Ethics in Health Care Services - Essay Example

Ethics in Health Care Services Health care sector forms a critical field in every society. Health care providers are required to maintain the best practice ethics to safeguard the well-being of their clients. Decision-making forms a major part of the practice. Good decisions help in the avoidance of the event of unethical practice on the mode exercising duties. Unethical practices in healthcare are not only risky to the health provider but may also have a major implication on the clients involved. The Neonatal chest physiotherapy at NWH case provides a suitable example of impacts of unethical practices. Health providers are required to follow laid out rules to ensure no occurrence of unethical practices and to avoid the legal implications attached to them. The protection of patient’s confidentiality forms a crucial tool in the health sector (Duncan, 2010). Health providers are often required to provide information on their clients to spouses, employers, administrators, or even insurance companies. Such requests may be of good intentions, but a careful balance should exist between the disclosure and ethical obligations attached to protect patient’s confidentiality. A discussion on the limits of confidentiality that include the use of electronic transmission and foreseeable uses of confidential information can help prevent confidentiality problems (Beauchamp & Childress, 2001). Ensuring the safe storage of confidential records can also help prevent confidentiality complications. The knowledge of federal and state law and the understanding the requirements in obeying mandatory reporting laws can also help in ironing out confidentiality and legal implications. Understanding what constitutes multiple relationship forms another major tool in preventing unethical practices. According to Ethics Code, health providers should avoid relations that in good reason impair their performance as professionals, or could harm or exploit the other parties (Freeman, 2001). On the other hand, multiple relationships not expected to have such implications may not constitute unethical deed. Sexual relationship especially with current clients can never be permissible. In case health providers find that, despite clear efforts, a potential harmful relationship has arisen, ethically they have a mandate to take steps to resolve the best interest of a person while adhering to Ethics Code (Freeman, 2001). Ethics Code obligates health practitioners to practice only on their area of competence. Sometimes, difficulties arise when they practice in emerging issues or areas where no clear standards exist. Through follow-up trainings in conferences, reading journals, and consulting colleagues, they can address the issue of competence. There are exceptions in Ethics Code in extraordinary circumstances where health providers with closely related expertise can offer services if no one else can (Beauchamp & Childress, 2001). It is, however, to a condition that they take a reasonable approach to acquiring competence required. Respect of people’s autonomy forms another crucial tool in minimizing cases of unethicality in the health sector (Duncan, 2010). Health care providers need to offer clients with the information they require to give their informed accord at the start. Failure to give details may cause sticky situations. For example, when a health practitioner fails to explain own duty to report abuse to an adolescent client before treatment commences, an unsure scene may occur if abuse is later revealed the client did not want to report. Important discussion should be the estimated length of therapy, fees, and billing practices, whom to involve in case of emergency and any alternative treatment approaches. When one of his twins died and one survived with brain injuries, Charles Munro argued that the results came about, because of year’s delay in handling the physiotherapy. He complained that, the delay was unacceptable as the disciplinary measures of those involved aimed at safeguarding everybody. He complained of the inaction of the ministry and Minister of Health. Munro viewed that the physiotherapy requires maximum care and dedication to ensuring the achievement of maximum results. If practitioners can take, maximum care to their parents there would be minimal or no deaths at all that would arise because of negligence. The health stakeholders should also ensure that set guidelines exist to monitor the services rendered to patients. A Case study of Paul suffering from Schizophrenia Paul is 50-year-old male living in a residential mental health setting. Paul has been diagnosed with schizophrenia and is suffering some intellectual disability. He is going through on a plan to move back into the community after having spent 10 years in various residential mental health facilities. He is due to move out in the next couple of months. One of the goals for Paul is to stop smoking in his bed. Not only is supporting clients to quit smoking a main thrust of the health sector in general, there are also significant risks of house fires stemming from smoking in bed. On the next visit to Paul, you find him smoking. The organization’s rules specify that such incidents must be reported to the service manager. You are confident that Paul can move into the community, live independently, and fear that reporting the incident will present a significant setback for him but you are also aware of the various risks this behavior poses to Paul. Virtue ethics forms a framework that centers on the character of the moral agent in place of rightness of an action. Virtue ethics considers relationships, motivations, and emotional sensitivities that are unique in the human society. It provides ethical analysis and encourages flexible and creative solutions in moral dilemmas. A virtue is a trait of character manifested in personal habits that is good for one to bear. There are cardinal virtues such as courage, justice, and temperance. On the other hand, there are theological virtues such as charity, hope, and faith. All these virtues are important in day-to-day life situations. Health care providers should be in a position to handle people’s virtues in daily exercise of their duties (Beauchamp & Childress, 2001). Human beings have the ability to make choices based on reason. Reasoning forms the unique feature of human beings that keeps them apart from all other creatures. Through reasoning, a person determines the best way to act, react, and feel in those ways that are appropriate for a given circumstance. The capacity to determine when and how to use the virtues makes a person complete. Emotions have a major role in ethics. In order to act it is necessary to perceive that an action is necessary. It requires the recognition of moral pertinent aspects of a situation (Holland, 2007). Emotions create sensitivity to various circumstances thereby illuminating people’s perception. There are needs to exercise critical judgment in examining and displaying emotional responses. A person with virtues perceives a situation and judges what is right thus act accordingly. Virtuous moral agent gives a deep desire to behave in the right way. Virtue ethic’s take of motivation lies well with the human society where people develop special alliances and bonds that encourage good behavior out of love, friendship, and loyalty (Freeman, 2001). Health care practitioners’ motivation is to improve the wellbeing of the patients. In this regard, they must balance their expert understanding