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Ethical challenges in healthcare
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I really enjoyed reading your post. Ethical considerations must be aimed at minimizing risks and likely harm to individuals and communities, such as the potential for stereotyping, stigmatization, or invasions of privacies. During the clinical case study, the patient health information through medical records have to be reviewed in order to assess the need for programs that increases access to healthcare and medical supplies, local clinics, health education, etc. Similar risks have to be faced during the program evaluation phase, to measure the improvement in daily foot and blood checks in the county residents. Thus, I share similar opinion that informed consent must be signed by the patient before any blood work or procedure is done. Informed
According to Terrence F. Ackerman, as of the 1980s the American Medical Association had to include the respect for a person’s autonomy as a principle of medical ethics (Ackerman 14, 1982). This includes having the physician provide all the medical information to the patient even if the information could cause negative implication onto the patient. The physician is also expected to withhold all information of the patient from 3rd parties (Ackerman 14, 1982). Although it is seen as standard in today’s world, in
Those who were affected by the testing in hospitals, prisons, and mental health institutions were the patients/inmates as well as their families, Henrietta Lacks, the doctors performing the research and procedures, the actual institutions in which research was being held, and the human/health sciences field as a whole. Many ethical principles can be applied to these dilemmas: Reliance on Scientific Knowledge (1.01), Boundaries of Competence (1.02), Integrity (1.04), Professional and Scientific Relationships (1.05), Exploitative Relationships (1.07, a), Responsibility (2.02), Rights and Prerogatives of Clients (2.05), Maintaining Confidentiality (2.06), Maintaining Records (2.07), Disclosures (2.08), Treatment/Intervention Efficacy (2.09), Involving Clients in Planning and Consent (4.02), Promoting an Ethical Culture (7.01), Ethical Violations by Others and Risk of Harm (7.02), Avoiding False or Deceptive Statements (8.01), Conforming with Laws and Regulations (9.01), Characteristics of Responsible Research (9.02), Informed Consent (9.03), and Using Confidential Information for Didactic or Instructive Purposes (9.04), and Debriefing (9.05). These particular dilemmas were not really handled until much later when laws were passed that regulated the way human subjects could be used for research. Patients
Furthermore, these doctors had no legal or ethical codes to conduct experimentations or research on African Americans. For example, during 1998, “172 employees, all but one of them black, sued Lawrence Berkeley Laboratory when they learned that they had secretly been tested for syphilis, pregnancy, and sickle-cell trait without their knowledge that the blood and urine they had supplied during required physical examinations would be tested…” (314). This indicates that there was no consent from these blacks and scientists where secretively testing immunities for sickle-cell on them without any permission whatsoever. The release of this experiment was against the Americans with Disabilities Act and these researchers had no right to release information without the patient’s consent. Furthermore, experiments that had no patient’s consent varied from blisters “to see how deep black skin went” to threatening surgeries, sterilization, inoculations, and not tested pharmaceuticals (54). Without consent, all experiments are considered as unethical. A patient’s consent is important because it is huge determination of privacy and respecting the patient’s wishes. Without any consent, it is indicating that patient’s do not have rights about their own privacy, which was against the law during colonial times and in present days. Some ethical guidelines include the right to withdraw from the study
A law is a rule of conduct or action, required (governments endorse laws) to maintain order and public safety in case of a breakdown of law. The criminal & civil law is applied to health-care practitioners or providers, if criminal wrongdoing or negligence occurred in patient’s care. Ethics or moral values serve as the basis for ethical conduct. Our societal values, Family, and cultural values help form an individual’s moral value (Pozgar, 2014, p. 217). The Pozgar further suggests that the healthcare executives needs to understanding the development of law, sources of law, the meaning of different terms to effectively handle change in environment due to frequent policy implementations.
The four major ethical principles in health care are: Autonomy – to honor the patient’s right to make their own decision (the opposite is paternalism - the health care provider knows best for the patient), Beneficence – to help the patient advance his/her own good, Nonmaleficence – to do no harm (many bioethical controversies involves this principle), and Justice – to be fair and treat like cases alike. All 4 principles are considered to be in effect at all times. In theory, each is of equal weight or importance. Ethical responsibilities in a given situation depend in part on the nature of the decision and in part on the roles everyone involved play.
