ILCTE Lesson Healthcare Ethics & Laws

Health Care Ethics & Laws

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Amanda Kilpatrick RN

Illinois CTE Endorsement Area: Health Science

Lesson Title: Healthcare Ethics and Laws

Lesson Author: Amanda Kilpatrick RN

ILCTE Leader and Lesson Consultant: Nance Budde RN

Lesson Created: June 2020

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Lesson Overview:

Do your students understand the importance of Ethics in Healthcare? They will explor e what ethical behavior looks like. They will have to make an “ethical” decision regarding who will receive a heart transplant from all the patients waiting on the transplant list. They will learn that it’s not always easy to make an ethical decision but realize the importance in Healthcare.

Responding to the immediate need of online resources, the ILCTE Innovative Curriculum Resources Project conducted a series of Professional Learning experiences. We wish to express our appreciation to the teachers for creating and sharing a lesson. This lesson is provided as a guide for online teaching. Click here to provide feedback on your implementation of this lesson.

Healthcare Ethics and Laws

What do you want the students to learn about this topic?

● Define key terms and key abbreviations related to healthcare ethics. ● Describe what ethical conduct looks like in healthcare. ● Explain how to prevent negligent acts while working in healthcare. ● Explain how to maintain professional boundaries necessary when working in healthcare.

Why do you think they need to know it (life skills, careers, etc.)?

● Knowledge of the code of ethics and nurse practice act is a required standard for Certified Nursing Assistants.

What Educational Standards are addressed?

National Health Science Standards: 2.1.2 Identify common barriers to communication. Students will have the ability to assess their own biases and stereotypes while examining case scenarios and choosing which patient is most appropriate for the heart transplant. 3.1.2 Examine the healthcare consumer’s rights and responsibilities within the healthcare system. Students will gain an understanding of individual and client’s rights in regard to ethics and prioritizing care of a patient(s). 4.1.1 Identify personal traits and attitudes desirable in a career ready member of a health team. Students will have the ability to reflect on their own beliefs and value system as a health care provider in making difficult choices related to medical care of clients.

Common Core ELA Standards CCSS.ELA-LITERACY.RST.11-12.7

Integrate and evaluate multiple sources of information presented in diverse formats and media (video, multimedia, print) in order to address a question or solve a problem.

Five years after graduation, what should they still know about this topic? How might they be using this knowledge/skill set?

● While practicing as a Certified Nursing Assistants it is important to maintain ethical behaviors and professional boundaries. ● Knowledge of ethical concepts and terminology is essential to ensure client safety and prevent misconduct.

Evaluate: (10 minutes) What do we need to see to be convinced that they know it?

1. Consider using a lecture worksheet found at the end of this lesson as a pre & post lesson assessment. Repeat as a post lesson assignment to validate learning of this material. This can be easily copy and pasted into a Google doc. 2. Using a shared google doc or similar resource, students will complete a matching terminology quiz or crossword puzzle appropriate to this lesson. Will need to develop a matching quiz or crossword puzzle for each student’s completion to assess for learning. ● Terminology for the matching quiz is found at the end of this lesson. (for matching quiz) https://www.turtlediary.com/reading-worksheet- generator/matching-lists.html ( for crossword puzzle) https://tools.atozteacherstuff.com/free-printable-crossword- puzzle-maker/ 3. A brief summary of ethical behaviors to include “how” the student will model those behaviors submitted online.

What class(s) or discipline(s) would be the most likely to do this lesson?

All Health Science Courses in the Career Pathway

What grade level do you feel would be most appropriate?

● Secondary students ● Post-Secondary students

Engage: (10-15 minutes) How will students get interested and excited about learning this material?

1. Consider using the lecture worksheet at the end of this lesson as a pre-lesson assessment. Ask students to keep their results to be able to change their answers as the lesson progresses. 2. Send students this link to a Grey’s Anatomy video (3:36)/ or current healthcare ethics news topics: https://www.youtube.com/watch?v=2D-K2twZwr8 Most students have seen Grey’s Anatomy so should be familiar with the show. 3. Be prepared to answer these questions:

