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Essay Instructions: Instructions
requesting JOwriter63 to do this paper

Patient rights include the right to informed consent, which entails that patients receive adequate information to make medical decisions. But many questions can arise if patients appear to lack the capacity to understand their medical condition or options. How is capacity determined? Who decides on behalf of the patient if the patient is determined to lack capacity? How should a surrogate decide on behalf of a patient?

In this Application Assignment, you will analyze the legal and ethical issues around patient capacity and surrogate decision making by focusing on the following scenario:

An 83-year-old diabetic male, Mr. Jones, is brought in to the emergency department because of respiratory distress, by his care-giving daughter, with whom he lives. In examining him, the emergency department physician discovers that Mr. Jones has gangrene on his right foot up to his ankle.

Mr. Jones' daughter reports that her father has been diagnosed with Alzheimer's disease. A preliminary capacity assessment is consistent with mild dementia, but one of the nurses suggests that Mr. Jones' confusion might be the result of his respiratory distress, coupled with the disorienting atmosphere of the emergency department.

The clinical recommendation is to perform a below-the-knee amputation. The patient refuses this surgery, saying he has lived long enough and wants to die with his body intact. His daughter disagrees and says she wants everything done so that she can take him home as soon as possible, and says that she will sue the hospital if they do not perform the amputation. A social worker comments that the daughter might be afraid of an elder-neglect investigation if her father dies.

Mr. Jones does not have an advance directive of any kind and is not under guardianship. Assume that the applicable law in your state is the same as Sections 5, 7, and 11, of the Uniform Health-Care Decisions Act, available at http://www.law.upenn.edu/bll/archives/ulc/fnact99/1990s/uhcda93.htm

To prepare for the Application:


Review Appelbaum, P. S. (2007). Assessment of patients' competence to consent to treatment. New England Journal of Medicine, 357(18), 1834?40.
Also review the section of the Merck Manual on surrogate decision making, http://www.merck.com/mmhe/sec01/ch009/ch009f.html. Refer to these readings as well as to the laws as described in Sections 5, 7, and 11 of the Uniform Health-Care Decisions Act in order to identify legal and ethical issues that apply to the scenario above.
Consider the role that capacity assessment must play in health care. Why is it important? What are the consequences of not adequately assessing a patient's capacity?
Read Chapter 4, "Health Care Ethics Committee," in Legal and Ethical Issues for Health Professionals (required reading in Week 6). In what ways would a health care consultation or committee be able to address the ethical challenges in this scenario? How do you think a bioethicist would deal with this case in terms of the procedures he or she would engage in?

This is the question to be answered...in terms of the legal and ethical issue please define them and relate it to the scenario to answer the question. For eg is Malpractice is a legal aspect define it in answering the question.



To complete this Application Assignment, write a 3- to 4-page paper in which you would address the following questions:
What are the relevant legal issues at stake? What are the legal rights of the patient and his daughter?
What are the relevant ethical issues at stake?
Why does capacity assessment matter?
How might the hospital's ethics committee or ethics consultation service help in addressing this? Include a description of how an ethics consultant or committee might become involved in this case.





Please use these resources along with what you have


Appelbaum, P. S. (2007). Assessment of patients' competence to consent to treatment. New England Journal of Medicine, 357(18), 1834?1840. Retrieved from http://proquest.umi.com.ezp.waldenulibrary.org/pqdweb?did=1&sid=1&Fmt=4&clientId=70192&RQT=309&VName=PQD
Also available at http://www.nejm.org/doi/pdf/10.1056/NEJMcp074045 as a PDF document.

