Ethics In Healthcare - Essay Example

Q.5 In the case of Miss E who is suspected as having a serious condition, possibly a brain tumor, there does not seem to be a definite means of gaining clearance for the blood tests useful in the process of elimination. This is because Miss E is covered under her employer’s HMO. As her physician, Dr. F feels strongly that a blood test is necessary and must then work around an HMO denial. The very first thing that is wrong in this scenario is that an HMO is making a decision to essentially not treat a patient thereby tying the hands of the physician. The physician can however, appeal this denial in hopes of having it approved on an emergency basis. The flaw in this system is that so many cases of medical relevance; do not always have the luxury of time. To circumvent this, there is little that Doctor F can do besides simply administering the tests required in a timely fashion, in the best interest of the patient. Once the patient has been treated and given the tests required, either the physician may personally work out a payment plan with the patient or encourage the patient to apply for Medicare which will cover procedures retroactively up to 90 days. Useful information which may be used to evaluate an HMO morally would certainly be letters of denial as well as proof of non coverage in emergency treatment situations. If we were to assume that HMO’s are beneficial because they do in fact lower costs of healthcare, we must also consider the fact that HMO’s are often useless to those who have them because they simply don’t cover so many different medical procedures and they set their criteria for what will be covered, so high that many patients are out of luck with coverage . Sadly, it is as though HMO’s see cost and profit as a priority over patient care. There is no price tag on a human life so the risks essentially outweigh the benefits when it comes to HMO’s. Ultimately, access to HMO’s can be curbed without setting limits, if HMO’s would cover necessary tests and treatments in the first place instead of leaving patients no other choice but to not seek treatment. In the event that a patient is not granted the medical procedures that they require, they do not just go away but later resurface as much sicker than before whereby ultimately costing more than if they had been treated or tested in the first place. The element of flexibility almost does not even exist with regards to HMO.s. Rules and guidelines can be in place while still affording some level of flexibility. This however, is not the case with most HMO’s. I absolutely agree with critics who feel that the rigidity of HMO’s is in direct opposition to the very nature and purpose of healthcare. The unethical and inhumane practice of denying individuals treatment or testing absolutely does not contribute to putting the healthcare needs of the patient first; which is an ethical responsibility of all those employed in the field of healthcare. Q.6 In the case of the internist who shall be referred to as DrI, owns a fair amount of shares in multiple companies such as a clinical laboratory, an HMO and a pharmaceutical company to mention a few; a large conflict of interest absolutely exists. If Dr. I owns such stocks, it is certain that he will only prescribe medications from the pharmaceutical company in which he holds stocks. It also stands to reason that he may even order extra or unnecessary lab tests regularly, from the lab in which he owns stocks. Certainly, in the event that he owns stocks in a specific HMO, he may be tempted to treat patients with that specific HMO coverage in different manners of treatment than what would be appropriate for their condition. In other words, an HMO denial coming from Doctor I’s HMO company in which he owns stock, is a benefit to him because the less money the HMO spends on patient care, the more their profit margins rise. The issue of boundary violations can arise when physicians use their medical position as a means to benefit someone else in particular in which they have vested interests. Boundary violations reflect any form of using one’s healthcare employment as a means to benefit, achieve an agenda or benefit someone significant in their lies. A conflict of interest is more of a situation where a physician finds herself in between two opposing sides of things; both of which she has strong opinions or feelings for. In many cases, this type of boundary violation may be so because of money and profit. The position of dual roles as a source of bias can certainly jeopardize a physician’s ethics and is therefore similar to conflict of interests. Similarities to blinding in research is meant to remove as much bias as possible. This is a means of avoiding both boundary violations and conflict of interests. Without blind studies, numbers and data would be constantly altered ultimately harming patients. The idea that clinicians who have certain monetary investments within their field are acting unethically or endangering the performance of their work due to simply having an invested interest. If this were true, no employee of any company would ever be permitted to own stock in their own field of work or specific company where they are employed. Ways in which we can screen or keep an eye open for situations in the medical industry where clinicians are operating with a conflict of interest could include possible rules about having monetary investments in pharmaceutical companies if one is licensed to write prescriptions. Another way would be to rearrange the pharmaceuticals such that they could no longer legally function as door to door charlatans at physicians’’ offices. Q7. The law as well as medical ethics, makes provisions for those who are in the midst of a medical emergency with no healthcare insurance. Certainly, if one were suffering from a possibly fatal gun shot wound, the question of whether or not to treat would likely be non existent, as a person‘s life is at stake. In the case of Mrs. Z and her family’s lean financial means, she is limited as to what type of healthcare she receives if any. She suffers from chronic illness including diabetes, constant infections and depression. There should not even be a line here as this woman absolutely deserves and requires health care treatment otherwise, her condition will worsen and she will die. In the event that Mrs. Z was not the one without healthcare but in fact, it was one of her children. The same rules have to apply to adults, children, men and women alike. To not do so would allow for a medical industry to refuse treatment