The Medical Codes of Ethics - Coursework Example

Ethics and Law Introduction Professional of ethics regulates the behaviour of healthcare experts and signifies the commitments to perform with honesty in severe conditions (Farrell et.al, 2011). The patients expose themselves to risk of sharing intimate medical information with doctors thus they are vulnerable to loss of confidential information. Ethical principles of conducts such as Hippocratic Oath protect the patients and doctors when dealing with delicate issues of their lives (Dowrick & Frith, 2012). The medical codes of ethics forbid against certain practices such as disclosure of information and determine how doctors should conduct their activities for the advantage of the patients (Dolan & Barrister, 2004). The doctors are required to sympathize with the patients, cure those in suffering, and portray a high level of understanding when delivering bad news to the patients and not to judge the morals of any patients. PART ONE The case involves a fourteen year old girl who was admitted in A&E hospital with severe abdominal pain. The girl was tested for pregnancy in accordance to the hospital’s policy that requires all women at childbearing age suffering abdominal pain to undergo the test. The girl was in the company of her parents who were interested in doctor’s report regarding their daughter. The parents had agreed to take care of their daughter irrespective of the outcome of the test results. However, they appeared shocked when the doctor requested for their daughter’s urine for conducting the pregnancy test and feared their daughter was sexually active. The tests of the results were positive and the girl requested the doctor not to inform her parents that she was pregnant. The case had legal and ethical implications dilemma on the doctor due to the responsibility he had for the patient. The “General Medical Council (GMC) requires doctors to take their patients with great concern” (Jackson, 2013, p. 5). When dealing with minor patients the first concern should be the client, but the parents of the child should also be considered. The healthcare providers are supposed to involve both parents and their children in a discussion involving the treatment and health conditions of the children (Dolan & Barrister, 2004). They have to be honest with the parents and children and maintain confidentiality of the patient’s information. This aspect poses an ethical dilemma to the doctors because they have to maintain the secrets of their patients and help the patients to make a sound decision regarding their health (Gabel, 2011). The minor may lack capacity to make an independent decision, thus they rely heavily on their parents in whatever decision they make. According to Mental Capacity Act 2005, all persons are presumed to have mental capacity to make decisions unless it is proven that they have no such capacity to make an independent decision. However, even if they lack such capacity to make a wise decision they should be assisted to make decision in a way that will not restrict their freedom and rights of action (Farrell et.al, 2011). In the case above, the doctor should give the child an opportunity to make her decision as long as it is in her best interest. "Sharing of information regarding the health conditions of the children with their parents helps the parents to make decisions on behalf of their children" (Anderson & Wearne, 2007, p.99). Doctors should seek consent of sharing information from the child. This will enable the doctors to show respect to the child and make children develop trust for their doctors. The healthcare givers should assist the children to learn why it is essential to share the information with the parents (Dowrick & Frith, 2012). Also, it will help the parents and children to establish a stronger relationship because the decision will be arrived at in a mutual agreement. Finally, involving parents and children in decision making in regard to the health condition of the child will help the parents to decide on what is best for the children and be able to take care of them (Gleeson & Clarke, 2008). In this case, the patient who is a fourteen year old girl is pregnant. The patient is a school going girl thus sharing about her pregnancy with her parents is essential because they can make arrangement on how their daughter will resume studies after delivering the child. However, the girl is unwilling to share the information about her pregnancy with her parents. She has requested the doctor not to disclose any information to her parents. From the way, her parents reacted to the doctor’s request for a pregnancy test it is apparent that they may take punitive action against their daughter. On the other hand, the girl’s request to the doctor not to disclose the information to her parents depicts the girl could be having other plans and may never inform her parents about. The doctor has the duty of ensuring the patients are safe thus has to protect life and avoid causing conflict between the parents and their children (Herring, 2006). This implies the doctor has to consult the girl and discuss the importance of sharing the news of her pregnancy with her parents. The doctor should obtain permission from the girl to inform her parents about the girl’s condition (Dowrick & Frith, 2012). In addition, the doctor should offer counsel to the girl’s parents against overreacting to their daughter because of her condition. The doctor should inform the parents of the consequences of not respecting and loving their daughter due to her condition (Dev, Sanders & Metcalfe 2013). However, the doctor should inform the parents about the girl’s pregnancy since the consequences of not informing the parents may be severe than the consequences of sharing information with the daughter’s parents (Garden& Bradbury, 2012). The nurse has an obligation to maintain the secrets of the girl’s pregnancy and not to disclose it to her parents. In addition, the nurse has an obligation to protect the lives of the unborn baby and that of a girl (Smith, 2012). The nurse’s obligation for the girl contradicts with that of the girl’s parents. In Gillick v West Norfolk and Wisbech Area Health Authority [1985] 3 All ER 402 (HL), the judge issued the parents consent was unnecessary for the doctor to give contraceptives to girls below sixteen years because the lack of parent’s consent may increase early pregnancies of the teenagers. In this case, the parents had requested to be given all the details of the information regarding the test results of their daughter and the nurse has an obligation to share the information with the parents since they are responsible for making decisions on behalf of their daughter. However, for the sake of the girl’s security and the likely consequences of girl’s reaction afterwards calls for the doctor’s intervention to inform the parents about it and direct them on how to handle their daughter without causing severe consequences to the girl and the foetus (McLean, 2009). In the case involving Tarasoff v. Regents of the University of California [1976], the court granted doctor obligation to disclose information for the security of the patient and those in danger, such as the unborn child. Furthermore, in Re W (A Minor) [1992] CA, the court stated