This article discusses legal and ethical issues that arise in the challenge of assessing a patient's capacity or competence to understand health care options and give consent.
Article: Coiera, E., & Clarke, R. (2004). e-Consent: The design and implementation of consumer consent mechanisms in an electronic environment. JAMIA: Journal of the American Medical Informatics Association, 11(2), 129?140. Retrieved from http://jamia.bmj.com.ezp.waldenulibrary.org/content/11/2/129.full.pdf


Caring Connections: What Are Advance Directives?
http://www.caringinfo.org/i4a/pages/index.cfm?pageid=3285

This website explains the meaning of advance directives and offers tips for personally developing an advance directive.
Caring Connections: Download Your State's Advance Directives
http://www.caringinfo.org/i4a/pages/index.cfm?pageid=3289

This website provides access to advance directives in states across the U.S. Use this site for one of this week's Discussion options.
Merck Manual: Surrogate Decision Making
http://www.merckmanuals.com/home/sec01/ch009/ch009f.html



Hampton, T. (2008). Groups push physicians and patients to embrace electronic health records. JAMA: Journal of the American Medical Association, 299(5), 507?509. Retrieved from http://jama.ama-assn.org.ezp.waldenulibrary.org/cgi/content/full/299/5/507?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=hipaa+health+information+patient+2009&searchid=1&FIRSTINDEX=10&resourcetype=HWCIT



Please use APA format for referencing.



This article discusses the unresolved issues, including privacy concerns, that have slowed the adoption of electronic health records by health care providers and organizations, as well as by patients.
Article: Rothstein, M. A., & Talbott, M. K. (2006). Compelled disclosure of health information: Protecting against the greatest potential threat to privacy. JAMA: Journal of the American Medical Association, 295(24), 2882?2885.
Retrieved from http://jama.ama-assn.org.ezp.waldenulibrary.org/cgi/content/full/295/24/2882?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=hipaa+health+information+patient+2009&searchid=1&FIRSTINDEX=10&resourcetype=HWCIT
This article examines the challenges that the electronic health record poses to patient health information privacy and confidentiality.

Essay Instructions: White Paper

Security and Control of Health Data for Euclid Hospital

Euclid Hospital has a longstanding commitment to the Boone County, Texas community. Last year alone, it provided care for 5,320 hospitalized patients, 2,593 surgical patients, and 25, 699 emergency patients. Beyond sheer numbers, it demonstrates daily its commitment to quality care and patient satisfaction. In 2001, Euclid Hospital received a three-year accreditation from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the nation?s leading independent standards-setting and accrediting body.

The hospital keeps striving to improve quality and continuously elicits feedback from patients about the care it provides. On a quarterly basis, it compares patient satisfaction scores against prior scores, as well as against other hospitals in the system and hundreds of hospitals in a national database. Consistently, Euclid Hospital achieves high scores, which compare favorably with its peers.

It?s also committed to bringing the community the latest advances in medicine and excellence in patient care, comfort, and convenience. It recently introduced highly advanced surgical interventions and new diagnostic testing capabilities. It also recently renovated and expanded the emergency room with a new outpatient registration area. The hospital has its first-ever contract with Reed Physicians Medical Group, as well as a longstanding relationship with Russell Medical Group.

Euclid Hospital believes it?s important to be a good corporate citizen. Its financial contributions to the local economy exceed $43.5 million annually. Its provision of charity and discounted care totals more than $212 million annually. In addition, it supports and sponsors local community efforts.

In an effort to maintain a successful profile in the local health-care community, the chief executive office (CEO) and the chief information officer (CIO) have some concerns about the legacy information system becoming dated, and may also have concerns about health data security.

As a manager of health information, the CIO asked you to prepare a white paper on the protection of Euclid?s health data. You?ve been instructed that the paper is to be no longer than 10 pages and conventionally reference with timely information.

The CIO has given you this working outline of the minimum topics to be addressed in the paper:

Health-Care Data at Euclid Hospital
Security and Control
A White Paper

I. Introduction ? Protecting Health-Care Data
II. Privacy and Confidentiality of Health-Care Data
a. Legislative Protection of Privacy
b. Patient Rights
c. Access to Health-Care Data
d. Health Insurance Portability and Accountability Act (HIPPA)
III. Security Fundamentals
a. Protecting Informational Privacy
i. Unauthorized User Activity
ii. Downloaded Files
iii. Trojan Horses
iv. Informational Privacy Models
b. Protecting Data Integrity
c. Ensuring Data Availability
IV. Establishing A Security Program
a. Components of a Security Program
i. Determining the scope of the security program
ii. Security Program Organization
iii. Security Policies, Procedures and Standards
V. Risk Analysis and Management
a. Risk Analysis
i. Identification of Assets
ii. Evaluating Information Assets
iii. Risk-Analysis Methods
iv. Sample Risk assessment
b. Development of Countermeasures
VI. Conclusions on Protecting Health-Care Information at Euclid Hospital




