Monday, March 4, 2019
Health policy, law and ethics Essay
For the use of goods and services of this assignment I bequeath look at the reasoned and estimable aspects knobbed in the next scenario and this will be discussed. I will take into consideration both(prenominal) the deontological and consequentialism theory. Laws relevant to this scenario will be looked at. ScenarioTo nurture confidentiality the name of the unhurried has been changed. The forbearing D is 60 years over-the-hill male who had kidney cancer he had been admitted to the hospital for further treatment. On the stick withing investigation the longanimous had been diagnosed with the last stages of cancer which meant it had spread into the surrounding tissue. Prognoses were poor, moderating was to be offered. The family had requested that the enduring should non be informed on that pointfore, D was not awargon about his current condition. The patient could not visualise why checkup mental faculty only made him comfortable and were not taking a different cou rt to his treatment. Consequently, he lost assent in the rung and his will to live and refused everything that was given up to him. The nurses made a decision to inform him of his terminal illness, believing this to be in his outflank interest. He understood the mail service and expressed a wish to flunk at home. Legal aspectsThe situation that the nurses faced in this scenario was uncomfortable for both the patient and the wellness precaution professionals. The nurses had a dilemma of legal and good aspects on one hand, and patients legal rights on other hand. In whatever discussion of ethical issues in medicine, legal aspects may arise. both of them set standards of conduct, where law often shows a kind of minimal ethical societal consensus (Emanuel et.al. 1999, p2). The study of law expresses a process of legal opinion and applying legal doctrine to the real-life situation in the health portion out setting ( outflow and Meacham 2011). A deontology comes from the Hell enic term deon, meaning barter (Jones and Beck 1996). White and Baldwin (2004) state, deontological is fundamental in medicine as it means do no harm and flake in the patients best interest (p.54). Using deontology nest in this case, healthcare providers were issue forthing the rule Act in the patients best interest. The hassle that occurred in this situation is that it was difficult for the healthcare professionals as from a legal point of view thepatient had a right to know the fair play if he wish.The NHS Constitution (2013) states, that a patient has the right to be involved in discussions and decisions about his the health and care, including end of life care, and they be given information to alter the patient to do this (p.9). Healthcare professionals were acting accord to the Hippocratic Oath and following a set of rules, which are formal as a framework of the NHS. One of the rules states, that nurses must safeguard and drive interests of individual patients and cl ient ( bang and Cribb 2007, p.16). Medical professionals must always act in the best interest of the patient. However, difficulty may be experienced in certain situations as the borderline between legal issues and ethics is narrow. The of import professional concept of nursing is accountability for their actions to deliver appropriate care for their patients. This accountability is applicable in the legal context and important professionally, it is found on knowledge and understanding.Therefore, legally it is closely related to negligence and duty of care (Young 1995). In this scenario the nurses felt that they were acting as an advocate for the patient by following the rules. Montgomery (1995), state that accountability, responsibility and duty of care are closely linked. Irrespective of professional standing responsibilities, healthcare staff are still accountable, with regard to duty of care within the expectation of their job (Fletcher and Buka 1999). In this case, the patien ts anxiety could overhear been protruding if he had been full informed of the severity of his medical condition. This would then enable him to understand and accept this untrieds, and would not lead the further complications in his psychological condition. Kravitz and Melnikow (2001) suggest that patients participation in the decision guess process about their care is necessary.Analysing this situation I felt that patient D had a lack of shore leave. A patient should be fully informed about the diagnosis, and consent should be obtained for the treatment proposed otherwise the independent being would be disregarded (Fletcher et al 1995). The importance of patient autonomy came from Nuremberg Trials codes of ethics, which was established in 1948 and stated that The voluntary consent of the human theatre is absolutely essential (Washington 1949 p.181). The autonomy of D was disregarded by his family as they believed it would not be beneficial for him to know the equity. Howeve r, D had the capacity to make autonomousdecisions, such as whether or not he valued to receive information about his current condition.Ethical aspectsThe issue that medical staff came across was to respect patients autonomy that had been breached in the expound situation. Pearson et al (2005) states that patients are individuals, they have the right to be involved in making the decision process about themselves and their future. This belief refers to patient autonomy which is defined as freedom of making decisions within their limits of competency. macrocosm unaware of his medical condition patient D had been deprived of his autonomy. Hendrick (2004) described autonomy as the ability to think about their lives and act thence to a chosen set of rules. Respecting autonomy