c. j. tai
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Dynamic Moral Status among Hospital, Patient and Physician. Chih-Jaan Tai, MD., MSc. Department of Health Services Administration, China Medical University, Taiwan Department of Otolaryngology, China Medical University Hospital, Taiwan. C. J. TAI. Contents. - PowerPoint PPT PresentationTRANSCRIPT
C. J. TAIC. J. TAI
Chih-Jaan Tai, MD., MSc.
Department of Health Services Administration, China Medical University, TaiwanDepartment of Otolaryngology, China Medical University Hospital, Taiwan
Dynamic Moral Status among Hospital, Patient and Physician
2007/3/21
C. J. TAI
Contents
The dynamic status among the principles of medical ethics
The dynamic status between physician and patient
The dynamic status between hospital and patient The dynamic status from society to patient
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Preface: The movement of medical ethics
BC 460 Non-maleficence: “Do no harm” by Hippocrates ~ AD 1900s Beneficence:
from passive to active paternalism and moral attitude
AD 1950s-70s Autonomy: Nuremberg code Patient bill of right
AD 1980 Fidelity: Confidentiality, veracity AMA: from paternalism to patient rights
AD 1999 Non-maleficence: IOM “ To err is human”, Patient safety
AD 2000s Justice: Resource allocation
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The Ethical Obligation of Physician
Prima facie principles Beneficence Non-maleficence Respect for autonomy Justice
Dilemma in practice
Priority among principles?
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Between Physician and Patient
Dilemmas
Patient’s autonomy versus professional value and professionalism
Respect for autonomy versus beneficence
Disclosure of information to patient
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Between Physician and Hospital
Partnership or employment
Dilemma: employee’s loyalty and professional ethical requirement
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Between Hospital and Patient
Cost contain from the third party payer
Managed care: gatekeeper, case management, utilization review, practice profile
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Physician to Society
Does physician have social obligation?
Narrow physician-individual patient framework or have to consider family, community, and the general society?
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Hospital to Society
Service, but not profitability
Maximize community benefits
Protect the commonweal
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Dilemmas in hospital administration
Profit or services
Market share to survive
No margin, no mission?
Resources allocation and resources restraint
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Patient to Society
Patient’s social obligation
Equally treated and resource allocation
Resource restraint