and knowledge about the patients’ preferences. It also calls for consideration of the means through which a person has made a choice and practitioners ensuring they do not transgress any moral code in the field. Professional codes bind practitioners with a strong emphasis on doing right and good in every practice. In the current world, practitioners should work with patients, inform, guide, advice, and help them make appropriate choices on how to deal with their problems. These choices should be typically adapted to suit patients considering their cultural background and social situations (Beauchamp & Childress, 2001). The upbringing, personal priorities, and addiction are likely to influence the decision patient makes. A challenging point may arise where the patient declines doctor’s advice and guidance-for example, Paul smoking in bed despite efforts to help him stop. If a patient is to decide competently on his health, he should be in a position to make competent decisions on the implications of his actions. In the case of Paul, he should be in a position to figure out the risks involved in his behavior. Though it may be an addiction scene, he should make a choice that is of the best interest to him in the end (Ghebrehiwet, 2012). On a virtuous doctor point of view, a clear examination would do well. There is a need to identify emotional response that helps in the assessment of such a situation. This situation calls for self-motivation and that of a patient. As a doctor, there might be a disappointment to make professional judgment bearing in mind the implication the case would bring on the patient’s future (Sofaer et al, 2014). Though Paul’s motive is to stop smoking, the doctor should weigh and reflect on the virtues helpful in the circumstance. Compassion refers to an active regard for another’s welfare with the imaginative awareness and emotional response that constitute a deep sympathy, and dissatisfaction at person’s misfortunes (Holland, 2007). In a compassionate approach of this case, one may consider what it takes a person to smoke knowing the consequences. In the human nature, there is the likelihood to recognize the courage and the efforts to turn down the behavior. It may provoke feelings of admiration of the efforts and deep sympathy towards Paul. Discernment provides a sensitive insight, wise judgment, and understanding to a situation. As discerning practitioner, there is a need to identify the complex emotional elements in the case (Sofaer et al, 2014). One should be able to weigh up the motivations involved in the patient’s health. This should be effectively destined on the motivation of the patient upon where his life is underpinned. Thus, a discerning practitioner may consider motivating the patient, but this would bring more harm than good (Ghebrehiwet, 2012). It is also necessary for a discerned practitioner to consider the well-being of an institution despite pressure from other sectors. On the other hand, one of the pillars of a doctor- patient relationship is trustworthiness. Trustworthiness also applies in the relationship between the institution and the practitioner. Patients rely on the moral character and the competence of the doctors in their health secrets (Seedhouse, 2009). They give out deepest and most personal concerns and even allow most intimate examination. Though this is the case, Paul’s case requires to be reported for the own good health and welfare of the institution. Virtue ethics provides for the flexibility in assessing each situation individually and the search of suitable action a virtuous person would do (Duncan, 2010). Individual sensitivity on the circumstance allows and encourages creative solutions in hard problems where application of rules and principles may be difficult. In the case of Paul, the decision to report is hard but such decisions are worth from an ethical point of action. Utilitarianism theory states that an act is right and deserves if it brings about the greatest happiness to the greatest number of people in society (Beauchamp & Childress, 2001). There are also numerous variations on the basic definition among different proponents of the theory of utilitarianism. Taking consideration of Paul’s scenario in the case study, there are different available alternative course of action. One may consider the fact that Paul is almost finalizing his treatment and reporting may harm his spirit and that of the family members. On the other hand, it is the requirement of the organization that such cases require reporting. Failure to report may imply that Paul’s behavior may result to some fire which that may harm the public at large. There is a need to weigh these two available alternatives to bring out the best result that brings the overall happiness (Seedhouse, 2009). Thus, basing an argument on this theory reporting Paul will bring more happiness to organization that represents the majority who are the society. Consequentialism in the general view holds that the moral rightness of an action should be determined based on whether it produces none moral intrinsic value more than other available courses of action in a situation (Freeman, 2001). Non-moral intrinsic value refers to the state of wellbeing, happiness, and pleasure. It depends on what one thinks it is worth having for its own sake, rather than considering the instrumental value in bringing about something else. Thus, it is worth reporting Paul rather than considering his person efforts as the probable outcome might bring more harm in the public. Classical utilitarianism takes consideration of the consequentialist view that the rightness of an action, if approached from the consequence point of view, may involve the maximization based on intrinsic value of states of happiness (Beauchamp & Childress, 2001). This creates the core point of the greatest happiness for the greatest number. This theory provides the best empirical solution on ethical dilemmas like in Paul’s scene. According to Seedhouse (2009), it would be advisable thus to consider the best interest of the organization. Virtue ethics faces the problem of conflicting duties. For example, abortion is wrong in the natural law, on an ethical view the outcome of if abortion is not done may result to starving children, children abuse or unwanted children. Virtue ethics offers guidance of a person to apply practical wisdom using available tools to make judgments to resolve the difficult situation and move on. This approach may have a negative effect where the difficult situation involves going against some natural laws for the personal interests. On the other hand, virtue ethics has more interest in the development of ethical persons than the development of imperatives and maxims (Beauchamp & Childress, 2001). References Beauchamp, T. and Childress, J. (2001). Principles of Biomedical Ethics, (5th Ed.). Oxford, New York: Oxford University Press. Duncan, P. (2010). Values, ethics, and health care. London: Sage Seedhouse, D.F. (2009). Ethics: the heart of health care, (3rd Ed.). Chichester: John Wiley and Sons. Freeman, M.D (2001). Ethics and Medical decision-makingAldershot, Hants, England Ashgate? Dartmouth. Ghebrehiwet, T. (2012). Reflection on nursing ethics, Nursing Ethics. 19(3), 313-315 Holland S. (2007). public health ethics. Cambridge, UK: Polity. Sofaer, N. Lewis P. &, Davies, H. (2014). Forthcoming practical framework for ethics committees and researchers on post-trial access to the trial intervention and healthcare, J Med Ethics 40, 217-218 Read More