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Disproportionality in health care
Disproportionality in health care
Disproportionality in health care
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In this scenario there a number of ethical principles of health that related to it. Beneficence is the first principle that directly engages the staff to perform their task with a focus on well to the subject. Another principle is the non-maleficence which defines the aim not to do any harm to the patient being handled. Additionally, fairness is another principle that the staff and OB-GYN physician observe because the staff seems to be fair to both the mother and the baby while the OB-GYN physician recommends patient referral to another hospital(Scotland, 2015). In relation to the scenario, the staff and the OB-GYN physician are under the jurisdictions of the legal principles in the health sector. These legal principles include providing better
Not only do health care providers have an ethical implication to care for patients, they also have a legal obligation and responsibility to care for the patient. According to the Collins English dictionary, a duty of care is ‘the legal obligation to safeguard others from harm while they are in your care, using your services or exposed to your activities’. The legal definition takes it further by making it a requirement that a person act towards others and the public with watchfulness, attention, caution and prudence which a reasonable person in the circumstances would use. If a person’s actions fail to meet the required standard, then the acts are considered negligent (Hill and Hill, 2002). If a professional fails to abide to the standard of practice for their practice in regards to their peers, they leave themselves open to criticisms or claims of breach of duty of care, and possibly negligence. Negligence is comprised of five elements: (1) duty, (2) breach, (3) cause in fact, (4) proximate cause, and (5) harm. Duty is defined as the implied duty to care/provide service, breach is the lack thereof, cause in fact must be proven by plaintiff, proximate cause means that only the harm caused directly causative to the breach itself and not additional causation, and harm is the specific injury resultant from the breach.
Why is it so important that healthcare executives adhere to a professional code of ethics?
The four ethical virtues of health care must be shown, compassion, discernment, integrity and trustworthiness. Respecting a person’s autonomy understanding and acting on the belief the people have the right decision to make decisions and take action based on their beliefs and value systems. The ethical issues that would be encountered will be to treat each person with passion and respect regardless of sex, race, and religious preference. The environment has no human rights violations, sustains nursing ethical
In the medical profession, doctors and nurses run into ethical dilemmas every day whether it be a mother who wants to abort her baby or a patient who has decided they want to stop cancer treatment. It is important for the nurse to know where they stand with their own moral code, but to make sure they are not being biased when educating the patient. Nurses are patient advocates, it is in the job description, so although the nurse may not agree with the patient on their decisions, the nurse to needs to advocate for the patient regardless.
My initial response to the issues was only based on the hospital policies regarding the care of the patients within the hospital. However, when I was guided down the different paths and made to look through the different ethical lens, I found it tough to do so and seem to resort to my core values of autonomy and rationality. By putting the patients’ first, hospital policies, and then their loved ones in the first scenario, I determined that a compromise was necessary. Whereas in the second scenario, I feel as no agreement was needed just staff education (EthicsGame Simulation, 2016). In this particular case, Carlotta, the RN shift supervisor, needed further training to understand the hospital policy on who is or is not considered to be family (EthicsGame Simulation,
...o find a balance between interventional and non-interventional birth. With this being said, I also understand that there are strict policies and protocols set in place, which I must abide to as a healthcare provider, in any birth setting. Unfortunately, these guidelines can be abused. Christiane Northrup, MD, a well recognized and respected obstetrician-gynecologist has gone as far as to tell her own daughters that they should not give birth in a hospital setting, with the safest place being home (Block, 2007, p. xxiii). Although I am not entirely against hospital births, I am a firm believe that normal, healthy pregnancies should be fully permissible to all midwives. However, high-risk pregnancies and births must remain the responsibility of skilled obstetricians. My heart’s desire is to do what is ultimately in the best interest of the mother, and her unborn child.
Providers must act in the best interest of the patient and their basic obligation is to do no harm and work for the public’s wellbeing. A physician shall always keep in mind the obligation of preserving human life. Providers must communicate full, accurate and unbiased information so patients can make informed decisions about their health care. As a result of their recommendations, providers are responsible for generating costs in health care but do not generate the need for those expenses. Every hospital has both an ethical as well as a legal responsibility to provide care, even if the care may be uncompensated.
Nurses everywhere face problems and challenges in practice. Most of the challenges occur due to a struggle with the use of ethical principles in patient care. Ethical principles are “basic and obvious moral truths that guide deliberation and action,” (Burkhardt, Nathaniel, 2014). Ethical principles that are used in nursing practice include autonomy, beneficence, non-maleficence, veracity, confidentiality, justice, and fidelity. These challenges not only affect them, but the quality of care they provide as well. According to the article, some of the most frequently occurring and most stressful ethical issues were protecting patient rights, autonomy and informed consent to treatment, staffing problems, advanced care planning, and surrogate decision making (Ulrich et. al, 2013). The ethical issue of inadequate staffing conflicts with the principle of non-maleficence.
