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Professional ethics of medicine
Professional ethics of medicine
Medical law and ethics chapter 8 professionalism
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Description My colleague and I received an emergency call to reports of a female on the ground. Once on scene an intoxicated male stated that his wife is under investigation for “passing out episodes”. She was lying supine on the kitchen floor and did not respond to A.V.P.U. I measured and inserted a nasopharyngeal airway which was initially accepted by my patient. She then regained consciousness and stated, “Oh it’s happened again has it?” I removed the airway and asked my colleague to complete base line observations and ECG which were all within the normal range. During history taking my patient stated that she did not wish to travel to hospital. However each time my patient stood up she collapsed and we would have to intervene to protect her safety and dignity, whilst also trying to ascertain what was going on. During the unresponsive episodes we returned the patient to the stretcher where she spontaneously recovered and refused hospital treatment. I completed my patient report form to reflect the patient's decision and highlighted my concerns. The patient’s intoxicated husband then carried his wife back into the house. The concerns I had with this job, was with regard to the patient's capacity. My feelings. I wrongly assumed that we were attending just another alcohol intoxicated patient, so typical of a Saturday night duty. On arrival I had considered scene safety due to the behaviour of the intoxicated male shouting at me, “where have you been?” I felt he tested my communication skills due to his aggressive behaviour, I put this down to the amount of alcohol he had consumed. This proved frustrating at times but I knew I had to diplomatic, as it could have escalated the situation. His body language displayed he did not... ... middle of paper ... ... of proficiency. Available: http://www.hpc-uk.org/assets/documents/1000051CStandards_of_Proficiency_Paramedics.pdf. Last accessed 22nd October 2012. http://www.direct.gov.uk/prod_consum_dg/groups/dg_digitalassets/@dg/@en/@disabled/documents/digitalasset/dg_186484.pdf. Last accessed 13th Oct 2012. NHS CHOICES INFORMATION. (06/01/2011). DO I HAVE THE RIGHT TO REFUSE TREATMENT? Available: http://www.nhs.uk/chq/Pages/899.aspx?CategoryID=68&SubCategoryID=156. Last accessed 13th Oct 2012. NHS Scotland. (). Public (owing a duty of care). Available: http://www.advancedpractice.scot.nhs.uk/legal-and-ethics-guidance/accountability/public-(owing-a-duty-of-care).aspx. Last accessed 12th October 2012. Katharine Evans,James Warner, Elizabeth Jackson. (2007). How much do emergency healthcare workers know about capacity and consent?.Emergency medical journal. 24 (6), 391-393.
As the EAI team was discussing Molly’s case, one of the ED Residents made a few telephone calls. Molly’s PCP reported that during her last visit about 2 weeks ago, Mollie was alert and able to respond to questions appropriately. He confirmed that Mollie’s daughter and son in law have experienced psychiatric problems, adding that the son in law has expressed anger regarding Mollie’s living arrangements. The home health care agency was contacted. The RN and aide both report they have never met the son in law and have had very limited contact with Mollie’s daughter. When contacted by telephone, the daughter provided no explanation for Mollie’s extensive bruises noted on admission to the hospital. The daughter stated that Mollie did not fall, but in fact lowered herself to the floor in an effort to draw
Health Care workers are constantly faced with legal and ethical issues every day during the course of their work. It is important that the health care workers have a clear understanding of these legal and ethical issues that they will face (1). In the case study analysed key legal and ethical issues arise during the initial decision-making of the incident, when the second ambulance crew arrived, throughout the treatment and during the transfer of patient to the hospital. The ethical issues in this case can be described as what the paramedic believes is the right thing to do for the patient and the legal issues control what the law describes that the paramedic should do in this situation (2, 3). It is therefore important that paramedics also
I cared for a 76-year-old end-staged chronic obstructive pulmonary disorder patient who was admitted for respiratory distress. The doctor requested that my nurse and I get the family together for a family meeting. During the meeting, the doctor communicated to the patient and his family members that the patient will be palliative and no longer be in the ICU. The family members were concerned about the transfer of care to the medicine unit, what to expect from palliative care and other options for care. This scenario did not go well because the patient and family would have benefited from a palliative nurse with expertise, respiratory therapist to discuss other options, pharmacist about medication change if needed, social worker to help guide the family through end of life care for their father. In addition, there was no collaboration with interprofessionals prior to the family
Everyone has the right to make his or her own decisions, health and care professionals must always assume an individual has the capacity to make their own decisions unless it’s proved otherwise through capacity assessment.
NHS Choices. (2013). Health watchdog and authorities: CQC. [Online]. .GOV.UK. Available at: http://www.nhs.uk/NHSEngland/thenhs/healthregulators/Pages/carequalitycommission.aspx [Accessed 30 April 2014].
In America, the legal age to sign off on any medical consent is 18 years of age. Seventeen year olds should be able to compose their own medical decisions, and sign off on their own medical consents. Power should land in their hands, accompanied by the professional advice of a doctor. It is your body, be compelled to fabricate a decision without having to have your parent’s signature.
