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Ethics Medical Dilemma
Ethics Medical Dilemma
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Introduction
Teen pregnancy is an imperative aspect and issues relating to it ought to be dealt with keenly and through use of necessary ethical practices. There are healthiness dangers for children born to teenage mothers as they are prone to suffer health, social, and emotional complications. Women who become pregnant during their teens are at an increased risk for health problems such as premature labor and socioeconomic consequences. In this case, the patient (Rachel) has not been given any form of medication or seen by a physician on duty. The patient is distressed because of the fear that her parents do not want any assistance. The assigned nurse is cognizant of Rachel’s status; personal freedom to make a choice between prayer and religious tradition in place of medical treatment for medical problems (Welfel, 2009). Consent for treatment such as cesarean section for premature fetal distress has to be obtained by the hospital before treating the patient. If denied the treatment, Rachel and her baby are in danger and given that she is a minor, the hospital will have to face a big lawsuit.
Ethical Issues Presented In the Simulation
The dilemma puts two of the most significant ethical principles in direct confrontation; respect for patient autonomy and beneficence. In this context, patient autonomy offers personal freedom to choose prayer and religious ritual in place of medical treatment for a medical problem. Beneficence principle relates to facilitation of treatment to the patient (the minor) regardless of the wishes of the parents (Husted & Husted, 2008). In most cases, parents ought to get consent for treatment such as cesarean section so that Child Protective Services can avoid lawsuit. However, in cases extremely risky therapeutic situations, courts and Child Protective Services usually acted contradictory to the parents’ stand and conduct treatment of the minors appropriately. From these affirmations, ethical decision making underpins the balance between the needs and interests of the patient, the society, and Child Protective Service.
Decision-Making Steps to Ethically Address These Issues
Ethical decision making is required through considering ethical principles such as fairness, beneficence and autonomy as well as the professional, ethical standards and codes. A sound decision making framework is a prerequisite tool in solving complex ethical dilemmas such as the one presented in this simulation study (Donnelly, 2011). The steps followed in making an ethical decision in relation to the case of Rachel is as follows:
Clarifying and precisely determining what ought to be decided
In this case, a full range of alternatives are formulated, and patently impractical and illegal options eliminated based on the health care ethical principles and values (Welfel, 2009).
Examination and evaluation of the options
Facts and assumption relating to ethical health care principles are critically assessed so as to ascertain the credibility of the alternatives by considering their benefits, burdens and risks to each stakeholder.
Making the ethical decision
Making a choice from the developed and assessed alternatives done by examining what is not true and their respective consequences to the stakeholders (Husted & Husted, 2008). Ethical healthcare values are chosen and advanced while unethical ones are dropped; this implies that the patient is treated in the most benevolent way so as to protect her life and that of the unborn child.
Implementing, monitoring and modifying
The decision is implemented to maximize its benefits and minimize health risks. The decision can be modified so as to take a different course of action by adjusting to new information.
Ethical Perspectives or Lenses Used to Make Decisions in the Simulation
The ethical perspectives considered in making decisions in this context are respect for autonomy of patients. Choices for treatment are executed through a jointly accredited expertise between patients and healthcare physicians (Husted & Husted, 2008). Participatory lens in decision making is vital in making feasible decision that will strike a balance between the patient, health care service providers and the community. Fairness and shared decision making are key perspectives which are put in consideration when treating Rachel in this simulation, while upholding patient autonomy.
How the ethical lenses influenced decisions
Ethical lenses play an imperative role in decision making as they guide the health care practitioners in ascertaining the needs of patients. The ethical dilemma presented concerning the medical complication of Rachel and her child required analysis of the benefits of the treatment plan to be used (Donnelly, 2011). This implies that autonomy of the patient as a principle and beneficence had to be weighed so as to save her life and avoid the lawsuit. Through participatory decision making, it could not work since parents were aligned to an option which could jeopardize the life of the minor and her child. Their views were thus overridden on medical treatment grounds and in line with the beneficence principle (Donnelly, 2011).
Relevance of concepts from this simulation to my work place
Concepts such as ethical health care decision making are particularly relevant to my work place. Patients are entitled to proper medical attention for their benefit while at the same time maintaining their autonomy (Welfel, 2009). Participatory decision making is vital as it ensures that treatment decisions based on jointly shared expertise between the health practitioner and the patient. Steps of ethical decision making are imperative as they ensure that appropriate options are evaluated and adopted based on their significance as far as ethical and professional codes of healthcare are concerned.
References
Welfel, E (2009). Ethics in counseling and psychotherapy: standards, research, and emerging issues. Edition 4. Brooks/Cole Cengage Learning.
Donnelly, M (2011). Healthcare Decision-Making and the Law: Autonomy Capacity and the Limits of Liberalism, Volume 12 of Cambridge Law, Medicine and Ethics. Cambridge University Press.
Husted, G & Husted, J (2008). Ethical decision making in nursing and health care: the symphonological approach Springer Series. Edition 4. Springer Publishing.