The word ethics is derived from the Greek word ‘ethos’ meaning character or conduct. It is typically used interchangeably with word moral which is derived from the Latin word ‘moves’ which means customs or habits. Ethics refers to conduct, character and motivations involved in moral acts. Ethics are not imposed by a profession, by law but by moral obligation. It is unwritten code of conduct that encompasses both professional conduct and judgement. Ethics helps support autonomy and self-determination, protect the vulnerable and promotes the welfare and equality of human beings. An ethical dentist- patient relationship is based on trust, honesty, confidentiality, privacy and the quality of care.1
Informed consent is the basis for all legal and moral aspects of a patient’s autonomy. Implied consent is when you and your physician interact in which the consent is assumed, such as in a physical exam by your doctor. Written consent is a more extensive form in which it mostly applies when there is testing or experiments involved over a period of time. The long process is making sure the patient properly understands the risk and benefits that could possible happen during and after the treatment. As a physician, he must respect the patient’s autonomy. For a patient to be an autonomous agent, he must have legitimate moral values. The patient has all the rights to his medical health and conditions that arise. When considering informed consent, the patient must be aware and should be able to give a voluntary consent for the treatment and testing without being coerced, even if coercion is very little. Being coerced into giving consent is not voluntary because others people’s opinions account for part of his decision. Prisoners and the poor population are two areas where coercion is found the most when giving consent. Terminally ill patients also give consent in hope of recovering from their illness. Although the possibilities are slim of having a successful recovery, they proceed with the research with the expectation of having a positive outcome. As stated by Raab, “informed consent process flows naturally from the ‘partnership’ between physician and patient” (Raab). Despite the fact that informed consent is supposed to educate the patients, it is now more of an avoidance of liability for physicians (Raab). Although the physician provides adequate information to his patient, how can he ensure that his patient properly ...
Why is it so important that healthcare executives adhere to a professional code of ethics?
Today’s society protects against discrimination through laws, which have been passed to protect minorities. The persons in a minority can be defined as “a group having little power or representation relative to other groups within a society” (The Free Dictionary). It is not ethical for any person to discriminate based on race or ethnicity in a medical situation, whether it takes place in the private settings of someone’s home or in a public hospital. Racial discrimination, in a medical setting, is not ethical on the grounds of legal statues, moral teachings, and social standings.
Physician-assisted suicide refers to the physician acting indirectly in the death of the patient -- providing the means for death. The ethics of PAS is a continually debated topic. The range of arguments in support and opposition of PAS are vast. Justice, compassion, the moral irrelevance of the difference between killing and letting die, individual liberty are many arguments for PAS. The distinction between killing and letting die, sanctity of life, "do no harm" principle of medicine, and the potential for abuse are some of the arguments in favor of making PAS illegal. However, self-determination, and ultimately respect for autonomy are relied on heavily as principle arguments in the PAS issue.
Ethics refers to the values and customs of a community at a particular point in time. At present, the term ethics is guided by the moral principles that guide our everyday actions. These moral principles guide the researcher into deciding what is ‘right’ or ‘wrong’. The foundation of medical ethics is governed by two philosophical frameworks that are deontology, and utilitarianism. However ultimately the ethics committees need to balance the risks, and benefits for the participants and the community associated with the particular research proposal. This balance is quite important as the well being of participants is at risk.7
... event arises and it was due to lack of assessment of genuine comprehension. I think the best system of obtain consent would incorporate a regulated system that accommodated each institution and their requirements, but also equally weighed the importance of true understanding of facts and realization of the patient’s capacity to make decisions. But even if this was established as standard practice, there would still be the issue of how the assessment is made and how accurate it is due to other influences i.e. current injury status or medications needed for full psychological and or conceptual functioning. There could also be an issue of how to regulate such a subjective issue; each physician is going to have different ethical views and this will inevitably influence how he/she assess the patient and their ability to make the best decisions concerning their health.
Informed consent is a very serious decision a patient has to make when it comes to their health and consenting to procedures that are believed to cure or treat their current health status. It is important to address the effectiveness of the role a physician play in the informed consent process assuring that the patient has given truly informed consent and what safeguards can be put in place to assure the patient is exercising informed consent. Informed consent is based on the fact that the person consenting is a rational individual that is aware of the action to which he/she is consenting. Allen and McNamara (2011) notes that "On the standard understanding, the important elements of informed consent are the provision of information, the voluntariness of the choice and the competence of the chooser to make the choice— so the potential research participant should be provided with information relevant to the decision to participate, they should be able to choose freely about their participation and they should be competent to decide.
The key ethical issue is that the patient has capacity to make a decision regarding surgery, and her autonomy should be respected, however the medical team is receiving conflicting information from the patient’s family about what the patient’s wishes are. Initially the patient was unable to communicate with the medical team due to a language barrier, and the patient’s husband insisted she wanted to proceed with surgery. Her children later state she told them she does not want to undergo surgery. The medical team cannot be sure what the patient’s wishes are. The physician then makes a suitable decision to involve an interpreter to communicate directly with the patient. After discussion with the patient, it is still unclear if the patient
The fictitious clinical audit that has been presented above does not involve anything being done to patients. Therefore, this audit does not require formal ethical approval. However, audits must always be conducted within the ethical framework, ensuring patient and staff confidentiality throughout. According to the ‘Data Protection Act’ (1998), there are eight principles an audit must comply with (See Appendix L) this is to ensure that the information gathered is handled accordingly. In accordance with the ‘Data Protection Act’ (1998), that any data collected must not be reviewed by non-trust staff, and any data collected must be anonymised such as name, address and date of birth.