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The four principles of healthcare ethics
The four principles of healthcare ethics
The four principles of healthcare ethics
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Obtaining consent for a treatment or procedure is extremely important in health care. It is required before a health care professional can proceed with the procedure or treatment. Pierre Dupont, a trained dentist and chiropodist, was found using experimental foot implants on unsuspecting patients. These foot implants are designed to restrict excessive joint rotation outward and creates an arch in the foot for patients who have flat feet. The foot implants used on Dupont’s patients were based off of a HyProCure model approved by Health Canada in 2006. These foot implants were used without any proof of documentation or certification. Because of Dupont’s actions, the patients now have to pay to have the implants removed by David Greenberg, who …show more content…
supervised Dupont. Pierre Dupont originally studied dentistry in Quebec. His licence was revoked when a patient stop breathing in the dentist chair and later on died after he injected her with too much of a dangerous dose of adrenaline. It is known that the University of Quebec at Trois-Rivieres attempted to “kick” Dupont out after gaining knowledge of his previous offence. Upon graduation, Quebec's College of Podiatrists also tried to block Dupont from practice. Dupont therefore moved to Ontario to practice. The College of Chiropodists accepted him on specific terms. During that time, David Greenberg supervised him during his two year probation period. After the two years passed the college approved him for registration without consulting Greenberg. Within Ontario’s College of Chiropodists certain legislations and rules must be followed in order to obtain registration. The applicant must provide proof that they have not “been the subject of a current proceeding of professional misconduct, incompetence or incapacity, in relation to chiropody or another health profession in or outside of Ontario.” (College of Chiropodists of Ontario, 4). Although Dupont completed his practice and successfully passed the examination, he was found guilty of wrongdoing. The College of Chiropodists of Ontario’s code of ethics indicates that members must maintain the principle of informed consent as well as “communicate complete, accurate information clearly to the patient through verbal, non-verbal and/or written material while establishing a feedback process to ensure individual understanding” (College of Chiropodists of Ontario-Code of Ethics). In this case, Dupont believed he was acting in the wellbeing of his patients. However, he ended up causing them harm. He used a coating on the implants that have been known to cause individual pain and can lead to severe complications. His patients believed they would receive the HyProCure implants because that is what they were told. They were misguided and therefore Dupont violated the code of ethics of chiropodists. When CBC followed up with Dupont’s previous patients they stated that the implants were painful. Children were not able to play sport or run like they used to. When Greenberg was told to remove the implants from the patients, it caused them extreme pain. Therefore, Dupont’s is liable for non-intentional negligence. In this case, consent and communication is the most important values that were relevant in this case. In regards to deontological ethics, Pierre Dupont never told the patients the brand of foot implants they would receive.
He gave them the knock-off brand believing it was in the best interest of his patients. Therefore, autonomy and beneficence was attempted but never accomplished. Instead, malfeasance and negligence was apparent in this case. By definition, health care professional who follow deontological ethics believe they have a professional duty to help the patient as opposed to just working in order to get paid. In the case with Pierre Dupont, he was doing just that. He viewed the patients as individuals that needed help in his field of …show more content…
expertise. In order to fix the ethical issue that is present in this case, I would talk to patients, doctors working with or supervising Dupont and Pierre Dupont himself.