● What did you think of the young man who had killed women offering his organs to a sick child? ● If someone you loved needed a transplant, would you accept this young man’s serious offer? ● How will you feel about taking care of prisoners in your hospital? ● Will you have any problem doing that? If yes, what? If no, why not? ● How did you feel about the sick child asking his doctor to tell his mother something good for that day even if it didn’t happen? ● Would you be willing to serve on your hospital’s Ethics Committee when you start working? If yes, why? If not, why not? Use Menti.com for individual quick 2-3-word answers. A discussion board will work well here also. You can also use Zoom & Google Meet breakout rooms and allow students to discuss as a group. Part I: #1-Bellringer: 1. Using the pin number given to you by your teacher, go to Menti.com and enter 2-3 words on what ethics means to you? 2. Using a 2 nd Menti.com question, enter what ethical behavior looks like to you? Discuss the use of the words appearing in Menti.com and relate terminology to the engagement activity of Grey’s Anatomy to assess what the students view of ethical vs unethical behaviors. There is also a glossary of terminology associated with this lesson, found at the end of this lesson. #2- Ethical dilemma scenario: “Who gets the Heart”? 1. In small groups/breakout sessions using Zoom or Google Meet have the students examine the activity (can also be done on a shareable google doc) and discuss several patients awaiting a heart transplant. The group should decide who should receive the heart transplant by putting the candidates in sequential order. Include reasoning of why each patient was assigned that number ● Discuss as a class using a Zoom or google meet, each group will report what place value was given to each patient. You will revisit this activity at the end of the Explore section. #3-Share with students your Lecture Notes/PowerPoint Presentation (share via google docs or whatever resource you typically use ) on ethics and key terms, defining ethical behavior. Consider developing a Quizlet to allow students to practice terminology at home on their own time. Quizlet also can allow for a matching game with the terms. You can consider assigning a corresponding chapter worksheet/guide for students to complete prior to next class. If you are using google docs, make it a shared worksheet for groups to work on. Explore: (60 minutes) What activities can be completed so that they experience and/or discover the material we want them to learn?

Consider developing a terminology crossword puzzle using this link: https://tools.atozteacherstuff.com/free-printable-crossword-puzzle-maker/ There are other free websites for developing your own crossword puzzles. #4- Allot time following completion of homework for students to revisit the scenario and make changes after the information learned from the lecture or discussion board sharing. Use a shared format for students to share their changes in the priority of who should receive the heart. Using a discussion board or preferably Zoom or Google meet, facilitate the heart scenario with the students on changes as a class to include rationales of why changes were made or not made and what patient would ultimately receive the heart transplant. Discuss the ethical dilemma with choosing a certain patient or not choosing them. Ask them to examine how they would feel if that was their relative and they did not receive the heart. How would they tell a family that their loved one was not chosen to receive the heart at this time? Explore the emotions involved with these decisions. Examine the student’s decisions and feelings on the subject and relate to different ethical dilemmas they may encounter working in Healthcare. #5- If you didn’t use the Quizlet matching activity for #3, this activity will match key terms and their definition. You will need to develop this Quizlet (unless there is something on Quizlet in shared files) or using the free matching quiz website, develop a short matching quiz: https://www.turtlediary.com/reading-worksheet-generator/matching-lists.html #6- Research and identify the healthcare professional standards and the healthcare provider traits & attitudes that would apply to the heart transplant scenarios. This can be through a discussion board or breakout rooms with student’s ideas recorded and shared when the group gets back together. This discussion should include the traits and attitudes a healthcare provider needs when making ethical decisions and understanding professional healthcare standards.

Explain: (10-15 minutes) What questions can they answer if they are beginning to understand this material?

Using Menti.com ask students to answer the following questions. You will have to develop a different Menti for each question which will have different pin numbers to enter.

● What 1-2 words describes ethical behavior? ● What 1-2 words describes a non-ethical behavior? ● Identify and define 3 key terms of ethics. ● Why should one person be chosen over another when considering a possible transplant recipient? ● Did you think the transplant scenarios presented an ethical dilemma?

Elaborate/Extend: (20-30 minutes) What situation can we set up so that students can build on their new knowledge to learn more? How can students use the knowledge/skill gained in this lesson to apply in other situations, for example in the “real world” or in other classes?

1. Students submit a brief summary of ethical behavior and “HOW” you plan to model those behaviors personally.

This can be a google doc or other online format for submission to you for evaluation. 2. Using a group meeting platform using breakout rooms, reflect on the material we just discussed. Be prepared to answer these questions and discuss when everyone comes back together. ● Did your group have any barriers in communication? ● Were there any personal bias or stereotypes involved in your discussions? ● Do you believe that there were any personal bias or stereotypes that needed to be put aside when making ethical decisions? If yes, what were they? If not, why not? ● Do your scenario patients waiting on the transplant list have any healthcare rights & responsibilities? If you are unsure, research this. If yes, what are they? If no, why not? ● Can you think of any additional example(s) of ethical dilemmas that could occur in the healthcare field? If yes, share with the group. ● What type of ethical dilemmas do you think you might encounter working in the healthcare field? ● Do you have to acknowledge and set professional boundaries for yourself? If yes, what are the boundaries? How will you be sure that you don’t cross the line of these boundaries? ● Have you heard of any ethics violations in the media lately? Take 5 minutes and research this. Meet with students after they have done their research and share their findings with the class in some type of group sharing platform.