on a regular basis in the case of those who’s lives are less valued do to age or other variables. Mrs. Z’s depression is an illness just like diabetes and cancer. Without treatment and medication to possible stabilize her psychologically, Mrs. Z could be prone to or likely to commit suicide or harm others. She should absolutely receive treatment for depression as should everyone suffering from it. Mrs. Z should have any and all access to healthcare as should everyone. The only real aspect of medical practice which is not in some way pertinent to human life and quality of that life rom a health related standpoint and that is plastic surgery. Plastic surgery of any kind should be available only to those who can self pay. Everything else should be covered, not just for Mrs. Z but for every human being. Society has an obligation to its citizens both in the area of healthcare and in education. Both of these basic necessities should be completely government funded all across the board. Whether or not Mrs. Z’s health problems are exasperated by stress, she should still be provided for medically. Q8. In the case of Miss G, society has an obligation to help its citizens and should provide transportation for her and her ill children, in the event that she or her children must get to a clinic. In the event that Miss G cannot provide for her children medically, the last thing that should happen is that she should lose her kids. Society should aid her in getting her children the care they need. Removing children, sick or not, from a loving parent due to finances or any reason other than neglect or abuse, is absolutely wrong. Miss G should also be entitled to government funds such as SSI due to her ill children. This is a way of allowing her the resources to care for her children. Q9. In the event that a couple is planning to have children but Mr. D is fatally injured, suddenly. As long as there is some sort of documentation expressing his wishes with regards to having children with Mrs.D, postmortem sperm donation as well as comatose sprem donation should absolutely be acceptable and possible. This is not so unlike the removing of viable organs from the dead in order to provide those in need of a transplant with the organs they require. In both cases though, an advanced directive should dictate such permission. If a woman is pregnant and becomes irreversibly comatose, there is no reason at all why the pregnancy should not continue, especially if the woman had planned to have the child. If there is no available father, adoption is a perfectly viable alternative. Thus far, science has not been able to narrow done how moral the process of cloning truly is. It is however immoral if the purpose of the cloning is simply to harvest organs. The difference between removing the viable organs of the recently deceased, in order to provide them for patients who will die without a transplant is not so dissimilar from harvesting eggs or sperm from a recently deceased person if in both cases, an advanced directive is given before hand. Q10. In the event that a woman is pregnant and considering an abortion due to her school commitments, the father of the baby should have the right to offer to take the responsibility of the child once it is born. It is true that her body is her own, but inside of her is another individual with a body of its own which is a composite of not only the woman but the woman and the man as well. In the event that the father wants her to have an abortion but she does not want to, she should have every right to decline having one. All of the above should apply regardless of the week of gestational development of the fetus. In the event that the woman learns through amniocentesis that her unborn child has Down’s Syndrome, she should have the option to wither have and keep the baby or have and give the baby up for adoption. Many individuals have lived full and important lives despite their handicapped. Down’s Syndrome is one of the lesser of the genetic anomalies which can occur. In the event that the baby is found to have trisomy 13, a decision on the part of the mother would have to be made as to weather she feels that it is morally right to have the baby and allow it to suffer for its one year of life or not. On one hand, the baby deserves a chance at life just like any other individual. We do not often shoot and kill our loved one’s when we find out that they have a year to live due to cancer or other terminal illnesses. The reasons for this particular woman to consider adoption or not is simply based on a sound decision as to whether she firmly believes or not that she can care for the child and treat it with love. In the event that the woman contracts with a couple upon the baby’s birth, to allow them to adopt the child in exchange for their paying for the medical bills incurred by the pregnancy; the woman and the couple would be acting legally and morally in a manner of readopting. Q11. In the event that a aoman which we may call Miss Z is pregnant but is partaking in harmful substances to the growing fetus. She should be subjected to the same legal ramifications that an individual would face for mistreating an already born child. Regardless of whether or not Miss Z saw this behavior growing u and does not know better, she is still not above the law. Many child molesters were molested as children. This does not grant them legal amnesty by any means. The same is true here. The legal ramifications that Miss Z should face should be identical to what she would be charged with if the child was born and she was neglecting it such that it became malnourished. The use of drugs should not be the only platform for the punishment of her behavior. One has a moral obligation to take responsibility for their own actions. If a woman engages in unprotected sex, she should do so knowing full well that she may become pregnant. If she does become pregnant; she should be obligated to care for the human being inside of her through the term of the pregnancy. At that point, she may sign over her parental responsibilities such that the child may be adopted. Her obligation to protect the human being inside of her should not be limited but should encompass any and all activity known to be harmful to a gestating fetus. It should be permissible for an employer to mandate pregnancy classes to avoid preterm labor as it is not only a company which one has agreed to work for but by implementing the pregnancy classes, the company is essentially enforcing a sort of humanitarian effort. Regulating pregnant women would not be a misguided