Values and ethics in InterProfessional E.ppt

Values and ethics in IPE

1. Values and Ethics in
Interprofessional Practices
Dr. E. Harikrishnan, MD
Associate Professor in Paediatrics,
IGMCRI, Puducherry

2.  Values are specific:
• principles
• beliefs
• standards
• ideals
that one holds as
- important
- right
 Values exert major influence:
These shape:
• our attitudes
• motivate actions
What are Values ?

3.  Values are the rules by which
one makes decisions:
- about right and wrong
- should and shouldn't do
- good and bad
 They are more than words-
they are:
- moral
- ethical
- professional
attributes of character - certain
core values that must be instilled
in us

4. My Values Give Me Direction
•Incredible damage that can be done
when individuals lose direction as
they forget to practice values
•Values give us a moral compass
•We need them to make good and
wise decisions, especially when we
face tempting circumstances

5. These values should:
- determine our character
- be central to our profession
- guide our lives as we serve
our Nation

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7. Trust-
Trust-
worthiness
worthiness
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RespectRespect
CompassCompass
-ion-ion
FairnessFairness
Citizen-Citizen-
shipship

8. •Be honest to the least bit
– don’t deceive, cheat or steal

•Be reliable
— do what you say
•Be convincing
— have the courage to do /say the
right thing
•Be loyal
— stand by your family, friends,
organization, and country
1. Be Trustworthy1. Be Trustworthy

9. • Take charge
– Do what you are supposed to do
• Give your best
— never settle for anything less than
the best that you have
• Be self-disciplined
— practice responsive behavior as a
rule, and exercise self-control in
difficult situations
• Be accountable for your choices
— think about the consequences
before you act
2. Be Responsible2. Be Responsible

10. 3. Show Respect3. Show Respect
• Have a positive attitude towards all
— check your biases, prejudices, etc.
• Treat each and everyone with respect
– Respect begets respect: a
fundamental human need
• Be considerate
— use good manners, not bad
language
• Be flexible and tolerant
— recognize and handle differences
in others’ beliefs, values,
standards, opinions, etc.

11. • Play by the rules in any situation
– whether win or lose
• Share what needs to be
— information, resources,
etc., even credit and blame
• Be open-minded
— handle conflict and
negotiate deals with a win-
win strategy
• Be empathetic
— listen carefully for
interjecting feelings with
pure objectivity
4. Be Fair4. Be Fair
FairnessFairness

12. 5. Be Compassionate5. Be Compassionate
 Be concerned with others’ welfare
• undoubtedly one of man’s
primary responsibilities in life
 Be forgiving
• say “no” to any ill-feelings that
creep in or linger on in your hear
against any individual
 Be grateful
• express thanks for any assistance or
favors you receive
 Be caring
• appreciate others’ personalities
publicly whenever possible
-- restrict criticism to their non-
conforming actions only and in
private (whenever possible)

13. 6. Good Citizen6. Good Citizen
 Get involved in community affairs
– do your share to make your
community better in any
respect:
cleanliness, poverty alleviation,
health care, etc.
 Be a good neighbor
— go out of your way to always
cooperate, and ensure
harmony
 Respect authority
— obey laws and rules
 Keep your surroundings clean
— protect the environment
Responsibility to
Country and Community

14. Relationship Between ValuesRelationship Between Values
And Performance And Performance
ValuesValues
Harmony in Harmony in
ValuesValues
Discord inDiscord in
ValuesValues
Positive ImpactPositive Impact
On PerformanceOn Performance
Negative ImpactNegative Impact
On PerformanceOn Performance

16. Ethics refers to principles that define:
–behavior as right, good and proper.
– well based standards of right and wrong
that prescribe what humans ought to do
Definitions
Of EthicsRight
Wrong

17. Difference
between Values & Ethics
•"Values are what we judge to be
right."
•Individually or organizationally,
values determine what is right
and what is wrong
•Doing what is right or wrong is
what we mean by ethics.
•To behave ethically is to behave
in a manner consistent with what
is right or moral.

