Question

What are ethical principles?  Are they specific to health information? Explain. What kind of ethical decision making questions should a health information management professional ask?

Answer 1

Professional values form the basis for the principles that are included in a code of ethics. Professional values for HIM (Health Information Management) include the importance of education and technical competency, patient safety, data validity and accuracy, truthfulness, compassion, and dedication to providing quality services in professional roles. Decision-making criteria for work decisions can include technological feasibility, reasonable cost, legality, available personnel expertise, standards of care, and organizational goals. The ethical decision is what should be done (the best action), given the competing interests, obligations, and values of others involved in making the decision. This criterion requires the professional to consider values that are beyond the personal and to take into account the values and perspectives of others who are involved.

The core ethical principles of beneficence (do good), nonmaleficence (do not harm), autonomy (control by the individual), and justice (fairness) stated by Beauchamp and Childress are important to a code of ethics. A review of codes of ethics from 1957 to 2004 revealed the following values: providing service to others; protecting information; promoting confidentiality and teaching others of the importance of this principle; preserving and securing health information; promoting the quality and advancement of healthcare; reporting data with integrity and accuracy; promoting interdisciplinary cooperation and collaboration; demonstrating loyalty; complying with laws, regulations, and policies; recognizing the authority and responsibilities of the HIM professional; advocating for needed changes in the health information system; refusing to participate in or to conceal unethical or illegal activities; reporting violations of practice standards to the proper authorities; being honest about credentials, degrees, certifications, and work experiences; bringing honor to self, peers, and the profession; committing to continuing education and lifelong learning; discharging association duties honorably; strengthening professional membership; representing the role of the profession to the public; and promoting and participating in research. The code of ethics of the American Health Information Management Association (AHIMA) that was passed in 2011 includes these same values.

Generally, ethics questions arise when the right thing to do is not clear or when people disagree about what is best for a person who is ill. Some examples of common ethical questions include:

• When should life-sustaining treatments like breathing machines or feeding tubes be started, continued, or stopped?
• What should family members and health care professionals do if a patient refuses treatment that promises to be medically helpful?
• Who should make health care decisions for patients when they are unable to communicate or decide for themselves?
• What should patients do when they do not understand what professionals are saying and feel they are not offered the opportunity to participate in their own health care decisions?