Ethics in Public Health Practice - Research Paper Example

? Ethics in Public Health Practice Ethics in Public Health Practice Introduction The application of ethical principles in public health practice is informed by the connection between morality and healthcare administration. Public health practice is regarded as a moral practice. It is carried out in the best interest of humanity and is anchored on the objective of improving the welfare of the human subject (Peckham & Hann, 2010). The ends of public health administration are understood within the need to protect and promote human health. The recognition of the sanctity of human life and the upholding of the objectives of good health are key considerations that underpin the practice and service of public health. Human life is considered as sacred and higher in hierarchy as compared to the lives of other living beings. Therefore, the best practices and methods should be adopted in the dispensation of healthcare, on which the essence of life is centrally dependent. Deontological Ethics Theory and Public Health Practice Theoretically, the inculcation of ethics within public health practice is considered along the theory of deontology. This theory affirms the need for people to stick to their duties and obligations when undertaking various activities. The deontological perspective on public health will require the public health practitioner to embrace the duty and obligation of community service by adopting approaches and attitudes that promote the welfare of the community (Bradley & Burls, 2012). A deontological perspective on health would involve the selfless application of duty in ways that prioritize service to humanity above private interests. The role and value of ethics in public health practice also takes the dimension of society. Individuals are not considered in isolation. They are regarded as part of the wider society. A patient is considered as a unit that forms part of the wider society. The application of public health practices is usually conceptualized within the wider scope of society. The aims are usually projected towards the wider public. In this regard, it is important to recognize the value of public health practices as those that seek to make impact in a wider scale. The promotion of societal health is considered as a moral duty of the healthcare practitioner (Novick, Morrow, & Mays, 2007). The healthcare practitioner has the duty of improving the health of the population by applying some basic principles that seek to preserve the health of the society as understood within the framework of morality. A distinguishing aspect of public health is that it is preventive in nature (Peckham & Hann, 2010). Although it may involve some curative elements, public health often works through the preventive methodologies that seek to promote health rather than handling the outbreak of diseases or responding to crises. The participatory nature of its practices makes it possible for the promotion of good health practices that lessen the possibility of diseases in the community. Related to this factor is the promotion of health interests of the disadvantaged in the society. The ethical consideration revolves around the promotion of interests of the less advantaged in the society recognizing their challenges and conditions, which reduce their ability to compete favorably with the healthy and more advantaged sections of the population in pursuing health objectives (Boylan, 2004). One perspective of public health is that it seeks to promote the interests of the community. The ethical angle of the discharge of public health practices requires that the practitioners enjoin the input of the community in a manner that uplifts public health to a communal and all-inclusive process (Boylan, 2004). The ethical angle also requires that public health institutions act with speed to contain health dangers that arise within the society, in order to avert possibilities of humanitarian crises. The practice of public health also requires that the caregivers carry out their duties in ways that protect the physical environment and the social environment of the community. The promotion of public health requires the development of policies that seek to promote the aspect of health as interpreted from a community level. Such practices require the attention of multiple players who must unite forces for the sake of well-being of the society. In standard practice, the caregiver is considered as a partner who seeks to contribute positively to the well-being of the entire society. The conduct and practice of caregivers in public health requires the regulation through the observance of some of the fundamental principles of morality. Theoretically, the caregiver or public health administrator is considered as wielding a significant amount of power over the patient (Boylan, 2004). The power wielded by the public health care giver can be used constructively and positively to promote the health status of the patient. As a result, it is usually considered that much of the requirements of the caregiver must be conceptualized within the aspect of dispensation of power to the point or person of need. Public health is dependent on the manner in which the caregivers appropriate the power and privilege given to them for the promotion of public health. Public health usually involves the utilization of locally available resources for the promotion of the health of the community. Ethically, the process of acquiring and utilization of resources should be conducted in ways that promote the principles of conservation and preservation of the resources for economic reasons (Dawson & Verweij, 2009). Collaborating with local organizations is one of the ways in which resources could be utilized in proper ways for the purposes of promoting the health of communities. The principles of accountability and transparency as understood within the concept of public health have to be upheld for the welfare of the community. The need to regulate the ethical foundation of public health is informed