scholarly journals Charting Spiritual Care: Ethical Perspectives

2020 ◽  
pp. 199-211
Author(s):  
Guy Jobin
Keyword(s):  
Decision Making ◽  
Life History ◽  
Clinical Practice ◽  
Electronic Health Records ◽  
Ethical Issues ◽  
Care Team ◽  
Decision Making Process ◽  
Note Taking ◽  
Health Records ◽  
Joint Decision

Abstract The introduction of electronic health records (EHRs) into clinical practice appears to be irreversible. Where EHRs are used, chaplains have cooperated willingly with this way of reporting and sharing information with other members of the care team. They will have to, as a result, adapt their own note-taking practices to ensure effective, relevant and meaningful communication as part of the joint decision-making process. Although the specialized literature has addressed some of the “classic” ethical issues raised by EHRs, in particular those in connection with confidentiality and access, other questions, no less crucial, have received less attention and are addressed here. They include questions about the recognition of all players in the care relationship (both patients and caregivers) as subjects, and the communication of “non-generic” information about emotions, values, life history, etc. The fact that chaplains contribute to EHRs is both a sign of and a vector for recognition of their work within healthcare institutions – yet a recognition that could involve a price to pay for chaplains and patients.

Identifying and Addressing Ethical Issues with Use of Electronic Health Records

2018 ◽  
Vol 23 (1) ◽  
Author(s):  
Susan McBride ◽  
Mari Tietze ◽  
Catherine Robichaux ◽  
Liz Stokes ◽  
Eileen Weber
Keyword(s):  
Decision Making ◽  
Electronic Health Records ◽  
Clinical Decision Making ◽  
Ethical Decision Making ◽  
Ethical Issues ◽  
Clinical Care ◽  
The United States ◽  
Unintended Consequences ◽  
Health Records ◽  
Electronic Health

With the passage of the Health Information Technology for Economic and Clinical Health Act in 2009, the United States, as of 2017, has achieved 95% saturation with electronic health records as a means to document healthcare delivery in acute care hospitals and guide clinical decision making. Evidence is mounting that EHRs are resulting in unintended consequences with patient safety implications. Clinical teams confront usability challenges that can present ethical issues requiring ethical decision-making models to support clinicians in appropriate action on behalf of safe, effective clinical care. The purpose of this article is to identify and address ethical issues raised by nurses in use of electronic health records. We provide a case scenario with application of the Four Component Model and describe a study of nurse experiences with the EHR. The nursing Code of Ethics, Nursing Scope and Standards, and Legal Implications are reviewed, and we conclude with recommendations and a call to action.

The Promise of Electronic Health Records to Promote Shared Decision Making: A Narrative Review and a Look Ahead

2018 ◽  
Vol 38 (8) ◽  
pp. 1040-1045 ◽  
Author(s):  
Alyce Mei-Shiuan Kuo ◽  
Berry Thavalathil ◽  
Glyn Elwyn ◽  
Zsuzsanna Nemeth ◽  
Stuti Dang
Keyword(s):  
Decision Making ◽  
Electronic Health Records ◽  
Shared Decision Making ◽  
Decisional Conflict ◽  
Shared Decision ◽  
Health Records ◽  
Look Ahead ◽  
The Face ◽  
Electronic Health ◽  
The Impact

Background. Shared decision making (SDM) involves the sharing of best available evidence between patients and providers in the face of difficult decisions. We examine outcomes that occur when electronic health records (EHRs) are purposefully used with the goal of improving SDM and detail which EHR functions can benefit SDM. Methods. A systematic search of PubMed yielded 1369 articles. Studies were included only if they used EHR interventions to support SDM and included results that showed impact on SDM. Articles were excluded if they did not measure the impact of the intervention on SDM or did not discuss how SDM had been supported by the EHR. Results. Five studies demonstrated improved clinical outcomes, positive lifestyle behavior changes, more deliberation from patients regarding use of imaging, and less decisional conflict about medication use among patients with use of EHRs aiding SDM. Discussion. Few EHRs have integrated SDM, and even fewer evaluations of these exist. EHRs have potential in supporting providers during all steps of SDM. The promise of EHRs to support SDM has yet to be fully exploited.