means treating a person as an individual, involving him in discussion about his planned treatment, allowing him make his feature decision. This is an essential part of any document of patients rights. OConnell et al (2010) states that on that point are close to ethical principles in nursing which include two important elements such as beneficence and non-maleficence. two of them have real implications for nurses. Hendrick (2000) supporting this view states that, in healthcare settings beneficence appears to be a straight forward term, and means to do good. In this situation there had arisen a massive ethical dilemma, and to choose the right approach to do good was not very easy for nurses. From one side, we had the patient who was not suitable for any medical treatment, as he was terminally ill but still had the right for palliative care, hence staff had to comply with all ethical principles. One of them was beneficence, as it seemed beneficial in the beginning not to tell the patient the truth about his condition, fit in to his family wishes. The family believed that patient Ds unawareness of reality would help him contend with his progressive illness. However, nurses whose responsi bility it was to protect the patient from psychological stress and follow another ethical principle, which is non-maleficence. Beauchamp and Childress (2009) state that, the principle of non-maleficence dictates an obligation not to harm.Both beneficence and non-maleficence were described in the Hippocratic Oath as I will use those dietary regimens which will benefit my patients according to my superior ability and judgement, and Iwill do no harm or injustice to them (Greek medicine 2010). The patient Ds reaction to the nimbus surrounding him determined the medical staff to change the original approach to his care and give him the correct information about his prognosis. Respect should be shown to the patient a simple obligation to give him a existent picture of his condition. The patient had a right to know the truth, as he was approaching the end of his life. He might need to discuss some questions with his family and carers in order to arrange his affairs (Nicoll 1997). Basfor d and Slevin (1999) state, the principles of autonomy and justice as, are vital in healthcare practice and are dominant in many origins within medical and nursing ethics. Consequently, there is a contest between the patients right to know and the carers duty of care. veracity is an important part of any relationship. Jeffrey (2006) suggests that communication would become meaningless if there was no overriding moral obligation to be truthful (p. 64). cultivationIn any ethical dilemma healthcare staff should follow the government polices according to the Code of Conduct. As they are responsible for peoples health and have an honour to represent the National Healthcare Service, therefore, they cannot take any situation emotionally and personally. The healthcare professionals attitude to clinical judgement seemed to have increased during the last decade. Considering this, healthcare staff were taking into account new views of recognition of patient rights, to make an autonomous choi ce. The patient D had an luck for choice and made a decision to die at home. The argument in this situation was that all medical professionals should be telling the truth whether or not the patients family agreed. In this case I believe the medical staff were acting professionally and the patient legitimate the attention he required in time, and there were no declension afterwards.ReferencesBasford and Slevin (1999) Theory and practice of nurse Cheltenham UK Beauchamp and Childress (2009) Principles of biomedical ethics (6th edition) New York US Emanuel L, von Gunten C and Ferris F (1999). The Education for Physicians on End-of-life Care (EPEC) curriculum US Fletcher N, Hold J,Brazier M and Harris J (1995) Ethics, Law and nursing Manchester UK Flight M and Meacham M (2011) Law, Liability, and Ethics for Medical Office Professionals Delmar (5th edition) US Greek Medicine (2010) Hippocratic Oath translated by North M Online at https//www.nlm.nih.gov/hmd/greek/greek_oath.html Access ed on 21/03/14 Hendrick J (2000) Law and ethics in nursing and healthcare Cheltenham UK Hendrick J (2004) Ethics and Law Cheltenham UK Jones R and Beck S (1996) Decision making in nursing Delmar US Kour N and Rauff A (1992) Informed patient consent-historical perspective and a clinicians view capital of Singapore Med 33(1) 446 Kravitz R and Melnikow J (2001) Engaging patients in medical decision making. British Medical Journal 323 584-585. Nicoll L (1997) Perspectives on Nursing Theory New York US OConnell S, Bare B, Hinkle J, and Cheeveret K (2010) standard of Medical-surgical Nursing (12th edition) Philadelphia US Pearson A, Vaughan B, Vaughan B, FitzGerald M and Washington D (1949) Trials of War Criminals beforehand the Nuremberg Military Tribunals under Control Council Law 10 (2) 181-182 Online at http//history.nih.gov/ inquiry/downloads/nuremberg.pdf Accessed on 11/03/2014 The NHS Constitution (2013) Online at http//www.nhs.uk/choiceintheNHS/Rightsandpledges/NHSConstitution/D ocuments/2013/the-nhs-constitution-for-england-2013.pdf accessed on 10/03/2014 Tingle J and Cribb A (2007) Nursing law and Ethics (3rd edition) Oxford UK White S and Baldwin T (2004) Legal and Ethical aspects of Anaesthesia critical care and perioperative medicine. Cambridge UK BibliographyGeorge J. Annas Edward R and Michael A. Grodin (1992) The Nazi Doctors and the Nuremberg Code Human Rights in Human . Oxford US Morrison E (2010) Ethics in Health Administration A Practical approach for Decision Makers (2nd edition) London UK
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