I have come to fully understand that in order to treat my patients in a way that is person centred, I have to treat each person as an individual and realise that every individual has different needs and different rights and preferences to me which may go against my morals and beliefs but I always have to maintain my professional boundaries and treat each individual with respect and dignity. If I was a nurse who witnessed a similar situation to Kat’s, where another healthcare professional was disregarding my patient or any patients views or requests I would go into the patient’s room and find out what the problem was. Then I would politely ask the healthcare professional to step outside of the room and I would gently remind them of the code of ethics ((Kozier, Erb's & Berman, 2010, p.97) and the Registered Nurses standards of practise (2016), and how every individual has the right to make their own independent decisions about their healthcare needs/goals based on their own values, morals and beliefs. I would further explain that the patients are our main priority and it is our responsibility as nurses’ to ensure that the patients are safe and are receiving the proper care. I would then explain to the patient what was happening and apologise to them about the situation, and I would rearrange and try to negotiate with the patient when the procedure could be performed. Then I would notify the Nurse Unit Manager on the ward to ensure that situations like this do not occur
Professional standards of practice and behaviour for nurses and midwives’ (2015) which states that obtaining patient’s informed consent is an act in their best interest and that nurses and midwives are required to respect individual’s right to accept or refuse treatment, moreover, support and document their decision, give evidence-based information, use clear language, cooperate with patients to help them with making the decision and be aware of the current legislations. This includes ‘Mental Capacity Act 2005’, ‘Mental Health Act 1983‘and ‘Human Rights Act 1998’. From a healthcare perspective vital articles are those which set out the rules for accessing patient’s capacity to make a decision, clarify who makes decisions for those who lack capacity and how this should be done, likewise those that regulate how to treat and protect patients without their consent but also those that specify basic human rights: to life, privacy, receiving information and other such as right to be free from discrimination or inhuman, degrading treatment. Other regulations to consider are ‘Human Tissue Act 2004’, ‘Human Fertilisation and Embryology Act 1990’ (GMC, 2015). Professionals should also consider common criminal
In this diverse society we are confronted everyday with so many ethical choices in provision of healthcare for individuals. It becomes very difficult to find a guideline that would include a border perspective which might include individual’s beliefs and preference across the world. Due to these controversies, the four principles in biomedical ethic which includes autonomy, beneficence, non-maleficence and justice help us understand and explain which medical practices are ethical and acceptable. These principles are not only used to protect the rights of a patient but also the physician from being violated.
Case #2 is a perfect example of a case that causes one to question which ethical principles are most important and to whom those principles should be applied. Case #2 involves Jane Trause who has had a history of drug use and is currently pregnant. Upon being admitted into labor and delivery, it quickly becomes evident to medical staff that the fetus is medically unstable and needs to be delivered immediately. However, it is determined by the medical staff that the baby will not survive a natural delivery and that the only way the baby will be born alive is by a C-section. Jane and her husband Doug adamantly refuse to allow a C-section and remind the staff that they have a right to refuse treatment. The residents of the hospital must decide if they can morally respect Jane’s autonomy and allow her to deliver naturally, while putting the fetus’ life in jeopardy or if they will override Jane’s wishes and perform the C-section without her permission to ensure a safe delivery.
In doing so as a midwife there are times when certain boundaries are put in place in order to treat the women with respect and care within certain aspects of their life, such as maintaining the women’s dignity in a foreign hospital environment. It is illustrated that when women aren’t given their specific needs or wishes, they may resort to other techniques in order to gain what they want therefore leading to avoidance and confrontation (Clark, 2010). Another quality is by providing a therapeutic relationship with the women. According to Widang et al (2008) when women are treated as an individual and not an object to be treated, their experiences during pregnancies and labour and choices are greatly valued. This allows the women to feel inclusive throughout their pregnancy journey although women who come across discrimination and disrespect would increase the chance of negative experiences, therefore the women would need greater support to overcome certain issues. Therefore, in order for women to feel safe and participate without fear effective communication between health professionals is needed for better care. In the end, it is important for health professionals to reinforce the need for evidence-based practice and overcome the obstacles that midwives will be faced within their practices. These include providing a suitable model of care for
Therefore, they should consider the fact that induction of labour is a bad idea, especially when the mother and her baby are healthy. It also leads to an increased need for medical intervention such as epidural anesthesia, cesarean, and analgesia (Maslow, 2000). While applying the principle of beneficence, the midwife should act in the best interest of the woman. Thus, the midwife should realise that when using any medical intervention, the benefits should far outweigh the risks. Lastly, the principle of justice is concerned with the fair distribution of health resource.
My nurse first acknowledged the doctor’s perspective, suggestions, and frustration. “I understand where you were coming from and I know that my response was not what you anticipated,” my nurse said. She then synthesized her own assessment with the doctor’s and suggested a compromise: “we can do a pelvic exam on our patient, so long as you promise not to rupture her membranes unless it’s necessary.” My preceptor was neither asking nor demanding; rather, she evidenced to the fellow that she had considered the fellow’s perspective, combined with a risk-benefit analysis, and arrived at a course of action about which the two could agree. Performing a pelvic exam would allow the fellow to assess the mother’s progress through labor and obtain data to revise or tweak the plan of care, with the risk of infection and with minimal medical intervention in the childbearing experience.