18. - about words
–– what we say
- simply a written code
- an intention

19. (and character) is whether we
are willing to do the “right” thing
… even when it requires our
personal sacrifice
The Real Test of Ethics

22. Nonmaleficence
•Obligation of a physician not to harm patient
–Do not kill
–Do not cause pain
–Do not incapacitate
–Do not cause offense
–Do not deprive others of the goods of life
•But it is always weighed with the benefits against
burdens of interventions and treatments and to
choose the best course of treatment

23. Beneficence
•Obligation of the physician to act for the
benefit of the patient
•Supports a number of moral rules to protect
and defend right of others
•Prevent harm
•Remove conditions that will cause harm
•Help persons with disabilities
•Rescue persons in danger

24. Autonomy
•Needs to be weighed against competing moral
principles
•Some times can be overridden
–Cause harm to others
–Persons lacking capacity or competence to act
autonomously
•Paternalism

25. •Respecting the principle of autonomy
obliges the physician to disclose
medical information and treatment
options that are necessary for the
patient to exercise self-determination
and supports informed consent, truth-
telling, and confidentiality.

27. Conflicts between Beneficence and
Autonomy
•a young man with asthma may refuse mechanical
ventilation for reversible respiratory failure.
Simply to accept such refusals, in the name of
respecting autonomy, seems morally constricted.
• Physicians can elicit patients' expectations and
concerns, correct misunderstandings, and try to
persuade them to accept beneficial therapies.
• If disagreements persist after discussions, the
patient's informed choices and view of his or her
best interests should prevail.

28. Patients WHO Lack Decision-Making
Capacity
•Patients may not be able to make informed
decisions because of unconsciousness,
dementia, delirium, or other conditions.
•Physicians should ask two questions regarding
such patients:
•Who is the appropriate surrogate?
•What would the patient want to be done?

29. Surrogate Decision maker
•Previously autonomous but presently
incompetent
•Non autonomous patients
•Substituted judgement standard (what the
patient would wish )
•In the best interests for the patient

30. Assessing Capacity to Make Medical
Decisions
•All adults are considered legally competent unless
declared incompetent by a court.
• In practice, physicians usually determine that
patients lack the capacity to make health care
decisions and arrange for surrogates to make
them, without involving the courts.
•By definition, competent patients can express a
choice and appreciate the medical situation; the
nature of the proposed care; the alternatives; and
the risks, benefits, and consequences of each.

31. • Their choices should be consistent with their
values and should not result from delusions or
hallucinations.
•Psychiatrists may help in difficult cases because
they are skilled at interviewing mentally impaired
patients and can identify treatable depression or
psychosis.
• When impairments are fluctuating or reversible,
decisions should be postponed if possible until
the patient recovers decision-making capacity

32. Truth telling
•Right to know the diagnosis and prognosis
•But has the option to forgo this disclosure
•Autonomy prevails – right to authorise a
family member to take decsions

33. Confidentiality
•Physicians are obligated not to disclose
confidential information given by a
patient to another party without the
patient’s authorization
•Exceptions
–Consent
–Reporting of STD or epidemics
–Court order

34. Justice
•Fair, Equitable and appropriate treatment to all
•Fairness to the patient assumes a role of primary
importance when there are conflicts of interests.
•A flagrant example of violation of this principle
would be when a particular option of treatment
is chosen over others, or an expensive drug is
chosen over an equally effective but less
expensive one because it benefits the physician,
financially, or otherwise.

35. Ethical Dilemmas
•Physicians frequently confront ethical issues in
clinical practice that are perplexing, time-
consuming, and emotionally draining.
• Experience, common sense, and simply being
a good person do not guarantee that
physicians can identify or resolve ethical
dilemmas.
• Knowledge about common ethical dilemmas
is also essential.

36. •In most clinical settings, different goals and
approaches are possible, outcomes are
uncertain, and an intervention may cause
both benefits and harms.
• Thus competent, informed patients may
refuse recommended interventions and
choose among reasonable alternatives.

37. Informed Consent
•For patients to make informed decisions,
physicians need to discuss with them the
nature of the proposed care, the alternatives,
the risks and benefits of each, and the likely
consequences, and obtain the patient's
agreement to care.
• Informed consent involves more than
obtaining signatures on consent forms.

38. • Physicians need to educate patients, answer
questions, make recommendations, and help
them deliberate.
•Patients can be overwhelmed with medical
jargon, needlessly complicated explanations,
or too much information at once.

39. VALUE AND ETHICAL ASPECTS
OF IPE

40. •Who are all involved in health care team ?
•Who decides the patient outcome?

