2012-2013 Ethics and Professionalism I

<-- 2012-2013 MCH Competency Reflections

Lisa Parker, PhD spoke on the topic of Ethics & Professionalism. Dr. Parker, a philosopher and ethicist, is associate professor of Human Genetics and Behavioral and Community Health Sciences within the Graduate School of Public Health at the University of Pittsburgh.  She is currently the director of the Masters of Arts Program in Bioethics at the University and is a member of the Steering Committee of the Women's Studies Program and a fellow of the Center for Philosophy of Science.  Dr. Parker received her bachelors in philosophy from Hillsdale College, and her Masters and PhD in philosophy at the University of Pittsburgh.  She has an extensive list of books and articles that she has written and edited including Ethics and Public Health: Model Curriculum and Informed Consent: Legal Theory and Clinical Practice.  Much of her research and writing has revolved around the ethical implications of consent, research, genetics, mental health, confidentiality and the feminist philosophy. 

Although many of the Maternal Child Health Bureau competencies were addressed (critical thinking, communication, negotiation, and family centered care), the focus was on ethics and professionalism.  Although these areas are clearly related there are multiple distinctions between them. Dr. Parker stated that professionalism includes specific components such as expertise, self-regulation, a division of power, and a fiduciary relationship.  While professionalism has the expectation of an internal set of expectations, regulations, and safeguards, the discipline of ethics entails a more generalized approach for setting standards of behavior and beliefs that supersede  any organization’s or professional’s regulations.   

A significant portion of the class was spent on the topic of informed consent and ethical dilemmas that arise when the patient is an adolescent or cognitively impaired. There are multiple reasons for utilizing the consent process, often depending on the differentiation between care and research.  From a legal and business perspective the consent process is often used to eliminate liability.  However, from a philosophical and ethical stand point informed consent is to promote one's autonomy.

There are often underlying barriers to receiving truly informed consent, often concerning youth, people with disabilities, and elders.  It is difficult to ensure that the decision-making party truly understands the information being provided and the possible outcomes.  The ability of an individual to provide consent should be based on an individual basis.  In the care provision sector of medicine it is used to allow one to seek what is best for them as an individual.  However, in a research context, autonomy infers the ability of one to accept an external pursuit of good, helping others without the potential for a direct benefit to them.

Dr. Parker further discussed the issue of cultural competency and ethics.  In the decision-making process all parties maintain certain biases and cultural understanding; it is critical to recognize one's own biases before assisting others in ethically charged issues.  Regardless of the circumstances, nonmaleficence, beneficence, and autonomy must be respected.