HIV confidentiality
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HIV confidentiality
Introduction
Medical information is perhaps the most sensitive information that individuals share with doctors and nurses outside their immediate families. It is, therefore, no wonder that hospital staff take an oath that requires them to maintain confidentiality. They should not reveal the medical information of a patient to any other person. It gives patients the capacity to obtain medical care without unwarranted embarrassing and damaging disclosure of their medical information or the fear of betrayal. Medical confidentiality obligation touching on patient information and records lies not only with the physicians but also the hospitals. Since HIV infections are associated with drug use and sexual activities, which are universally regarded as sensitive and personal activities, the patients would like to maintain confidentiality of their health. In addition, HIV/AIDS comes with stigma from the public. It is, therefore, understandable why provisions pertaining to accessing HIV-related information are made only in limited occasions, usually when public health is threatened. Courts play a significant role in interpretation of the laws as well as the applicability of concepts pertaining to physician confidentiality in HIV-AIDS settings. One court case, in which a medical facility was held liable of breaching confidentiality pertaining to HIV status, involved a New Jersey otolaryngologist.
The otolaryngologist had been admitted to a local hospital where he had been diagnosed with pneumonia. A blood test showed he was HIV positive, findings that were previously unsuspected by the treating physician and the patient. While the treating physician took measures to maintain confidentiality, the patient received calls at home from fellow physicians, none of whom had been involved in providing him medical care. All indicated that they were privy to his condition. Within a short time, several people in the broader community showed that they were privy to his condition. Consequently, the otolaryngologist was socially ostracized and had his medical practice contracted.
Consequently, the otolaryngologist sued the treating physicians and the medical center for breach of confidentiality. While it was impossible to identify the size of information disclosure, he alleged that the spread of information pertaining to his health indicated that the defendants did not reasonably restrict access to the test results. On their part, the defendants held that they were not liable for disclosures made by employees or even other people beyond their control.
The court, however, ruled in the otolaryngologist’s favor, holding the defendants liable for the disclosure of his HIV status. It was evident that the medical facility had disregarded the importance of safeguarding the patient’s confidentiality. It was established that the plaintiff’s hospital chart gave the results of bronchoscopy as well as HIV test results, which amounted to a definitive AIDS diagnosis. While the hospital argued that the physicians decide whether to make a chart, the easy access to the charts as well as the deficiency of policies to limit access resulted in breach of confidentiality. Having in mind that the medical facility knew the consequences of such accessibility, it should have put in place reasonable measures necessary for safeguarding the confidentiality.
Conclusion
Safeguarding confidentiality of health information is extremely crucial in health facilities. This is especially having in mind that the information is perhaps the most sensitive to any individual. In cases where such information is disclosed, the treating physicians may be liable of breaching confidentiality if they did not take the appropriate measures to safeguard the information.
Works cited
http://www.ajronline.org/content/176/3/599.short#sec-1
Savkar S, Waters RJ. Telemedicine: implications for patient confidentiality and privacy. In:. New York: Faulkner & Gray, 1996
Ethics is the differentiation of good from evil, the virtues from the vice and what is right from what is wrong
Ethics is the differentiation of good from evil, the virtues from the vice and what is right from what is wrong. ‘It deals with the rightness and wrongness of human actions,’ Dinesh Babu, (2007). While values can be said to be the maintenance of the ethics that are depicted as good. Responsible conduct can be said to be living according to the set rules and regulations that are expected of an individual. In public organizations, the maintenance of responsible conduct can be either by external control or internal control.
External controls.
This is the attempt to impose on people the kind of behavior you want and expect them to have. It could involve the change of a certain set of rules and regulations on the finding out of misconduct among the members in the organization. It could also involve the re-organization of the structure of the organization in order to come up with a plan that has a more careful monitoring system on what takes place in the organization. This could be through changing the supervisory roles in a department or appointing new members to such positions. This way it will be much easier to find out the individuals that are irresponsible. For example in the criminal and justice system, a number of in service training on the ethics of the organization are included as part of the programs in the police departments. This is a different approach to ethics scandal in the public office that seems to encourage professional socialization. In such a department like the police force, there are devoted training programs on ethical conduct and discussions on ethics are part of the agenda in their local meetings.
The external controls though imply that the people working in the public service do not have the chance to make decisions on their own course. They are limited to abide by the set rules of conduct and not by what they believe is right. Haque (2004), proposes that knowing how, when and the purposes for exercising discretion by the administrators will be the best way to handle the external controls. Public administrators should deal with the rationality of the use of the external controls in order to avoid suppression that is a very common component of this type of curbing the ethical scandals.
Internal controls.
These are the type of controls that set the rules, observe the response of the public to the sets rules, and then adjusts the set rules to the public demand or to the public convenience. This calls for the administrators of the rules to be responsive to the people who the rules are directed to and also work according to the anticipation of the public who are the subjects as proposed by Herman Finer (1986). For internal controls to be efficient double standard should be allowed with the administrators being firm on maintaining the set rules. The internal controls will therefore involve the proper knowledge of the technical applications and also sensitivity towards the subjects who are to abide by the rules. Technical knowledge is the standard by which the administrators are accountable but this accountability can only be held by fellow technicians. A good example of the internal control is the communication of the public with their government in a democratic society. The public mostly do so in form of inquiries, suggestions and criticism which are directed to the government either directly or through the administrator. The public will demand that the administrator be responsive to their demands and preferences. The administrator on the other hand will have to keep at par with the changing trends in the society, therefore give administrations according to the preference of the society at large rather than according to his own wills.
Internal controls can therefore be said to be a set of attitudes values and beliefs that are internalized, unlike the external controls that are commanded by the power and behavior of an individual and have their origins from a particular source of power.
References
Dinesh, Babu. (2007). Professional ethics and human values. Laxmi publication Ltd.
Herman, Finer. (1936). Better government personnel.