Reference Book:

Information Management for Health Professions, 2nd Edition, Merida L. Johns
Delmar ? Thompson Learning
Chapter 9: Security, Audit and Control of Health Data
(will e-mail this chapter to you as it will be needed to write the white paper)

Essay Instructions: Select one of these leading ethical issues to explore using the decision-making framework. Please be specific about the issue that you are focusing on in your narrative. Prepare a minimum 3- 5 page, double-spaced paper and submit it to your Assignments Folder as an Here are some suggested issues-
1. Privacy on the Web. What is happening now in terms of privacy on the Web? Think about recent abuses and improvements. Describe and evaluate Web site policies, technical and privacy policy protections, and current proposals for government regulations.
2. Personal Data Privacy Regulations in Other Countries. Report on personal data privacy regulations, Web site privacy policies, and governmental/law enforcement about access to personal data in one or more countries; e.g., the European Union. This is especially relevant as our global economic community expands and we are more dependent on non-US clients for e-business over the Internet.
3. Spam. Describe new technical solutions and the current state of regulation. Consider the relevance of freedom of speech. Discuss the roles of technical and legislative solutions.
4. Computer-Based Crimes. Discuss the most prevalent types of computer crimes, such as Phishing. Analyze why and how these can occur. Describe protective measures that might assist in preventing or mitigating these types of crimes.
5. Government surveillance of the Internet. The 9/11 attacks on the US in 2001 brought many new laws and permits more government surveillance of the Internet. Is this a good idea?
6. The Digital Divide. Does it exist; what does it look like; and, what are the ethical considerations and impact?
7. Privacy in the Workplace: Monitoring Employee Web and E-Mail Use. What are current opinions concerning monitoring employee computer use. What policies are employers using? Should this be authorized or not?
8. Medical Privacy. Who owns your medical history? What is the state of current legislation to protect your health information? Is it sufficient? There are new incentives with federal stimulus financing for health care organizations to develop and implement digital health records.
9. Software piracy. How many of you have ever made an unauthorized copy of software, downloaded software or music (free or for a fee), or used copyrighted information without giving proper credit or asking permission? Was this illegal or just wrong? How is this being addressed?
10. Predictions for Ethical IT Dilemma in 2020. What is your biggest worry or your prediction for ethical concerns of the future related to information technology?
11. Consumer Profiling. With every purchase you make, every Web site you visit, your preferences are being profiled. What is your opinion regarding the legal authority of these organizations to collect and aggregate this data?
12. Biometrics & Ethics. Your fingerprint, retinal-vessel image, and DNA map can exist entirely as a digital image in a computer, on a network, or in the infosphere. What new and old ethical problems must we address?
13. Ethical Corporations. Can corporations be ethical? Why or why not?
14. Social Networking. What are some of the ethical issues surrounding using new social networks? How are these now considered for business use? What are business social communities? Are new/different protections and security needed for these networks?
15. Gambling in Cyberspace. Is it legal? Are there national regulations and/or licensing? What are the oversight and enforcement requirements? Are there international implications? What are the social and public health issues?
16. Pornography in Cyberspace For example, the U.S. Supreme Court ruling protecting as free speech computer-generated child pornography
17. Medicine and Psychiatry in Cyberspace. Some considerations include: privacy issues; security; third-party record-keeping; electronic medical records; access to information, even by the patient (patient rights); access to information by outsiders without patient knowledge; authority to transfer and/or share information. Are there any policies proposed by professional organizations?
18. Counterterrorism and Information Systems Your protection versus your rights
19. Open-source Software versus Closed-source Software Ethical ramifications and impact on intellectual property law
20. Creative Commons Licenses How do they work and what are the legal and ethical impacts and concerns?
21. Universal ID Card. What is the general position of the U.S. government about issuing each individual a unique ID Card? Which individual U.S. government agencies have already provided a unique ID Card? What steps have been taken to include individual ID information electronically in passports? How is privacy and security provided?
22. Federal and State Law Enforcement?s Role to enforce computer-based crime.