by the fact or possibility of misappropriation of the power vested in the public health administrators (Dawson & Verweij, 2009). Nurses and doctors have often engaged in practices that flout the tenets of morality in the course of administering their services. Over the times, public health ethics were only interpreted from abstract and implied standpoints. However, recent developments in healthcare and the increasing involvement of rights groups and governmental regulation have demanded for express development of the codes of conduct consistent with the framework of ethics (Dawson & Verweij, 2009). On this note, governments and public health institutions have collaborated on the development of specific ethical practices that should govern the conduct and practices of healthcare administration. Dispensing healthcare practices are an activity and process that undergo change over the times. The realization of diversity as understood within the concept of humanity is a key indicator of the need to infuse ethics in the practice of healthcare (Novick, Morrow, & Mays, 2007). On this matter, it becomes necessary for workers within the healthcare industry to consider the special interests that different groups of people may wield. Humanity is diverse and approaches various matters from multiple dimensions. Generally, the aspect of diversity requires that caregivers recognize and respect the uniqueness of groups in order to avoid conflicts that may result from misunderstandings on certain matters. The application of ethics calls for some element of flexibility on various dimensions. Healthcare practice enjoins the practitioner to discharge his or her duties in a balanced manner in a way that promotes the aspect of unity in diversity (Bayer & Beauchamp, 2007). It is important to consider the fact that some of the processes of public health administration are largely dependent on the manner in which the wider public responds to the nature and practice of service. The aspect of communication and the pursuit of mutual interests hold both the caregiver and the patient on the same scale of objectives. The caregiver must use his or her power in a manner that promotes the ethical dimension of public health administration (Bayer & Beauchamp, 2007). On this matter, some of the issues that attend to the administration of justice have to be understood within the same dimension as the ethical value of healthcare provision. The processes and effects of healthcare practice as understood within the framework of public health must be consistent with the obligation of the caregivers to the wider society. Case analyses indicate that some of the medical malpractices that have been reported in the past are largely caused by failure of the caregivers to align their services within the ethical tenets of the profession (Bradley & Burls, 2012). Some caregivers fail to consider the interests of the patient, leading to a communication breakdown that eventually leads to situations of healthcare malpractice. On this note, it becomes important to recognize the fact that some of the issues that connect with the matter of healthcare administration require a social angle just as much as it is determined by the scientific perspective. For instance, some of the health issues that affect humanity are classified under the category of lifestyle conditions. This implies that the status of health is largely dependent on the social, moral, and ethical values of a people. Violation of Deontology Theory and the Case of Jehovah Witnesses Treating patients as human subjects requires the engaging of attention to their feelings and attitudes in order to promote some sense of balance in perspectives. A case example of the relevance of ethics in dealing with special populations could be seen from the perspective of the Jehovah Witnesses group. The Jehovah Witnesses religious group subscribes to a range of beliefs that determine the way in which they live and perceive matters of general interest (Holden, 2012). Their religious interpretation of issues that transcend into the secular domain makes it important to consider the application of health in a customized method. The Jehovah Witnesses beliefs range from matters of diet to associations. For instance, this group does not believe in blood transfusion (Holden, 2012). They hold that the Bible directs against the practice. The group also believes in dissociation from sinners or people they perceive as sinners. The group’s diet is determined by various biblical determinants that categorize certain foods as sinful and unfit for human consumption (Gruss, 2001). Generally, the many practices and beliefs upheld by this group have the potential of affecting their levels of health. The refusal to consume certain foods, for instance, could expose them to some significant health challenges. The task of the public health administrator is to interpret and analyze these beliefs and practices in a way that would lead to the development of the most appropriate approaches of handling the challenge. Handling the health concerns of the Jehovah Witnesses group requires that the public health administrator communicate with the group in ways that would promote collaboration without compromising their beliefs. As such, the public health administrator should provide some basic denominators on which both the necessity and faith of the group are dependent. The approach should be moderated in a manner that maintains respect for the group’s beliefs without compromising the professional requirements. The process should involve a combination of negotiation skills and the use of mild coercion. In cases where negotiation seems effective, the public health administrator should seek support of the group’s leadership in order to effectively put the message across. In some cases, dealing with members of closed societies may require some level of coercion on health matters that have a high level of significance. For instance, the public health administrators should seek government directives on matters such as vaccination or blood