Within public health, the issue of paternalism has become a controversial topic. Questions about the ethics of public health are being asked. The role of ethics in medical practice is now receiving close scrutiny, so it is timely that ethical concepts, such as autonomy and paternalism, be re-examined in their applied context (Med J Aust. 1994). Clinically, patients are treated on a one on one basis, but public health’s obligation is toward the protection and promotion of an entire population’s health. So, based on this difference, the gaping questions targeting public health now becomes, under what conditions is it right to intervene and override an individuals’ autonomy? And if so, is the paternalistic intervention justified? Part of the concern
Health and social care professionals encounter a diverse amount of individuals who have different needs and preferences regarding their health. As professionals they must ensure that all services users, whether it is older people with dementia, an infant with physical disabilities or an adult with an eating disorder (National Minimum Data Set for Social Care, [no date]), are treated in a way that will successfully meet such needs. In fact, health and social care professionals have a ‘duty of care’ towards services users, as well as other workers, in which they must legally promote the wellbeing of individuals and protect them against harm, abuse and injury. (The Care Certificate Workbook Standard 3, [no date]) Duty of care is a legal requirement
As a result, she breached the standard 6 which states that “registered nurse should provide a safe, appropriate and responsive quality nursing practice” (NMBA, 2016). In line with this standard, nurses should use applicable procedures to identify and act efficiently to potential and actual risk such as unexpected changing patient’s condition (NMBA, 2016). Through early identification and response by the nurse, this will ensure that the patient’s condition is recognised and appropriate action is provided and escalated (Australian Commission on Safety and Quality in Health Care, 2011). Moreover, the nurse did not immediately escalate the patient’s deteriorating condition to the members of the health care team. Therefore, she also disregards the standard 4.3 stating that nurses should have work with the interdisciplinary health care team and to collaborate, communicate and discuss the patient’s status (NMBA,2016). The purpose of collaborating and communicating with the team is to provide a comprehensive plan of care for the patient and to facilitate early treatments needed by the patient (Cropley,
There was inappropriate staffing in the Emergency Room which was a factor in the event. There was one registered nurse (RN) and one licensed practical nurse (LPN) on duty at the time of the incident. Additional staff was available and not called in. The Emergency Nurses Association holds the position there should be two registered nurses whose responsibility is to prov...
Consent is an issue of concern for all healthcare professional when coming in contact with patients either in a care environment or at their home. Consent must be given voluntary or freely, informed and the individual has the capacity to give or make decisions without fear or fraud (Mental Capacity Act, 2005 cited in NHS choice, 2010). The Mental Capacity Act perceives every adult competent unless proven otherwise as in the case of Freeman V Home Office, a prisoner who was injected by a doctor without consent because of behavioural disorder (Dimond, 2011). Consent serves as an agreement between the nurse and the patient, and allows any examination or treatment to be administered. Nevertheless, consent must be obtained in every occurrence of care as in the case of Mohr V William 1905 (Griffith and Tengrah, 2011), where a surgeon obtain consent to perform a procedure on a patient right ear. The surgeon found defect in the left ear of the patient and repaired it assuming he had obtained consent for both ear. The patient sued him and the court found the surgeon guilty of trespassing. Although there is no legal requirement that states how consent should be given, however, there are various ways a person in care of a nurse may give consent. This could be formal (written) form of consent or implied (oral or gesture) consent. An implied consent may be sufficient for taking observation or examination of patient, while written is more suitable for invasive procedure such as surgical operation (Dimond, 2011).
Consent has been a fundamental part of nursing practice dating back as far as Hippocrates in ancient Greece. The Hippocratic Oath is an ancient form of guideline, devised for those who chose to enter the medical profession. Here these guidelines show physician-patient conversation were key components in healthcare, along with ensuring patients were kept informed on issues related to their health and the importance of gaining consent during the delivery of care (Miles, 2009).
Paramedics In an emergency, when someone needs medical help, paramedics are the first response team that will provide them with assistance until they can make it to a hospital. Paramedics are a person’s first point of contact before they can see a doctor. Emergency Medical Technicians (EMTs) and Paramedics are the first responders who attend to victims of accidents, disasters, or any other type of emergency. Job Description
A Bunch C, Woolnough B, Hope T. (2001). Clinical Ethics Support in the UK: A review of the current position and likely development. The Nuffield Trust, London: p. 22.
I escorted her to a room, and helped her change into a gown. I understand that a 22-year old is capable of changing her own clothes, but I wanted to spend more time with her for further investigation. Auscultation of the lungs revealed bilateral clear and equal breath sounds, and heart tones were audible and regular. No peripheral edema was noted upon examination of her lower extremities, and she denied a history of similar symptoms or any medical issues in the past. Again, my nursing experience was challenged. Everything looked great, except this feeling remained that something was wrong. ER was busy that day, so I put in on order for a chest x-ray, and then told the doctor why she wanted to be seen. I told him that I ordered an x-ray, but something was not right about her skin color, not jaundiced, swallow, or cyanotic just not right, and I asked for basic lab work. The doctor felt lab work was not needed at that time, and I did not push the issue. I just thought to myself, “maybe he is right, and I have worked too many days in a row”. When the patient returned from the x-ray department, I met her at the room. I asked how