attached Microsoft Word file. Remember to select one of the four common approaches to ethical decision making [elaborated in your textbook (Chapter 1, Table 1-5; see also Appendix A)] and explain why you chose that approach?how it fits with the issue?to help decision makers find the right balance concerning the acceptability of their actions.
Indicate appropriate American Psychological Association (APA) reference citations for all sources you use. In addition to critical thinking and analysis skills, your paper should reflect appropriate grammar and spelling, good organization, and proper business-writing style.

? Describe a current IT-related ethical issue; and define a problem statement
? Apply the decision-making process?see especially the Framework in Reynolds, pp. 16 ? 20. Note: A framework provides a methodical approach for developing a problem statement, identifying alternatives, evaluating and choosing alternatives, and implementing the decision, and evaluating results.
? Consider the impact of the decision on you, your organization, stakeholders, your customers and suppliers, and he environment
? State the approach that comes closest to your ethical decision an dprovide your rationale using one of the four common approaches.

This process may be applied to real-world situations. First, apply the model; then use one of the four common approaches in implementing your decision.
Here are some suggested issues-
1. Privacy on the Web. What is happening now in terms of privacy on the Web? Think about recent abuses and improvements. Describe and evaluate Web site policies, technical and privacy policy protections, and current proposals for government regulations.
2. Personal Data Privacy Regulations in Other Countries. Report on personal data privacy regulations, Web site privacy policies, and governmental/law enforcement about access to personal data in one or more countries; e.g., the European Union. This is especially relevant as our global economic community expands and we are more dependent on non-US clients for e-business over the Internet.
3. Spam. Describe new technical solutions and the current state of regulation. Consider the relevance of freedom of speech. Discuss the roles of technical and legislative solutions.
4. Computer-Based Crimes. Discuss the most prevalent types of computer crimes, such as Phishing. Analyze why and how these can occur. Describe protective measures that might assist in preventing or mitigating these types of crimes.
5. Government surveillance of the Internet. The 9/11 attacks on the US in 2001 brought many new laws and permits more government surveillance of the Internet. Is this a good idea?
6. The Digital Divide. Does it exist; what does it look like; and, what are the ethical considerations and impact?
7. Privacy in the Workplace: Monitoring Employee Web and E-Mail Use. What are current opinions concerning monitoring employee computer use. What policies are employers using? Should this be authorized or not?
8. Medical Privacy. Who owns your medical history? What is the state of current legislation to protect your health information? Is it sufficient? There are new incentives with federal stimulus financing for health care organizations to develop and implement digital health records.
9. Software piracy. How many of you have ever made an unauthorized copy of software, downloaded software or music (free or for a fee), or used copyrighted information without giving proper credit or asking permission? Was this illegal or just wrong? How is this being addressed?
10. Predictions for Ethical IT Dilemma in 2020. What is your biggest worry or your prediction for ethical concerns of the future related to information technology?
11. Consumer Profiling. With every purchase you make, every Web site you visit, your preferences are being profiled. What is your opinion regarding the legal authority of these organizations to collect and aggregate this data?
12. Biometrics & Ethics. Your fingerprint, retinal-vessel image, and DNA map can exist entirely as a digital image in a computer, on a network, or in the infosphere. What new and old ethical problems must we address?
13. Ethical Corporations. Can corporations be ethical? Why or why not?
14. Social Networking. What are some of the ethical issues surrounding using new social networks? How are these now considered for business use? What are business social communities? Are new/different protections and security needed for these networks?
15. Gambling in Cyberspace. Is it legal? Are there national regulations and/or licensing? What are the oversight and enforcement requirements? Are there international implications? What are the social and public health issues?
16. Pornography in Cyberspace For example, the U.S. Supreme Court ruling protecting as free speech computer-generated child pornography
17. Medicine and Psychiatry in Cyberspace. Some considerations include: privacy issues; security; third-party record-keeping; electronic medical records; access to information, even by the patient (patient rights); access to information by outsiders without patient knowledge; authority to transfer and/or share information. Are there any policies proposed by professional organizations?
18. Counterterrorism and Information Systems Your protection versus your rights
19. Open-source Software versus Closed-source Software Ethical ramifications and impact on intellectual property law
20. Creative Commons Licenses How do they work and what are the legal and ethical impacts and concerns?
21. Universal ID Card. What is the general position of the U.S. government about issuing each individual a unique ID Card? Which individual U.S. government agencies have already provided a unique ID Card? What steps have been taken to include individual ID information electronically in passports? How is privacy and security provided?
22. Federal and State Law Enforcement?s Role to enforce computer-based crime.