transfusion in situations where communication fails to yield positive results. However, coercion should be adopted as the last option after the total collapse of communication. Studies suggest the use of social engineering as one way of achieving change in perspectives. This would require the development of some nucleus group to form as the basis of educating and informing the group on the dangers of some of their religious practices and the merits of certain healthcare practices, which may come into conflict with their religious practices and beliefs. Solution The recognition of the social angle in healthcare practice must involve an awareness of the importance of morality in handling a human subject. In this context, public health administration becomes a service to humanity. It must be regulated by certain ethical factors that unite the process to other concerns that seek to promote the welfare of humanity as understood within the aspect of health and morality (Bradley & Burls, 2012). Some practices require the consent of the patient. Appropriate communication skills must be put into use in the process of engaging the patient within the healing process. The public health caregiver must learn to move beyond the physical processes of healing and seek insights into the cultural factors of the patient. Understanding the culture of the population will awaken the caregiver to important considerations that can be used within the process of diagnoses and the prediction of health needs within a given population. Culture condenses the sum of values and practices of a people. It promotes a shared worldview and provides a framework of interpreting needs and activities within and beyond their immediate environment. As such, culture becomes an important consideration on matters such as healthcare and the general welfare of a people. People within a given cultural sub-set will tend to adopt common perspectives on healthcare. Some of the perspectives may be progressive in aspect while others may have a retrogressive quality on the people. As such, it becomes important to consider the fact that people may object to certain professional practices because of their cultural conditioning (Novick, Morrow, & Mays, 2007). The duty of the caregiver in the public health sector is to negotiate the distance between the cultural values and professionalism in a manner that aligns with the basic tenets of professional ethics. Patient satisfaction has become a universal benchmark of determining the quality of healthcare practice. According to a range of scholarly publications, patient satisfaction is a factor of the ethical dimension of healthcare practice (Novick, Morrow, & Mays, 2007; Bayer & Beauchamp, 2007). Patients will tend to assess the quality of healthcare in terms of the combination between the treatment process and the interpersonal nature they receive at the facility. On this matter, it becomes important to consider the fact that some of the matters that attend to the subject of patient satisfaction are often considered as the measure of the level of ethics within healthcare administration. Past and recent surveys have indicated that public health facilities that anchor their services within the framework of professional ethics have higher ratings of patient satisfaction as compared to those that choose alternative approaches. The index of performance in healthcare practice has shifted from the angle of service provision to include multiple considerations that are used to assess the quality of practice (Novick, Morrow, & Mays, 2007). In the modern world, approaches have shifted significantly in ways that determine the nature of practice of healthcare administration. Generally, globalization and liberalization have affected significantly the administration of healthcare practice in the public domain. Currently, there is a trend of continuing migration of patients from public institutions to private institutions. Generally, socioeconomic factors have contributed to a pattern whereby patients with relatively higher income statuses choose to obtain healthcare services from private facilities as opposed to private healthcare institutions. Comparative analyses have established that the ethical angle in healthcare administration is one of the determinant factors in the process (Bayer & Beauchamp, 2007). Generally, it makes sense to consider the fact that some of the issues that engage in healthcare administration are related to perspectives on ethical practices within and between institutions. Studies have established that the fundamental differences that exist relate to the manner in which private institutions structure their systems on ethical frameworks as one of the ways of attracting customers (Bayer & Beauchamp, 2007). In both Britain and the United States, there has been the trend of public institution performing poorly in terms of the incorporation of quality and ethical practices in healthcare administration (Bayer & Beauchamp, 2007). The application of ethical practices has become the competitive advantage that determines the position of healthcare institutions within a liberal environment. References Bayer, R., & Beauchamp, D. E. (2007). Public health ethics: Theory, policy, and practice. New York: Oxford University Press. Boylan, M. (2004). Public health policy and ethics. Dordrecht: Kluwer Academic. Bradley, P., & Burls, A. (2012). Ethics in public and community health. London: Routledge. Dawson, A., & Verweij, M. F. (2009). Ethics, prevention, and public health. Oxford: Clarendon Press. Gruss, E. C. (2001). Jehovah's Witnesses: Their claims, doctrinal changes, and prophetic speculation: What does the record show? Fairfax, VA: Xulon Press. Holden, A. (2012). Jehovah's Witnesses: Portrait of a contemporary religious movement. London: Routledge. Novick, L. F., Morrow, C. B., & Mays, G. P. (2007). Public health administration: Principles for population-based management. Sudbury, Mass: Jones and Bartlett. Peckham, S., & Hann, A. (2010). Public health ethics and practice. Bristol, UK: Policy. Read More