Challenges in Capacity and Decision Making - Case Study Example

Introduction Health complications are diverse and dynamic, and so are the means through which they are addressed. Health care providers and caregivers collaborate and work hand in hand to ensure that the goals and objectives of healthcare are met. On the same note, healthcare practices are guided and informed by laws and regulations, all of which are designed to safeguard the welfare of patients, caregivers, clinicians, and all other stakeholders in the health sector. Cultural, social, economic, legal, and political factors influence every aspect of health care practices. The primary objective of healthcare provision is to meet the demands of patients, by enhancing care access and caregiving procedures. Legal Issues at Stake The Mr. Jones scenario presents one of the many complexities that are experienced in the healthcare practice. Numerous stakeholders are confined into a common ground where objectives are straight and result-oriented. Mr. Jones is facing health complications that the relevant parties must try and resolve in a bid to improve the patient’s health status and welfare. In the Mr. Jones scenario, a number of legal issues emerge. To start with, Mr. Jones is entitled to quality health care just like any other patient. The law provides for indiscriminate care of patients in whatever state (Sultz & Young, 2010). Patient rights are at stake in the scenario. Choice and consent to care is another critical legal issue observed in the scenario. Although Mr. Jones is entitled to care by law, the caregivers and physicians cannot force him to any medical practice if he does not consent and choose to be treated. A complementing legal aspect herein is the role of guardian or surrogate decision maker. If Mr. Jones is entitled to one, then the surrogate decision maker can make a choice on behalf of Mr. Jones. However, the legal process that provides this practice must be observed. Another legal issue pertains to the role of doctors and nurses attending to Mr. Jones. They must adhere to the code of ethics and conduct in caring for Mr. Jones. They should work to their level best to ensure that Mr. Jones receives the attention he needs, subject to ensuring that Mr. Jones capacity to make a decision is accounted for. On the same note, there are underlying lawsuits that may be filed if one or more provisions of the law are overlooked (Patricia, 2001), relative to Mr. Jones treatment. Relevant Issues at Stake There are a number of issues in relation to Mr. Jones condition. The gangrene discovered on Mr. Jones leads to care recommendation that Mr. Jones opposes. The issue here is whether to execute the care procedure or adhere to Mr. Jones refusal. Mr. Jones’ daughter takes care of him, and feels that the physicians needs to do what is necessary so that she can take her father back home. Another issue arises in relation to whether the physicians should listen to the daughter or the father. The physicians have undertaken the tests, and they have all the information they need to execute care giving procedures on Mr. Jones. Capacity assessment on Mr. Jones emerges as a pertinent issue. He needs to be evaluated for his capacity to make decisions in relation to surgery or any other procedure that may be required. This is a sensitive issue due to the complexities involved. There have been many instances where the extent of incapacitation relative to making critical personal decisions is hard to establish, making capacity assessment a difficult task (Bratman, 2009). On the same note, Mr. Jones is not signed for guardianship, and a second party making such a crucial on his behalf is difficult. Advance directive would solve the puzzle in this case, but unfortunately the patient is not signed up for it (McFadden et al., 2006). Amid this, the rights and freedoms of the patient and the laws of practice have to be adhered to. Capacity Assessment Capacity assessment seeks to evaluate the patient’s condition in terms of the ability of that patient to make critical decisions during care procedures (Applebaum, 2007). Patients are entitled to quality care, but they cannot be forced into something they do wish to do. If a patient wishes not to be treated, then the physicians have no say to that, except in the event of an emergency, and the primary concern is saving the patient’s life. However, in the same event, there are complexities involved relative to advance directives. The capacity assessment practice can determine the patient to be incapacitated, a situation that would require surrogate decision making in relation to the course of action that physicians should take. Guardianship plays the same role in making decisions on behalf of the patient. Capacity assessment matters relative to ensuring that the patient’s wishes or those of a close party to the patient are observed. Different health conditions may render patients unable to make critical decisions about themselves the care giving setting, an aspect that capacity assessment seeks to account for (Applebaum, 2007). It is crucial in determining the patient’s soundness prior to administering care procedures. This practice also matters in line with the laws that protect the autonomy of patients or that of their close counterparts (Applebaum, 2007). Addressing the Issue at Hand Addressing the issue at hand in Mr. Jones scenario is not a matter of what constitutes right or wrong. It is a matter of taking into account all variables that influence this scenario, taking into account the underlying moral values therein. In times of such difficulties, the hospital's ethics committee or ethics consultation service should be engaged into the resolution of the matter (Landesman, 2005). The emerging complexities call for deliberation and evaluation of all possible aspects of the matter in order to alleviate violation of either party’s rights or freedoms and engage in lawful practices. The ethics committee in the hospital becomes integral to the case due to the emerging concerns and complexities. Mr. Jones’ daughter cannot engage in guardianship acts if she is not signed up for it. The physicians cannot speculate on the course of action since there advance directives are lacking (Birnbaum, 2006). The patient is also entitled to care that he consents to. An emerging situation in this line should involve the ethics committee for complexity oversight, guidance, and direction, to minimize the occurrence of lawsuits, as well as patient-guardian-physicians conflicts. All the three parties have moral obligations to account for. Conclusion Healthcare is an extensive practice that brings on board massive concerns from every aspect and stakeholder involved. It is vital that collaboration and cooperation be observed across the different levels of care in health services. Guidance, laws, and regulation of healthcare practice play a vital role in enhancing coherence and service across the various persons involved, from patients to caregivers. In view of the Mr. Jones case, every single concept of care is vital, especially in ethical and legal contexts. References Applebaum, P.S. (2007). Assessment of patient’s competence to consent to treatment. New England Journal of Medicine, 357(18), 1834-1840. Birnbaum, R. (2006). Health Maintenance Organizations. New York: Spectrum Publications, Inc. Bratman, S. (2009). The alternative medicine sourcebook: A realistic evaluation of alternative healing methods. New York: Lowell House. Landesman, L. (2005). Public Health Management of Disasters: The Practice Guide. New York: American Public Health Association. McFadden, K., et al. (2006). Exploring Strategies for Reducing Hospital Errors. Journal of Healthcare Management, 51(2), 123-35, Discussion 136. Patricia, M. (2001). Managed Care Organizations: Manage to Escape Liability: Why Issues of Quantity v. Quality Lead to ERISA’s Inequitable Preemption of Claims, 34 Akron L. Rev. 571. Sultz, H., & Young, K. (2010). Health Care USA. New York: Jones & Bartlett Publishers. Read More