Essay Instructions: Instructions:

1.Review the ethical decision-making scenarios attached below.
2.Each scenario has a word minimum of 1000 words.

SCENARIOS:
1. A medical imaging professional, whom coworkers and the supervisor suspect of having an alcohol problem, appears at work with an alcohol smell on his breath, compromised gait, and slightly slurred speech. The supervisor pulls him aside, specifically identifies the signs he has outwardly observed, reminds the employee that, according to the substance abuse policy, this is grounds for drug testing, and requests that the employee undergo a blood test. The employee refuses to cooperate with his request. Is this insubordination, or would the testing be a violation of the professional’s rights?

2. A medical imaging professional who works for a mobile imaging company is given a company-owned vehicle to drive as part of his employment contract. The company begins receiving complaints from several of their clients that this professional is drinking on the job, and is also suspected of snorting cocaine while working. One day after work, a representative for the company goes to his house, when the company car is parked and requests to search the vehicle. The medical imaging professional refuses the request. Is this an ethical issue, a legal issue, or both? Who is right? Can an employee refuse to cooperate without risking being charged with insubordination or another similar policy violation?

The following guidelines will be used to submit your project:

Use this modified Dowd Model:
Dowd Model Step-by-Step Approach to Ethical Decision Making

Society is asking for greater accountability from all professionals12.Hence, the greater need for education and training in resolving ethical problems in the workplace. In the allied health sciences, authors like Patterson and Vitello12, Golden13, Purtilo5, and Dowd14 have presented simple step-by-step processes to assist in ethical decision making.
The Dowd Model specifically addresses ethical problem solving as it relates to those in the medical imaging profession. It consists of six steps. These steps have been adjusted for your use in responding to the hypotheticals below. Please address each of these issues in your responses.
Step 1??"Assessment of the Problem what is the ethical context in which this situation occurred? This requires a determination as to which type of ethical problem is occurring (ethical dilemma, ethical dilemma of justice, ethical distress, or locus of authority issue).
Step 2??"Isolation of the Issues At this point, issues that are significant to the situation must be separated from those that are insignificant. A determination as to what values should be maximized should also be made. Consideration must be given as to which of the ethical principles are involved, which patient rights are being compromised, if any, and which principle or area of your professional code of ethics or conduct covers your behavior in situations of this type. You should also address the ultimate meaning of the problem for the people involved. What are the long term interests to be considered for the employee, patient, doctor, or hospital. Why should we care about this problem?
Step 3??"Analysis of the Data In this step, all pertinent information should be separated from pure conjecture. Only facts as they relate to the problem should be examined; all other issues should be deleted. List the facts and assign them under headings such as, but not limited to, the following:
•
Ethical value promoted or compromised
•
Rights of the patient violated or supported
•
Your particular medical imaging professional code of ethics or conduct violated or supported
•
Institutional policies and/or procedures upheld or desecrated
Step 4??"Development of a Plan of Action In this step, a decision should be made as to what options are available to solve the problem. Remember, you can only do one thing at a time, so a choice must be made. It should, of course, be the best ethically, from all the available alternatives. Here you should be listing all the possible options of what could be done.
Step 5??"Institution of the Plan At this step, proceed with your solution. Go ahead and do it. Hopefully, you have made the correct decision based on the due process provided in steps 1 through 5. Obviously you will not be able to actually institute the plan. However, you should choose from among the plans you outline in Step 4. Make sure to explain why you think the chosen plan of action is the best.


Thank you! :)
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