Differentiation: How might this lesson be adapted to varying abilities?

● Provide website(s) with different ethical dilemmas for students having difficulty understanding the concept and applying it to this lesson plan. ● Videos for visual learner ● Menti, Kahoot, Quizlet or Quizizz gaming opportunities to reinforce material ● Individual activities such as matching or crossword puzzles.

Essential Employability Skills:

There are four essential employability skills: https://employabilityskills.org/wp- content/uploads/2020/03/Illinois-Essential-Handout.pdf ● Personal Ethic: integrity, respect, perseverance, positive attitude ● Work Ethic: dependability, professionalism

● Teamwork: critical thinking, effective and cooperative work ● Communication: active listening, clear communication

For this lesson, the focus is on Personal Ethic (integrity) & Work Ethics (professionalism), Teamwork (critical thinking) and Communication (verbal and non-verbal).

Skill

How it is addressed:

Personal ethic

Students will have to examine their own ethical beliefs and accept responsibility for the decisions they are making. Engage: Step 2 Students will learn the behaviors to act in a professional manner while dealing with difficult situations. Explore 1: Step 1 & 2 Explore 2: Step 1 The students will have the ability to work as a team, discuss and critically think about which client would be most appropriate to receive a heart transplant. Explore 2: Step 1 Explore #6 Elaborate #2 The students will have to listen and communicate with each other within their assigned breakout group and with the class when explaining their rationale for choosing the heart transplant patient they did. Explore 2: Step 1 Elaborate #2

Work Ethic

Teamwork

Communication

Resources Needed: What tools, materials, documents, etc. are needed to teach this lesson?

● Chromebook, phone or computer ● Zoom Platform or Google Meets (whatever platform you use that has ability to assign students to breakout sessions) ● Internet connectivity ● Pen and paper ● Handout “Who gets the heart?” ● Ethical dilemma scenario: https://www.youtube.com/watch?v=2D-K2twZwr8

Lecture Worksheet – you can copy this into a google quiz for students to take online prior to and at the end of the lesson to evaluate learning.

1. What does it mean to be prejudiced or biased? 2. separates helpful behavior from non-helpful behaviors. 3. ___________________________________ is the unlawful restraint or restriction of a person’s freedom of movement. 4. What is abuse? Name 3 types of abuse. What can it cause? 5. List 3 reasons vulnerable adults have problems caring for or protecting themselves

a. _____________________________________ b. _____________________________________ c. _____________________________________

6. Leaving a resident or client lying in a soiled brief this is an example of _________________. 7. A nursing assistant makes fun of and laughs at the way a resident or client talks and acts. This is ____________________________.

Answer Key 1. To make judgments and have views before knowing the facts 2. Professional boundaries 3. False imprisonment 4. Crime, physical harm, pain and/or mental anguish for the resident or client (physical, emotional, psychological, financial) 5. A mental, emotional, physical, or developmental disability, brain damage, changes from or related aging 6. Neglect 7. Emotional abuse

WHO GETS THE HEART ACTIVITY

Notes to Instructor: Divide into teams of about 3 to 5 before describing the activity or distributing handouts. Often it is best for the teacher to organize the groups – this helps ensure that all students are involved, and it encourages associations that might not otherwise occur.

Copy and paste this activity into a shared Google doc.

This activity deals with organ donation and transplantation, which is becoming more and more common and is recognized as a great way to improve health and prolong life for many people. If you can, you may

want to discuss personal experiences (self, family members, friends, acquaintances) who are potential donors or who have donated or been the recipients of this great program. Some of your students may want to share similar experiences.

This activity works well with any group, high school age or above.

Provide at least one copy of the handout to each group.

Encourage creative, outside the box, thinking. Encourage debate and even disagreement – this fosters great discussions. Anything goes, as long as everyone speaks English.

It’s interesting to list the preferences of each group on the board and then compare, discuss and debate.

Presentation to Students: You are members of the “Medical Science and Ethics Committee” in your city. Now, you have seven patients who desperately need a heart transplant if they are to have any chance of living. All seven patients live near your hospital and are classified as “critically ill.” Without a transplant he / she could die at any time. You have just received news that the heart of a 16-year-old boy who was killed in an auto accident has become available for transplantation. Speed is extremely important as you decide which of the following patients, on the list to be provided, is to receive the heart. Not only might one of the patients die, but the donor heart will soon begin to deteriorate.

