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Chapter 2 Ethical, Legal, and Economic Foundations of the Educational Process. Differentiated View of Ethics, Morality and Law. Natural law (basis) Deontological (Golden Rule) Teleological (greatest good for the greatest number). Evolution of Ethical/Legal Principles in Health Care.
A. Informed consent
B. Right to self-determination
1. Autonomy: the right of a client to self-determination
2. Veracity: truth telling; the honesty by a professional in providing full disclosure to a client of the risks and benefits of any invasive medical procedure
3. Confidentiality: a binding social contract or covenant to protect another’s privacy; a professional obligation to respect privileged information between health professional and client.
4. Nonmalfeasance: the principle of doing no harm
A. Negligence: the doing or nondoing of an act, pursuant to a duty, that a reasonable person in the same circumstances would or would not do, with these actions or nonactions leading to injury of another person or his/her property.
B. Malpractice: refers to a limited class of negligent activities that fall within the scope of performance by those pursuing a particular profession involving highly skilled and technical services.
C. Duty: a standard of behavior; a behavioral expectation relevant to one’s personal or professional status in life.
5. Beneficence: The principle of doing good; acting in the best interest of a client through adherence to professional performance standards and procedural protocols.
6. Justice: Equal distribution of goods, services, benefits, and burdens regardless of client diagnosis, culture, national origin, religious orientation, sexual preference and the like.
“…probably the most undocumented skilled service….”(Casey, 1995)
Documentation is required by:
Challenge for health care providers:
Direct Costs: those that are tangible and predictable, such as rent, food, heating, etc.
Fixed Costs: those that are stable and ongoing, such as salaries, mortgage, utilities, durable equipment, etc.
Variable Costs: those related to fluctuation in volume, program attendance, occupancy rates, etc.
Indirect Costs: those that may be fixed but not necessarily directly related to a particular activity, such as expenses of heating, lighting, housekeeping, maintenance, etc.
4. Cost Savings: money realized through decreased use of costly services, shortened lengths of stay, or fewer complications resulting from preventive services or patient education.
5. Cost Benefit: occurs when the institution realizes an economic gain resulting from the educational program, such as a drop in readmission rates.
6. Cost Recovery: occurs when revenues generated are equal to or greater than expenditures.
Revenue Generation: profit realized when fees for an educational program exceed the aggregate costs of program preparation and delivery.
Cost-Effectiveness Analysis: refers to determining the economic value of an educational offering by making a comparison between two or more programs, based on reliable measures of positive changes in the behaviors of participants as well as evidence of maintenance of these behaviors, when a real monetary value cannot be assigned to the achievement of program outcomes.
Cost-Benefit Analysis: the relationship (ratio) between actual program costs and actual program benefits, as measured in monetary terms, to determine if revenue generation was realized.