41. Value and ethics in IPE
1.Work with individuals of other professions ( team members)
to maintain a climate of shared values, ethical conduct and
mutual respect.
2.Respect the unique cultures ,values , roles and responsibilities
and expertise of other health professions

42. Need..
•Patient centred , interprofessional collaborative
practices improves the patients outcome
•Improving the quality of health care
•Improve the health of population

43. CULTURAL HUMILITY
•A humble and respectful attitude towards individual
of other cultures to challenge their own cultural bias,
realize they cannot possibly know everything about
other cultures as a life long goal and process

44. Value and ethics – competencies
(11)
•VE 1 : Promote the values and interests of persons
and populations in health care delivery , one health
and population health initiatives

45. •VE 2: Advocate for social justice and health equity
of person and populations across the life span

46. •VE 3 : uphold the dignity, privacy , identity and
autonomy of persons while maintaining the
confidentiality in the delivery of team based care

47. •VE 4 : Value diversity, cultures and differences

48. •VE 5: Value the expertise of health professionals and
its impact on team functions and health outcomes

49. •VE 6 – Collaborate with honesty and integrity while
striving for health equity and improvements in health
outcomes

50. •VE 7 : Practice trust, empathy , respect and
compassion with persons, care givers , health
professionals and populations

51. •VE 8 : Apply high standards of ethical conduct and
quality in contributions to team based care

52. •VE 9 : Maintain competence in ones own profession
in order to contribute to interprofessional care

53. •VE 10 : Contribute to a just culture that fosters self
fulfilment , collegiality and civility across the team

54. •VE 11: Support a workplace where differences are
respected , career satisfaction is supported and well
being is prioritized

55. Value and Ethics in
Interprofessional Practices
Building a Foundation for
Collaborative and Ethical Healthcare

56. Core Values in Interprofessional
Practices
•Respect for Roles: Recognizing and valuing
the unique expertise of each professional.
•Eg: A nurse identifying a subtle change in a
patient’s condition and the physician valuing
and acting on that observation

57. •Collaboration: Sharing knowledge and
responsibilities for better patient outcomes.
•Eg: A dietitian working with a physician and
physical therapist to develop a comprehensive
recovery plan for a post-surgery patient.

58. •Patient-Centered Care: Focusing on the
needs, values, and choices of patients.
•Eg: A social worker assisting a patient with
access to community resources based on their
financial and cultural needs.

59. •Transparency: Open communication within
the team and with patients.

60. Ethics in Interprofessional
Practices
•Confidentiality: Ensuring patient data is
shared securely among team members.
•Integrity: Upholding honesty and ethical
conduct in all decisions.
•Accountability: Taking responsibility for
individual and team actions.
•Equity: Providing unbiased and fair care to all
patients.

61. Ethical Challenges and Solutions
•Challenge: Conflicting opinions on treatment
plans.
• Solution: Regular team meetings to discuss and
reach consensus, keeping patient welfare as the
focus.
•Challenge: Maintaining confidentiality in large
teams.
• Solution: Adopting secure communication
platforms for information sharing.

62. •Challenge: Navigating cultural differences
within the team and with patients.
• Solution: Providing cultural competence
training for all team members.

63. Benefits of Values and Ethics
•Enhanced Teamwork: Building trust and
cohesion among team members.
•Improved Patient Outcomes: Delivering
holistic, well-rounded care.
•Ethical Practices: Ensuring fairness,
transparency, and accountability in healthcare
delivery.
•Sustainability: Promoting long-term
collaboration and professional satisfaction.

64. Conclusion
•Values and ethics are the cornerstone of
interprofessional practices. By fostering
respect, collaboration, and accountability,
healthcare teams can deliver equitable,
effective, and patient-centered care,
ultimately enhancing the well-being of
individuals and communities.

65. •The fact of caring about the needs and
happiness of other people more than your
own
_ l_ _u_ _m

66. •Altruism

67. •The quality of Being Honest and Having strong
moral Principles is called as___________

68. •INTEGRITY

69. •Sita who is diagnosed to have Breast cancer
was counselled about the same and explained
best options for treatment.She prefers to go
with chemotherapy.
•This is _u_ _n_ _y

70. •AUTONOMY

71. •Duty of a health provider to do good to the
patient is called ________________

72. •BENEFICENCE

73. •Refusing to write a medication to a patient if
it has not been proven to be effective is called as
_________________

75. •Non-Maleficence- Do not do any harm