I would talk to patients to see if they were led to believe they would receive the HyProCure implants and paid the estimated cost of the HyProCure implants. By talking to the patients and their parents I would be able to gather the information that would determine if Dupont asked for consent or told them they would receive the correct implants they thought they were going to receive. By talking to Greenberg, the chiropodist, supervising Dupont during his probation period, I would be able to ask him how often the College of Chiropodists of Ontario check on him and what restrictions Dupont had regarding his practice and qualifications. When speaking with Dupont, I would get him to explain the procedure and how it is done. This would include Dupont explaining the implant and if he explained the procedure to the patients. As mentioned previously we already know Dupont claims that he used the experimental implants on patients because it was in their best interest but I would ask him why he thought that and if he ever thought about the harm it may cause them. If the patients sit down with Dupont and talk to him about what they are going through, Dupont may feel inclined to change his actions or help the patients in one way or another. I would also talk to the College of Chiropodists of Ontario because that would allow me to
have a better understanding of their legislations and code of ethics. I would follow up with them to see if they have any steps when dealing with misconduct. If they do I would follow up with Dupont to see if he was aware of these policies. Because Dupont has an offence already against him with his dentistry license being revoked, I would possibly be inclined to convince Ontario’s College of Chiropodists to do the same with his license to practice Chiropodistry or atleast limit what procedures or examinations he is able to do. In order to implement the plan, I would have to set up appointment with the patients, the college, Greenberg and Dupont if they are willing to talk. I feel as though having the patients and Dupont all talk in a monitored area it would allow for Dupont to get his point across and the patients to show him how much pain and suffering they are going through. The only difficult part is that the college or Dupont may not want to say much because the investigation is still on going and previous reports have been made regarding his past in dentistry. I believe if the previous steps are followed the ethical dilemma may solve itself. To emphasize it again, consent and communication where the major ethical issues in the Pierre Dupont case. He inserted experimental implants into children and adults without their consent or knowledge. They were led on to believe they were receiving the HyProCure implants as opposed to a knock off brand. If Dupont, Greenberg, the college and patients all get together to talk about the guidelines, ethics, and patient’s opinions then problems and issues will be able to be communicated. The college may realize they should have followed up with Greenberg and Dupont before giving Dupont the registration to practice. Dupont may understand what code of ethics he was violating and the steps that he should take in order to fix the problem he created.
American Medical Int’l, Inc. According to this theory, individuals’ decisions are guided by what they are supposed to do, not by consequences or effects. That is to say, a person’s action is ethically right if it coincides with a prevailing moral duty (“Deontological Ethics,” 2007). In the dilemma involving the patient Riser, Dr. Lang violated the theory of deontological ethics by not performing his duty of acquiring informed consent from the patient. By standard of conduct, Dr. Lang was supposed to present a consent form to Riser prior to the operation that would explain the procedure of a femoral arteriogram (although it was supposed to be bilateral arteriograms instead) and thoroughly explain the possible benefits and risks of the procedure. As a result, the patient should have the right to decide whether the femoral arteriogram should be performed or not. However, Riser was not aware of the femoral arteriogram at all. Therefore, deontological ethics should have been followed, which would advise Dr. Lang to follow the ethical duties of a healthcare professional, and those include obtaining informed consent from the
Iturralde v. Hilo Medical Center (HMC) is a medical malpractice case brought about by a representative for the Estate of Arturo Iturralde. The plaintiff, Rosalind Iturralde, is suing both HMC and Dr. Ricketson individually and as a representative for Arturo Iturralde’s Estate. The Defendants are HMC, Medtronic Sofamor Danek and Robert Ricketson, M.D. This case was brought about as a result of gross negligence and malpractice on the parts of HMC and Dr. Ricketson. During spinal surgery on January 29, 2001, Dr. Ricketson implanted a portion of a stainless steel, surgical screwdriver shaft into the spine of Aurturo Iturralde. This screwdriver shaft was not intended or approved for human implantation. HMC staff failed to inventory the surgical
This case is about a 15 year old kid, along with a friend, who made an erotic call to a neighbor's house. The alleged incident took place on June 8, 1964 by Gerald Gault and Ronald Lewis. Mrs. Cook, the neighbor, filed a complaint which resulted in Gerald Gault’s arrest. Gerald was indeed on probation for something he had done prior to this incident. The officer who made the arrest did not leave notice for the juvenile's parents and did not endeavor to advise them of their child's arrest, however, they found out about the arrest from Ronald Lewis later.. “After arresting a juvenile, an officer must notify the juvenile's parent or legal guardian regarding: the whereabouts of the child, the nature of the charges, and the police department's planned course of action” (O'Neil, 2010). Gerald’s mother was giving information on when the hearing for her son was after arriving where he was
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
The case of Marguerite M presents an ethical dilemma. Medical ethics play a special role in medicine and is directly concerned with its practice. Its role has continued to evolve as changes develop in
DuPont has been known for its low reliance on borrowings. In the 1970’s, the company had to assume a substantial portion of debt of Conoco, a newly acquired company. In 1983, the managers have to decide about the future optimal target debt ratio. Should the company continue to keep about 40% of its assets financed via debt or should it strive to lower its borrowings to 25%?