The Cable Contract

2013 ◽  
pp. 1-7
Author(s):  
Ravichandran Ramamoorthy
Keyword(s):  
Decision Making ◽  
Ethical Dilemma ◽  
Small Businesses ◽  
Ethical Issues ◽  
Personal Values ◽  
Moral Values ◽  
Decision Making Process ◽  
Government Organization ◽  
Key Stakeholders

The case deals with an ethical dilemma of an entrepreneur. Chandran, a qualified contractor, had secured an electrical contract from a premier government organization. It was a turnkey project to be executed in a given period of time. In the process of work, he comes across major problems. He could not abandon the project or compromise on his moral values. He wanted a way out to salvage this project that was slowly slipping from his control. This case examines the ethical issues that confront small businesses, employees, suppliers and key stakeholders of every organization and explores the mindset of participants, their personal values and their decision making rationale. The participants get an opportunity to identify with the difficult choices a business situation may throw when ethical mindset clashes with the decision making process.

scholarly journals Research using electronic health records: Balancing confidentiality and public good

2018 ◽  
Vol 10 (4) ◽  
pp. 288 ◽  
Author(s):  
Katharine A. Wallis ◽  
Kyle S. Eggleton ◽  
Susan M. Dovey ◽  
Sharon Leitch ◽  
Wayne K. Cunningham ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Ethical Issues ◽  
Personal Health Information ◽  
Personal Health ◽  
Quality And Safety ◽  
Patient Relationship ◽  
Health Records ◽  
Patient Consent ◽  
Information Research ◽  
Electronic Health

ABSTRACTGeneral practitioners are increasingly approached to participate in research and share de-identified patient information. Research using electronic health records has considerable potential for improving the quality and safety of patient care. Obtaining individual patient consent for the use of the information is usually not feasible. In this article we explore the ethical issues in using personal health information in research without patient consent including the threat to confidentially and the doctor-patient relationship, and we discuss how the risks can be minimised and managed drawing on our experience as general practitioners and researchers.

Simply Academic: Linking Reporting Environments

2008 ◽  
Vol 23 (3) ◽  
pp. 455-466 ◽  
Author(s):  
Martin T. Stuebs
Keyword(s):  
Decision Making ◽  
Financial Reporting ◽  
Ethical Issues ◽  
Ethical Dilemmas ◽  
Decision Making Process ◽  
Academic Environment ◽  
Reporting Environment

This instructional case attempts to connect the environmental incentives and ethical issues from two different reporting environments. It provides two different scenarios that allow students to identify and grapple with multiple incentives and resultant ethical dilemmas present in the academic reporting environment. A summary then requires students to link stakeholders, activities, incentives, and dilemmas in the academic environment to corresponding situations in the financial reporting environment. The purpose of the case is threefold: (1) It makes students aware of the incentives and ethical issues present in various reporting environments. (2) By explicitly linking the academic and financial reporting environments, students see the relevance of ethics in their current lives and are motivated to develop ethical habits now in order to prepare for the challenges that will occur later in their careers. (3) The case forces students to practice making decisions in situations with conflicting incentives and ambiguous or nonexistent legal guidance. Strong conflicting incentives can cloud and compromise even the purest of intentions. Dealing with these conflicts early and often can mature one's judgments and improve the decision-making process.

Negotiation as a Joint Decision-Making Process

1977 ◽  
Vol 21 (4) ◽  
pp. 619-638 ◽  
Author(s):  
William Zartman
Keyword(s):  
Decision Making ◽  
Decision Making Process ◽  
Joint Decision

Engaging older people in decisions about their healthcare: the case for shared decision making

2012 ◽  
Vol 22 (2) ◽  
pp. 99-107 ◽  
Author(s):  
Joanne Lally ◽  
Ellen Tullo
Keyword(s):  
Atrial Fibrillation ◽  
Decision Making ◽  
Clinical Practice ◽  
Healthcare Professional ◽  
Older People ◽  
Shared Decision Making ◽  
Clinical Condition ◽  
Decision Making Process ◽  
Shared Decision ◽  
Risks And Benefits

SummaryShared decision making in clinical practice involves both the healthcare professional, an expert in the clinical condition and the patient who is an expert in what is important to them. A consultation involving shared decision making enables an examination of the options available, consideration of the risks and benefits whilst incorporating the values of the patient into the decision making process. A decision is aimed at, which is both clinically appropriate and is congruent with the patient's values.Older people have been shown to value involvement, to varying degrees, in decisions about their care and treatment. The case of atrial fibrillation shows the opportunities for, and benefits of, sharing with older people decision making about their healthcare.

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