Ethics is an essential part of health care, which means that its practice is fundamental. For an instance, lets think about that there was not an ethics committee in the past and how the rights of the patients and their families was violated. The modern practice of medicine has forced the health care profession to adopt new postures regarding medical, ethical, and legal issues.The scope of practice of the ethics committee is more profound and more valuable that most of the general public knows.
It is imperative that the public in general knows that sometimes making the right decision in the face of serious illness can be complicated. When there is uncertainty or disagreement, the Ethics Committee can help to reach a decision. An Ethics Committee
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is a group of Medical Center staff that includes physicians, nurses, social workers, chaplains, and members of the community who are available to help patients, families, doctors, and other healthcare providers when they face difficult ethical decisions to take. The following interview was realize to Ann Stephens a nurse in North Carolina with more than 30 years of experience in the field. Does your hospital have an ethics committee?
If there is an ethics committee, describe the members.
Every hospital has an ethics committee. Members usually include the hospital director, staff board members, doctors, surgeons, nursing administrator, director of social services, clergy, some board members are ethics experts and consumer members from our community.
Are they all healthcare professionals within the hospital?
Some of them are healthcare professionals and the others members are part of the community.
Are there any ethics experts or consumer members from the community?
Yes, The are ethics experts and consumer members from the community in the ethics committee.
Is there representation from risk management or chaplaincy on the committee? How are committee members chosen? Does the committee meet on a scheduled basis or on an as-needed basis?
Risk management and Chaplains are also on the ethics committee. Community members are chosen by the hospital director and board members. Most hospitals have quarterly scheduled meetings every year.
Does your hospital provide ethics education to medical and nursing staff?
Ethics education provides education to all medical and nursing staff during orientation and
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yearly. How are ethical principles incorporated into hospital policy development? Whether your hospital has a formal ethics committee or whether they meet JCAHO requirements in another way, what is the procedure to assist family or staff when ethical questions or concerns arise? Ethical principles are incorporated into hospital policy development thru yearly evaluation in education and in hospital ethics statement. If there is an ethical question on behalf of family of staff it is first directed to nursing director or head of medicine and followed up the chain of command to the ethics committee. The ethics committees in all the hospitals in the nation not only takes difficult decisions, but also act as institutional watchdog , have the task of of informing the public about health care ethics concerns, enforce policies, and write policies. it is important to mention that the ethics committee meets free of charge to provide a safe, supportive, confidential help in which the patient's family can think through a problem, consider different points of view and offer options. Every attempt to reach a decision is made to involve key members of the health care team as well as the patient and family, as appropriate, in the process. After discussing the ethical issues, the Ethics Committee offers advice in the form of a non-binding recommendation. It is then up to those involved to decide what to do next. The ethics committee is an aid to the patient and the family to help to find the best decision without pressure and always respecting the patient and his or her family. The responses that the nurse Stephens provided were not different from the book since every Hospital in the nation has the obligation to provide support to the patient and their family, and of course to the medical team. The most important part in my opinion was the depth of the work that the ethics committee has. The health care provider has in the ethics committee a support to obtain needed help in deciding what to do, to identify a practical way of doing what had already been decided should be done and implement a practical solution to the problem. At the same time the health care professional needs to obtain reassurance that the correct decision was being made better to face people who might otherwise think that the decision was inappropriate. There is a big compromise that the health professional has in his or her hands. It is not easy to take a critical decision that could be the difference between life and death. The implementation of ethics committees in hospitals around the world is important to have a better health care system.
The ethics committee will always provide valuable advisory help that will guide the patient and the family in the process to take a difficult decision. The modern society is confronting new medical, ethical, and legal issues that are still pending for a definitive solution. This is the case of euthanasia or abortion that still cause controversy around the world in which is the best solution to take when the patient decision is not enough to reach a final decision. It is imperative to come with a consensus that will help society
to move forward.
Healthcare creates unique dilemmas that must consider the common good of every patient. Medical professionals, on a frequent basis, face situations that require complicated, and at times, difficult decision-making. The medical matters they decide on are often sensitive and critical in regards to patient needs and care. In the Case of Marguerite M and the Angiogram, the medical team in both cases were faced with the critical question of which patient gets the necessary medical care when resources are limited. In like manner, when one patient receives the appropriate care at the expense of another, medical professionals face the possibility of liability and litigation. These medical circumstances place a burden on the healthcare professionals to think and act in the best interest of the patient while still considering the ethical and legal issues they may confront as a result of their choices and actions. Medical ethics and law are always evolving as rapid advances in all areas of healthcare take place.
They were part of the healthcare team and went along with the beliefs of their team. The team should have directly included the patient and parents. I cannot help but wonder if this legal battle would never have taken place had an ethics committee been assigned to this case. Ethics committees provide structure and guidelines for potential problems, serve as an open forum for discussion, and function as a true patient advocate by placing the patient at the core of the committee discussions (Guido,
notices to patients and their families, schedule and lead the meetings. Wishing to be actively involved in the process, I represented nursing along with the charge nurse of the unit and the charge aide.