Consider: The age and sex of the donor have no relationship to the age and sex of the recipient. In other words, the heart of the 16 year old would work well in a 50-year-old woman, etc.

Read the information about each patient carefully. Discuss why each person should receive the heart. Rank the patients in order of preference:

1 = first choice to receive the heart, to 7 = last to receive the heart

On back of the paper, record reasons each patient should or should not receive the heart.

Prepare a report and assign a group member to present it to the class. Remember, this is a life-or-death situation for many of these patients. You want your views to be clearly understood and considered.

Candidates for the Heart:

1. Amegneza Edorh, female, age 57: Mrs. Edorh, a renowned poet and novelist from Nigeria, received the 1987 Nobel Prize for literature. An inspiration throughout the developing world because of her anti-colonialist writings, Mrs. Edorh has been confined to bed for the past five months with steadily deteriorating health. (Married: four children between the ages of 30 and 37)

2. Soohan Kim, male, age 12: Soohan, a junior high school student from South Korea, was born with a congenital heart defect. Doctors wanted to wait until he was a teenager to replace his heart, but his condition has worsened dramatically. He is being kept alive on a heart-lung machine. 3. Al icia Pagan, female, age 27: Ms. Pagan’s heart problems, though recent, seem to have a genetic basis because her twin sister (patient 4) is similarly affected. Although Ms. Pagan is a promising Ph.D. student in biochemistry at Georgetown University, her failing heart and kidneys have caused her to drop out of school temporarily. (Unmarried) 4. Galia Feinstein, female, age 27: Mrs. Feinstein is Ms. Pagan’s twin sister. Mrs. Feinstein, who holds a Master’s degree from Harvard University in Computer Scien ce, currently operates a computer business with her husband. Mrs. Feinstein’s condition differs from that of her sister in that her kidneys have not been affected. (Married: one daughter, age 4) 5. Amahl Abdulah, male, age 34: Mr. Abdulah works for the Central Intelligence Agency (C.I.A.) and is considered the leading authority on Middle East military strategy. Like patient #2, Mr. Abdulah is being kept alive on a heart-lung machine. (He is a widower, his wife died in an Automobile accident and he has three children, ages 6, 3 and 2.). 6. Martha Rosales, female, age 23: Ms. Rosales’ heart problems originated from a bout he had with scarlet fever, a serious childhood disease, while growing up in the slums of New York. Unemployed and on welfare, Ms. Rosales raised money for her operation through the contributions of people in her neighborhood. (Never married, she has four children, ages 8, 6, 5 and 1) 7. Peter Jacobsen, male, age 42: Mr. Jacobsen’s family has a history of heart disease. His fath er died from a heart attack at age 39. Considered the leading scientist in the world in the area of bacteriological diseases, Mr. Jacobsen has already had one heart transplant operation. Since his body rejected that heart three weeks ago, Mr. Jacobsen has been kept alive by an artificial heart. (Never married, no children)

Quizlet Matching or Crossword Puzzle Activity

Abuse - willful infliction of injury, unreasonable confinement, intimidation or punishment with resulting physical harm, pain, or mental anguish

Assault - Unl awful threat or attempt to do bodily injury to another

Battery - touching a person's body without his or her consent

Boundary crossing- a brief act or behavior outside of the helpful zone, over-involved with the person

Boundary sign- an act, behavior, or thought that warns of a boundary crossing or violation

Boundary violation- an act or behavior that meets your needs, not the person's

Civil law- concerned with the relationships between people

Criminal law- laws concerned with offenses against the public and society in general

Crime- act that violates a criminal law

Defamation- injuring a person's name and reputation by making false statements to a third person

Ethics- Knowledge of what is right conduct and wrong conduct

False imprisonment- unlawful restraint or restriction of a person's freedom of movement

Fraud- doing something to trick, fool or deceive a person

Informed consent- process by which a person receives and understands information about a treatment, procedure and can decide if he or she will receive it

Intimate partner violence (IPV)- violence that occurs between individuals who maintain a romantic or sexual relationship

Invasion of privacy- violating a person's right not to have his or her name, photo, or private affairs exposed or made public without giving consent

Libel- a published false statement that is damaging to a person's reputation; a written defamation, i.e. newspaper, text, tv, online

Malpractice- Negligence by a professional person

Negligence- failure to take proper care in doing something (dropping dentures)

Slander- the action or crime of making a false spoken statement damaging to a person's reputation. (rumors)

Professional boundary- that which separates helpful behaviors from behaviors that are not helpful

Professional sexual misconduct- an act, behavior, or comment that is sexual in nature

Vulnerable adult- a person 18 years old or older who has a disability or condition that makes him or her at risk to be wounded, attacked, or damaged