Ethical Guidelines for the Quality Assessment of Healthcare

Ethical Guidelines for the Quality Assessment of Healthcare

Amit Chattopadhyay, Khushdeep Malhotra, Sharmila Chatterjee
DOI: 10.4018/978-1-61350-120-7.ch006
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Abstract

One of the keystone concepts of healthcare improvement is the belief that informed choices will lead to enhanced quality of life and healthcare. Medical Ethics, or Bioethics, is the study of moral issues in the fields of medical treatment and research. It is also used to describe ethical issues in the life sciences and the distribution of scarce medical resources. This chapter will review and describe the principles of ethics and discuss how ethical principles can be used as guidelines for the quality assessment of healthcare provision. It will also discuss areas such as: ethical handling of information, patient safety, communication, obligation for impartial quality assessment, private health information protection, ethical committees and supervision authorities, competence of the assessor, supervision of ethical guidelines for health quality assessment, research and publication ethics, and global ethics of healthcare. Another goal of the manuscript will be to serve as a central reference to access of information about resources related to this topic.
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Introduction

As a branch of Philosophy, Ethics guides the leading of a good life. Ethics also guides moral conduct in life. Applied Ethics, on the other hand, is a discipline that guides application of ethical theory to real-life situations. Medical Ethics or Bioethics, studies the role of value judgments and “moral issues in the fields of medical treatment and research. The term is also sometimes used more generally to describe ethical issues in the life sciences and the distribution of scarce medical resources. The professional fields that deal with ethical issues in medicine include medicine, nursing, law, sociology, philosophy, and theology, though today medical ethics is also recognized as its own discipline” (McGee & Caplan, 2007). Over time, Bioethics has grown as a discipline and its practitioners play important roles in clinical decision making, research studies, legislature, professional organizations, and community activities; in academia, government, non-governmental organizations and industry. Events that have shaped the development of Bioethics as a discipline over time are outlined in Table 1.

Table 1.
Developments in Bioethics – A timeline
YearDevelopmentResource for Further Reading
1947The Nuremberg Codehttp://ohsr.od.nih.gov/guidelines/nuremberg.html
1964The Declaration of Helsinkihttp://ohsr.od.nih.gov/guidelines/helsinki.html
1966Animal Welfare Acthttp://www.aphis.usda.gov/animal_welfare/awa.shtml
1974National Research Acthttp://www.hhs.gov/ohrp/irb/irb_introduction.htm
1979The Belmont Reporthttp://ohsr.od.nih.gov/guidelines/belmont.html)
2009 (update)US Code of Federal Regulations
Title 45 Public Welfare
Part 46 Protection of Human Subjects
http://www.hhs.gov/ohrp/humansubjects/guidance/45cfr46.htm
1995National Bioethics Advisory
Commission- Ethical and Policy
Issues in International Research:
Clinical Trials in Developing Countries
http://bioethics.georgetown.edu/nbac/human/overvol1.html
1997International Conference
on Harmonization: Guidance Documents
http://www.fda.gov/regulatoryinformation/guidances/ucm122049.htm
2002Council for International
Organizations of Medical Sciences (CIOMS) guidelines
http://www.cioms.ch/publications/layout_guide2002.pdf
2002Nuffield Council on Bioethics-
The Ethics of Research Related
to Healthcare in Developing
Countries
http://www.nuffieldbioethics.org/fileLibrary/pdf/errhdc_fullreport001.pdf
2003HIV Trials Prevention Network-
Ethics Guidance for Research
http://www.hptn.org/web%20documents/EWG/HPTNEthicsGuidanceFINAL15April2003.pdf)

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