The five key areas of responsibility for healthcare leaders according the ACHE Code of Ethics are (Perry, 2014, 9g. 134-35):
The main dilemma in this case study is that the patient wants her pacemaker shut off. She wants to stop the pacemaker as she believes this will end her life. She wants to end her life because she is miserable and feels she is making her family miserable. Although she believes this will end her life the cardiologist and primary care physician know that is not necessarily true. This could be a much longer process than she may think. Now the ethics consultant has been asked to meet with Dorthea and her family regarding the ethical/moral issues and medical rules about this dilemma.
Ms. Bardsley builds many professional relationships with her colleagues by sitting on a variety of hospital-wide committees.
Nursing ethics has a vast spectrum of subjects. The history of ethics was around way longer then the declaration of specific ethical issues. According to Fox, Myers and Pearlman (2007), the field of ethics consultation has been developing over the last three decades, (Kosnick 1974; Rosner 1985). Ethics has become an organized and accepted division of healthcare services. Gallagher (2010), discussed the purpose of nursing ethics is to help us think, speak and perform better in our practice. The Nursing Code of Ethics was addressed by Lachman (2009). “Futile care” is discussed by Sibbald, Downar, Hawryluck (2007). Ball (2009) addressed the need for clarification of DNR orders in surgery patients.
There is great debate in this country and worldwide over whether or not terminally ill patients who are experiencing great suffering should have the right to choose death. A deep divide amongst the American public exists on the issue. It is extremely important to reach an ethical decision on whether or not terminally ill patients have this right to choose death, since many may be needlessly suffering, if an ethical solution exists.
Nurses provide guidance and address the problems in the end-of-life decision-making process. It is the nurse’s role to explain to families and other healthcare professionals when an advance directive would be put to use. An advance directive serves as a guide for clinicians to respect and honor the autonomous decision of the patient when they are in a position to not be able to express their wishes (Roux & Halstead, 2009). Nurses could assist in ensuring the patient needs are met along with protecting their rights. The registered nurse act as client advocates in health maintenance and clinical care (Standards of Nursing conduct or practice, 2003). Advocating for patients could bring implications such as conflicts with physician and families regarding decision on the plan of care. Nurses struggle with having the feeling of powerlessness towards family decision rather than supporting patient decision. Nurses also experience moral distress and outrage at unsuccessful attempts at becoming patient advocate.
Many ethical, moral, and legal ramifications influence and affect how this type of care is provided. Unfortunately, death is an inevitable part of life; however, death does not come without its own rights. The right to die, refuse medical treatment, and the rights to choose how end-of-life care can be given, or withheld, are significant individual rights which influence and effect the medical and legal professions. For years, these rights have been upheld through either the legislature, judicial opinion, or ethical committees. In the present case, it is not the intent, nor desire of the committee to rewrite the existing policies which dictate how to handle a situation such as this one. As already stated, the committee strongly urges the primary care physician to review the patient’s records, and find that the patient meets the criteria required to implement her pre-existing Living Will. The primary care physician should take into consideration the ethical and legal ramifications as defined and analyzed in the above opinion prior to drawing a conclusion. Death is a natural part of life, and with death, should come dignity. The patient has demonstrated her wishes, and it is now up to the primary physician to uphold the patient’s
Fowler, M. D., & American Nurses Association (2008). Guide to the code of ethics for nurses: Interpretation and application. Silver Spring, MD: American Nurses Association.
The word ethics is derived from the Greek word ethos, which means character (1). Being moral always fills a nurse with morals respects, guidelines of good judgment and expert lead. There are three essential obligations for nurses, among many other which are the duty of autonomy, confidentiality, and obligation of care to all patients (2). There are professional duties with becoming distinctly legitimate obligations if any law and policies are ruptured in between professional practice. In 2001, a review found that there was an apparent requirement for more guidance on moral predicaments inside the medical professionals, subsequent to expanding legal cases and open request (3). Medical attendants ought to withstand to regulatory law and statutory law while managing the nursing practice.
The Standing Committees include: Academic Freedom, Academic Personnel, Academic Planning & Budget, Clinical Affairs, Committee on Committees, Courses of Instruction, Educational Policy, Equal Opportunity, Executive Council, Faculty Welfare, Graduate Council, Library & Scholarly Communication, Privilege and Tenure, Research, Rules & Jurisdiction, and Space. Faculty members must hold a 50% appointment to serve on Senate committees or councils, although a faculty member at any rank or percent time can bring matters to the attention of the Senate and request a review. All five faculty series are eligible to serve on any committee. Most committees meet monthly and a UCSF Division Meeting, covering key issues, take place twice a year.
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
...pendent. Every decision is made in a collaborative manner; it includes someone else in the health care field. Thanks to the code of ethics nurses keep a perception and a balanced view regarding challenging decisions.