3_Fiduciary duty .pptx

introduction

1. 3. Fiduciary duty

2. Fiduciary duty fiduciary - derived from the latin term “ fiducia ”, meaning trust an individual in whom another has placed the utmost trust and confidence to manage and protect property or money A fiduciary relationship exists when one party, because of superior knowledge, skill, and authority, assumes responsibility for the welfare of another party who is in a position of reliance fiduciary duty refers to the legal obligation of one party to act solely in the best interest of another party or principal , rather than serving their own interests In this trust-based relationship, fiduciaries have heightened obligations, including the moral imperative to put the interests of reliant parties ahead of their own interests 2

3. Fiduciary duty … the care professional placed the best interest of the patient first and was, in fact, the patient’s advocate A fiduciary obligation exists whenever one person, the client, places special trust and confidence in another person and relies upon that person, the fiduciary, to exercise his discretion or expertise in acting for the client; and the fiduciary knowingly accepts that trust and confidence and thereafter undertakes to act in behalf of the client by exercising his, the fiduciary's, own discretion and expertise 3

4. There are three different kinds of models of doctor-patient relationship : Paternalistic model: the doctor is the professional; he or she gives the order, the patient obeys Contractua l model: the doctor and patient "contract" for each other's mutual benefit; the patient determines or agrees to the doctor’s decisions Fiduciary model : the patient confidently entrusts his or her health care to the doctor, who takes on the obligation of working for the benefit of the patient Based on mutual trust and confidence 4 Fiduciary duty …

5. the doctor-patient relationship has been defined, through rules of ethics and rules of law, as a fiduciary one, as a relationship founded in trust the patient agrees to take the physician into her confidence, to reveal to him even the most secret and intimate information related to her health the physician, in turn, agrees to honor that trust, and to become the patient’s advocate in all matters related to her health, placing her interests above all others - including his own personal or financial concerns the loss of this doctor-patient relationship has obvious consequences for patients 5 Fiduciary duty …

6. Fiduciary duty … Fiduciary duties fall into two broad categories: The duty of loyalty: fiduciaries should act in good faith in the interests of their beneficiaries, should not engage in transactions that involve a conflict of interest called "self-dealing" transactions not act for the benefit of themselves or a third party The duty of prudence (duty of care): fiduciaries should act with due care, skill and diligence, investing as an ‘ordinary prudent man’ would do the duty to pay attention and to try to make good decisions 6

7. Fiduciary duty … A conflict of interest is a potential conflict exists whenever an employee or an employee’s close friend(s), relative(s), or associate(s) has a strong personal life interest, the employee is involved in decision making on behalf of the organization and the employee’s interest may cause (or may be perceived as causing) the employee to exercise his or her organizational decision-making power to further personal interest rather than the organization’s mission, to the detriment of the organization 7

8. Conflicts of interest… physicians should not allow a conflict of interest to influence medical judgment In some cases, conflicts are hard to avoid, and doctors have a responsibility to avoid entering such situations Research has shown that conflicts of interests are very common among both academic physicians and physicians in practice Health service providers can be affected by conflict of interest by the following situations among others 8

9. Conflicts of interest… Referral For example, doctors who receive income from referring patients for medical tests have been shown to refer more patients for medical test Fee splitting and the payments of commissions to attract referrals of patients is considered unethical and unacceptable in most parts of the world Treatment of family members Many doctors treat their family members Doctors who do so must be vigilant not to create conflicts of interest or treat inappropriately 9

10. Conflicts of interest… Vendor relationships Studies show that doctors can be influenced by drug company inducements, including gifts and food Many patients surveyed in one study agreed that physician gifts from drug companies influence prescribing practices Many academic institutions banned pharmaceutical industry-sponsored gifts and food to diminish the influence of pharmaceutical industry on prescribing practices of physicians Sexual relationships Sexual relationships between doctors and patients can create ethical conflicts, since sexual consent may conflict with the fiduciary responsibility of the physician 10