Denise Dudzinski, PhD, MTS, Helene Starks, PhD, MPH, Nicole White, MD, MA (2009) ETHICS IN MEDICINE. Retrieved from: http://depts.washington.edu/bioethx/topics/pad.html
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.
Metal foam in the future will be an integral part of our society, however, in order to prevent abuse from this technology ethical principles will be applied and anticipated. Metal foam will be heavily used in the medical field, specifically orthotics. It potentially could replace and enhance the human bone structure. Consequentially, there is a great potential that people will misuse the technology, prevent others from benefiting from the technology, and falsely misrepresent the technology. The principles used to anticipate ethical problems are justice, rights, and consequentialism.
Ohio Dep’t of Rehabilitation & Correction are the poor-quality patient care that Tomcik received and Tomcik’s health being at risk. Once engaged in a doctor-patient relationship, physicians are obligated to provide the best possible care for the patient by utilizing their skills and knowledge as expected from a competent physician under the same or similar conditions (“What Is a Doctor’s Duty of Care?” n.d.). However, in Tomcik’s situation, Dr. Evans did not deliver high-quality care, for he administered a perfunctory breast examination and thus did not follow standard protocols. There is evidence of indifference conveyed by Dr. Evans, and the lack of proper care towards Tomcik is an issue that can be scrutinized and judged appropriately. Additionally, Tomcik’s health was at risk due to the failure of a proper physical evaluation and the incredibly long delay in diagnosis and treatment. The negligence from Dr. Evans, along with the lack of medical attention sought out by Tomcik after she had first discovered the lump in her breast, may contribute to Tomcik’s life being in danger as well as the emotional anguish she may have felt during that time period. Overall, the incident of Tomcik’s expectations from the original physician and other employees at the institution not being met is an ethical issue that should be dealt with
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.
There are weaknesses in professional guidelines and rules because they are unable to provide the directives for moral reasoning and action is health care situations. Many people state that biomedical ethics provides a framework and emphasis on the person rather than the professional code and legal policy (Beauchamp and Childress, 2001). On the other hand they serve a purpose to provide some direction for professionals however codes of practise do not dismiss.
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.
6). Good intention is the main moral principle considered and consequences are irrelevant (Joel, 2013, p. 526). Seemingly, the deontological ideology focuses on the actions of the agent and would disregard patient focus and individuality. It is difficult to apply contemporary ethical theories to the nurse because of the values of the nursing profession. “Contemporary ethical theories do not lend themselves to the health-care professions or to ethically defensible decisions in health-care practice. None of the dominant ethical theories could be discovered in, or derived from, the profession of nursing” (Joel, 2013, p. 526). Casuistry, while not an ethical theory, is a case-based approach to practical decision-making. Cases that have set precedence are identified and comparisons are made using similarities, differences, and previous experiences. This concept is used to complement ethical theories in patient decision making by clinical ethics committees (Slowther, Johnston, Goodall, & Hope, 2004, § C4). Personally and professionally balancing ethical perspectives to be able to consider all details on a case by case basis seems like a more appropriate
McGee, Glenn and Arthur L. Caplan. "Medical Ethics." Microsoft® Encarta® 98 Encyclopedia. © 1993-1997: Microsoft Corporation. CD-ROM.