IMIA International Conference Harvard Medical School, 2011

Llus Baixauli Olmos IMIA Director & Spain Rep Universitat Jaume I (Spain) Jamia Millia Islamia (India)

1. INTRO

2. DESCRIPTION

A bit of context What and what for How

Sample Method

Theory: Philosophy & Sociology Sample: General: Types, aims contents Specific: Impartiality & accuracy

3. DISCUSSION

4. CONCLUSIONS

Understanding of documents Similarities and divergences Moral system and structure

PSI: young occupation and field Fundamental doubts: practical & philosophical Search for an ethos (a professional identity) is prominent, but no consensus Need for more work

WHAT
1. Analysis of

WHAT FOR
i.

Understand docs
i. Comprehensive view

deontological docs in force

2.Focus: impartiality

ii. Refine blurry ethical

principles

and accuracy

Object of study: deontological docs and ethical principles Qualitative study: semantic textual analysis
Also quantitative criterion

Method: Grounded Theory & Cluster analysis Process:

1. Gathering and selection of docs (sample: 7 docs) 2. Analysis of docs: General aspects, Ethical concepts, Discussion

A philosophical view A sociological view

Morals
Ethics Deontology Setting regulations General regulations

Ethics: moral philosophy

Morals & Ethics, related but

Ethics>applied ethics>professional ethics

Reflection upon duties and obligations Moral issues arising from specialization Goal: lay down a common set of rules

Study of rules: Deontology

Professional Ethics & Deontology, related but Ethics = reflection; Deontology = norms

Various purposes:
Influence, guide, formulate, express,

communicate, commit, stipulate demands, reflect...

Various types:
Code of ethics/conduct: binding, short, rules Standards of practice: informative, long,

guidelines

Outward reading Professionalization processes need:

Developing an ethos Influencing in various areas Sanctioning of document

Disentangle vicious circle

Various views poured in a melting pot Change crystallized in a document

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Content and purposes:

Description of ethos: guidelines Exaltation of contribution Justification of existence Internal control Training and assessment Emphasis on independence and autonomy Other: accreditation, regulation of relations, associations, continued competence

Codes value has been questioned

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General elements: types, aims, contents of documents Specific elements: ethical principles Accuracy and Impartiality

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The 7 texts are convergent Classification:

1. 2.

2.

AGENCY

3.

Scope Agency Concreteness

Association: CHIA, IMIA, NAJIT Official body: NRPSI, NCHIC Standardization: ASTM Mixed: NSGCIS

3.

1.

SCOPE

CONCRETENESS

All: ASTM, NRPSI, NSGCIS Medical: CHIA, IMIA, NCHIC Legal: NAJIT

Code of ethics: NRPSI, NAJIT Standards of practice: CHIA, IMIA, NCHIC, NSGCIS Mixed : ASTM

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The documents are intended to:

provide information for all and set clear

expectations (6/7) seek consistency (5/7) improve quality (4/7) serve as assessment tools (4/7) for accreditation (2/7) or hiring (2/7) be used for training purposes (3/7)

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Docs in content, in form Info organized in:

1. Introduction

1.

Introduction
publishing institution
purposes (situation,

need) 2. Body (ethical content) potential uses content & 3. Other issues organization

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2.

ETHICAL CONTENT

Confidentiality: 7/7 Impartiality: 7/7 Accuracy: 7/7

Fidelity
no variation
Accuracy, Completeness,

Respect: 5/7
Respect for individuals and

no variation

Competence:4/7

communities, No discrimination

Development , Maintenance

Professionalism: 5/7
Professionalism,

Other:

of Skills, Continued Competence

Competence, Integrity, Distance

Culture, Conflict of interests,

Limitations of practice, Protocol and demeanour, Credentials, Role

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3.

OTHER Terminology, 7/7 Bibliography, 4/7 Qualifications, 3/7 Organizations, 2/7 Role, 2/7

Settings, 2/7 Responsibilities, 2/7 Other topics:

Needs analysis, protocols, ethical dilemmas, advocacy

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Distinct value, most common Meaning (very recurrent):

Convey faithfully all messages (7/7). Maintain style, register, tone, naturalness (5/7) Inform about cultural/technical terms without

equivalent (5/7) Identify and correct mistakes (5/7)

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Meaning (II, less recurrent):

Inform of duty (4/7) Avoid interjecting additions, omissions,

explanations, suppositions (4/7) If not understanding, clarification (4/7) Preserve paraverbal and non-verbal content (3/7) Provide necessary cultural information (3/7) Manage spacial configuration (3/7)

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Non-distinct value, most common Meaning:

Disclose interest (6/7) Disclose personal ties (4/7) If factor affects impartiality/ trust, consider

declining or withdrawing (4/7) Remain impartial and avoid displaying bias (4/7) Not involve in conversation, give advice or respond (4/7) Not filtering or speaking on behalf of (4/7)

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Meaning (II, less recurrent)

Inform of duty and explain it (2/7) Identify biases and values (2/7) Not interject opinions, beliefs (2/7) Not interject thoughts (2/7)

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Influence among docs:

CHIA, IMIA, NCHIC, NSGCIS Role has been refined, narrowed

Diversity in length and content: type & scope Introductions Ethical content
Guidelines under principles Principles: Confidentiality, Impartiality, Accuracy Denominations , articulation

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Levels Values
Principles

? what why what for how

Greek axios deon telos praxis

Principles
Means

Goals
Goals

Strategies

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Impartiality and Accuracy

Accuracy is dense; Impartiality, dispersed
Dependence: Imp is needed for Acc Core: Accuracy = PSIs internal good

Non-ethical content, varied NSGCIS most thorough:

Interpreting and other levels of action

Controversial guidelines: explaining, register

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Codes have to be critically understood and applied, but not necessarily invalidated
They stem from reflection and need to rely on

training (ASTM) and professional judgement (NAJIT) Variety of settings & situations

Classification not straightforward

content, format, wording,

Reasonable coincidence theorysample

BUT, role? More restrictive approach?

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Ethics is open, fluid, dynamic, progressive Structure of professional norms

Values, principles, objectives, strategies

Rules are useful but not sufficient; they must be questioned

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Diverse solutions to problems and dilemmas

Ability to justify! What problem is, Why this strategy

Individual critical construction of professional judgement

training, practice, continuous development

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Llus Baixauli Olmos llbaixauli@imiaweb.org lluisbaixauli@gmail.com