that the doctor did not require to obtain consent from a sixteen years old girl in order to provide her treatment. PART TWO The case is about a child who is critically ill in intensive care unit and in urgent need of blood transfusion or else the baby may die. The parents protest the issue of blood due to their religious doctrines and have rejected the doctor’s decision to use blood transfusion in order to save the child. The medical experts have a duty for saving lives of all the people. Principle of Autonomy The ethical principle of autonomy requires people to be given liberty when making their own decisions (Dowrick & Frith, 2012). The parents should make decision on behalf of their child. However, sometimes people can make wrong decisions for lack of knowledge between right and wrong. Therefore, doctors have an obligation to teach the child’s parent on how to make better decision. The parents should be given support in their decision making process in order to ensure they do what is right for them. Furthermore, no one should coerce the parents to make decision (McConachie, 2009). However, guidance is essential in order to ensure the parent’s decision is effective and is based on adequate analysis of cost and benefit of whatever decision they opt to take. Therefore, the child’s parents should be given autonomy to make independent informed decision. Principle of Beneficence The ethical principle of beneficence requires decisions taken be for the benefit of the people concerned (Madsen, 2011). They should promote the wellbeing of the people, end discomfort and promote the potential of the people to live better lives. In this case, the parents of the child and the healthcare team should take decision that will benefit the child and other members of the society. The benefit should be perceived by the person concerned instead and does not specifically mean tangible benefits in the actual sense (Harte, 2005). The decision taken should protect the rights of the vulnerable people. In addition, the action taken should not cause harm to anyone, but instead it should promote a safe environment for the vulnerable people. The parents and the medical providers should make a decision that will support the benefits of the child. Failure to take a decision that will save the life of the baby is unethical and against the principle of beneficence (Hubrecht & Kirkwood, 2010). The parents’ reason for opposing the idea of blood transfusion is based on religious principles and does not have any tangible benefit either to the child or to the parents. In Re T [1992] CA, the judge stated it was right for the doctor to transfuse blood to a twenty years old patient against her wishes since her illness could have impaired her capacity to make sound decision. The parents and doctors should make decision on behalf of a minor or another person lacking mental capacity to make an independent decision. Principle of Non-Maleficence The principle of Non-Maleficence calls for the decision makers to take an action that does not cause any harm on the person whose decision was applicable (Dowrick & Frith, 2012) The action taken should save the life and should not cause death or any harm to other people. The parents and the doctor have a duty to protect the life of the baby (Youngner & Kimsma, 2012). According to the doctors, the only option to save the baby and alleviate pain is by providing blood transfusion. The parents are opposed to blood transfusion and this is likely to cause pain and even death to the child. The parents are after obeying the religious doctrines without mining about the consequences it will have on the baby’s life. The medical experts have a duty to implement the principle of Non-Maleficence by providing blood transfusion to the baby (Gabel, 2011). Medical ethics require doctors to protect human lives and should do anything to protect the life and alleviate sufferings. Principle of Confidentiality The principle of confidentiality emphasizes the doctors’ care for the patient as a basis for building trust between the patient and the doctor (Dolan & Barrister, 2004). When patients go to hospital their hope is that the doctor will do all it takes to alleviate suffering or save the life. The healthcare providers should protect the patient’s information against unauthorized people while trying to do anything to save the life of the baby (Crellin, 2005). In this case, parents are the right people to access the information of the baby. However, parents’ religious faith contradicts doctor’s mission of saving a life or alleviating the pain of the baby (Atkinson, 2014). However, the doctor should find means of saving the baby without disclosing the patient’s information to other people. The healthcare providers have an obligation to save the baby through blood transfusion irrespective of the parent’s opinion. Therefore, the medical ethics require doctors to save the life of the patient and ensure the patient is safe and happy. It is unethical for the doctors let the baby continue suffering just because of parents’ religious doctrines that have clashes with medical principles. It is the patient who is in suffering and nothing should stop them from saving the patient. Medical ethics allows the healthcare providers to go against other principles that poses threat to human life and that can prevent them from implementing medical ethics. The medical experts are answerable to the patients and should consider the parents opinion when dealing with a minor patient. In Re A (conjoined twins) [2001] 2 WLR 480, Mary and Jodie were conjoined at the abdomen. The doctor informed the parents that they kids had to undergo an operation in order to separate them. The operation would result to the death of Mary while Jodie would survive. The parents were against the operation on religious grounds although they were informed by the doctor that all kids would eventually die if not operated. The doctor carried out the operation and when sued the trial court found the doctor liable for the death of Mary. However, the court of appeal reversed the ruling by stating that the doctor’s action was in the best interest of Jodie. Therefore, both doctors and parents have the right to act in the best interest of their children. Bibliography Anderson, O. & Wearne, M. 2007. Informed consent for elective surgery—what is best practice? The Journal of the Royal Society of Medicine, 100(2). Pp. 97–100. Retrieved from Http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1791005/ Atkinson, R. 2014. Shades of Deviance: A Primer on Crime, Deviance and Social Harm. Routledge. Pp.24-31 Crellin, J. K. 2005. 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McConachie, I. 2009. Anesthesia for the High-Risk Patient. UK: Cambridge University Press. Pp. 16-27. Palmer, S. 2014. Strategies and Interventions for Reduction and Prevention. Routledge. Pp. 34- 39 Re A (conjoined twins) [2001] 2 WLR 480 Smith, S. 2012. The End-of-Life Decisions in Medical Care: The Principles and Policies for Regulating the Dying Process. UK: Cambridge University Press. Pp. 6-9. Tarasoff v. Regents of the University of California [1976] Youngner, S. & Kimsma, G. 2012. The Physician-Assisted Death in Perspective: Assessing the Dutch Experience. UK: Cambridge University Press. Pp. 36-42. Read More