASRT sponsors group liability coverage, and some feel it may be necessary for our profession.
500
The quality of having the ability or tendency to function independently.
What is AUTONOMY Right to information and self-determination. Free will and accord—intentional participation in treatment. Respect and dignity maintained. Free and informed consent.
500
Patient records are considered this type of document.
What is LEGAL DOCUMENT Patient records are considered legal documents, and information must be properly documented. -Do not erase errors. You must draw a line through it, then date and initial the correction -Do not write in pencil -Do not use inappropriate abbreviations -Do not leave blanks -Date and sign entries with full name and title