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1. LEGAL, ETHICAL, AND PROFESSIONAL ISSUES IN HEALTHCARE
LEGAL, ETHICAL, AND PROFESSIONAL ISSUES IN HEALTHCAREOrder
DescriptionQuestionUse the readings to evaluate the philosophical and theoretical
underpinnings of ethical decision-making and compare and contrast two differing essential
features or core principles of medical and behavioral ethical codes.ResponseIn a study of
primary care physicians, Rolfsen determined that ethical issues arise in a whopping 33% of
visits (2010). As if to emphasize the point, Rosenbaum agonizes regarding societal
expectations that place PCPs into ethical dilemmas (2011). As Joseph Des Jardins succinctly
explains, we need ethics to systematically analyze and answer questions such as, “ How
should I live?” and “ What should I do?” (2011).Ethical dilemmas in healthcare warrant a
deliberate and systematic examination of ethical components, including ethical gaps and
inadequacies, ethical standards, ethical philosophies, ethical perspectives, ethical processes,
and ethical approaches and decision-making (Runyan, Robinson, & Gould, 2013; Botes,
2000a; Botes, 2000b; O’ Donnell, 2013; Lawrence & Curlin, 2009)Freeman and McDonnell
introduce two philosophical approaches to ethical decision-making, utilitarianism and
deontology (2001). Quite simply, utilitarianism measures actions based on the value of the
consequences, and deontology measures actions based on the intention Freeman &
McDonnel, 2001; O’ Donnell, 2013; Lajeunesse & Lussier, 2010).Botes introduces two
ethical perspectives (2000a), ethics of justice and ethics of care. Ethics of justice is based on
concrete impartial rules, and ethics of care is grounded in empathy and context (Botes,
2000a; O’ Donnell, 2013). Both perspectives are inadequate in and of themselves; they
should both be considered during ethical discourse (Botes, 2000b).One of the Joint
Principles of the PCMH is grounded in patient-centered care (Braddock, Snyder, Neubauer,
& Fischer, 2012), and traditional principles of codes of ethics resonate with patient-
centeredness: justice, beneficence, nonmaleficence, and respect for patient autonomy
(Braddock, Snyder, Neubauer, & Fischer, 2012; O’ Donnell, 2013; Sokon, McFadzean,
Dickson, & Whitaker, 2011).Philosophical approaches (utilitarianism and deontology),
perspectives (ethics of justice and ethics of care), and principles of professional codes of
ethics are considered in ethical discourse. Incorporated are patient rights and perspective
(Barry & Edgman-Levitan, 2012) as well as provider telos, the virtues of the professional
(Botes, 200b; O’ Donnell, 2013).ReferencesBarry, M. & Edgman-Levitan, S.(2012). Shared
decision making– The pinnacle of patient-centered care. The New England Journal of

2. Medicine, (366)9, 780-781. Retrieved from
https://www.nejm.org.ezproxy1.lib.asu.edu/doi/pdf/10.1056/NEJMp1109283Botes, A.
(2000a). A comparison between the ethics of justice and the ethics of care. Journal of
Advanced Nursing, 32(5), 1071-1075. doi: 10.1046/j.1365-2648.2000.01576.xBotes, A.
(2000b). An integrated approach to ethical decision-making in the health team. Journal of
Advanced Nursing, 32(5), 1076-1082. doi: 10.1046/j.1365-2648.2000.01577.xBraddock, C.,
Snyder, L., Neubauer, R. L., & Fischer, G. S (2012). The patient-centered medical home: An
ethical analysis of principles and practice. Journal of Internal Medicine, (28)1, 141-146. doi:
10.1007/s11606-012-2170-xFreeman, J., & McDonnell, K. (2001). Ethical theory and
medical ethics. Tough decisions: Cases in medical ethics (pp. 185-211). New York, NY:
Oxford. Retrieved from https://myasucourses.asu.edu/Lawrence, R., & Curlin, F. (2009).
Physicians’ beliefs about conscience in medicine: A national survey. Academic Medicine,
84(9), 1276-1282.doi: 10.1097/ACM.0b013e3181b18dc5O’ Donnell, R. (2013). Modified by
L. Manson 2013. IBC 660: Healthcare legal, ethical, and professional issues: Theories of
ethics. [PowerPoint] retrieved from https://myasucourses.asu.edu/Richard, C., Lajeunesse,
Y., & Lussier, M. (2010). Therapeutic privilege: Between the ethics of lying and the practice
of truth. Journal of Medical Ethics, 36, 353-357. doi: 10.1136/jme.2009.033340Rolfsen M.L.
(2010). Ethics in the primary care office. Journal of Louisiana State Medical Society, 162, 26-
32. Retrieved from https://myasucourses.asu.edu/Rosenbaum, J. R. (2011). Daily dilemmas.
Annals of Internal Medicine, 155(12), 855-856. doi 10.7326/0003-4819-155-12-
201112200-00011Runyan, C., Robinson, P., & Gould, D.A. (2013). Ethical issues facing
providers in collaborative primary care settings. Families, Systems, and Health (31)1, 1-8.
doi: 10.1037/a0031895Sokol, D., McFadzean, W., Dickson, W., & Whitaker, I. (2011). Ethical
dilemmas in the acute setting: A framework for clinicians. BMJ. doi:
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