approach just like watching out for the treatment of children already born, is not a misguided approach but is an important and essential one. In the event that there was a heavy trend in policing the pregnant, it is doubtful that a pregnancy police would be necessary. Many people avoid certain behaviors simply because they know it is illegal. Many women who may not have abided by such regulations during pregnancy in the absence of such rules, may abide to them simply because they intend to follow the law and wish to avoid criminal prosecution or costly fines. Q12. Stem cells are perhaps the closest thing we have at this point in the medical field to a cure for many diseases such as Parkinson’s or even cancer. Harvesting stem cells from cadavers should be a given in place unless the individual has signed something requesting that not to be the case for them. Everyone in society has an obligation morally to work together to sustain our existence. In the event that a fetus is aborted, for whatever reason, its stem cells should be acceptably used, period. Having abortions arranged however, strictly for the harvesting of stem cells would be morally wrong just as killing an adult for their stem cells would be wrong. The fact that the fetus is unable to provide consent for the use of its stem cells can’t be an issue until it can be said that abortions cannot be conducted without the consent of sayd fetus. Both are congruent to one another. Q13. Questioning whether original consent was valid or not due to one’s ignorance of the details of what they signed. It is pretty much a universal given that when one signs something of their own free will whether or not they read what they are signing, does not relinquish them from their contract or declaration of acknowledging informed consent. The signing of consent or of a contract should be final with the signature and no amount of alleged misunderstanding should renounce the original form which was signed. Healthcare workers should only proceed in the event of a signed acknowledgment of informed consent or in the presence of solidly implied consent. Once an individual has signed the form of informed consent or right before signing it, they should be asked once if they have any questions or if they understand what it is thet they are signing. This is a one time chance which most healthcare professionals commonly offer. Q14. Compensating individuals for their participation in a study is relatively unethical because it establishes a way for those who are desperate to make money. This means that mostly the poor and needy, who most likely suffer from conditions not seen in a general and variable population thus skewing the results of the study. Paying patients more money to suffer discomfort is in no way moral or acceptable. This notion is not too far off from a prostitute being paid more than usual in order for her john to behave in physically harmful or demeaning ways towards her. The moral relevance between two groups which may take part in a scientific study is that one group is doing so in order to help accomplish a humanitarian effort in finding cures for diseases. The other group who is paid is obviously doing so due to financial desperation, thereby causing them to be exploited. With regard to children, through this part of the discussion, it should never be ok for parents to offer their children as test subjects in the presents of monetary compensation or not. Q15. With regard to valid and conformed consent within test subjects, as long as the participants are aware that they are not being told what the study is for and whether or not they are being given placebos, and they still agree to the terms of the study, then no aspect of informed consent has been omitted. It is true that volunteers within test groups who are among the placebo recipients are not being given adequate treatment or healthcare but in the event that studies are not conducted at all due to the fact that placebo groups in studies are off limits, then a much larger group of individuals would not receive proper or adequate ehalthcare because studies would not be able to be conducted. A crossover treatment would give everyone partial treatment but no one whole and up to standards treatment. Though regulations stipulate that no patient be without or deprived of adequate and proper healthcare. Only utilizing those who have no hope of improving however, is not an effective means of scientific study by any stretch of the imagination because if those individuals were terminally ill or permanently afflicted with an ailment then no data could ever be ascertained from them as subjects in a study. Q16. Biology is the study of life and physicians are essentially biologists who are expected through proper education, to preserve life. Those who are scientifically trained and become involved in creating biological warfare do an enormous injustice to mankind as well as to the title of Biologist. The ideology which says, “If I had not formulated this massive and destructive bio-weapon, someone else would have” is as absurd as a murder standing before a judge and offering his or her excuse for killing people as something that someone else would have done if they had not. If everyone used similar arguments to justify reprehensible use of the human mind, than people would forever be doing the unthinkable simply because they felt someone else would have done it anyway. Any scientist who knowingly formulates, assists and aids in the construction of bio-weapons and weapons of mass destruction should be held accountable for those who are killed by those weapons. Though they may not have been the one pulling the trigger so to speak, they were party to the opening of Pandora’s ugly box which would never have been opened had those who contained the scientific knowledge to do so, not taken it upon themselves to do the unthinkable. An argument stating that if one had not done something than someone else would have is not only an attempt at making an excuse but is also a weak excuse. Making weapons in general is being party to an invention designed to take a life. This is a homogenous ethic and is not a gray area. There is no use for weapons of mass destruction other than complete and other destruction. Having them to use just as a threat is not any different than blackmail or holding up a gas station with a loaded gun but never firing the gun. Simply having weapons of mass destruction is immoral period because the very nature of a human being will sooner or later be pushed far enough to turn the detonation key. Read More