Health Policy Analysis on Do Not Resuscitate - Essay Example

Health Policy Analysis on “Do Not Resuscitate” Total Number of Words 249 Introduction Legal, clinical, and ethical dimensions of health care practices are all interrelated subjects. Basically, the ethical dimensions of health care practices serve as a universally accepted medical professional practice in terms of moral issues. Violation of these ethical dimensions could lead to legal professional problems. For this reason, it is crucial for health care professionals to apply their knowledge on medical ethics and its legality to the clinical practice in order to avoid facing legal issues in the future. Upon the request of the terminally ill patient or the patient’s family member, physicians can write a “Do Not Resuscitate” (DNR) order even before the patient’s heart stops beating and/or respiration ceases based on the physician’s sound medical judgment. In line with this, the development of a health policy enables each hospital to have a guide for health care professionals which includes the physicians and nurses on what to do in case the patient’s heart stops beating. Considering the importance of developing and strengthening health policy within the hospital, the application of the Australian policy cycle on DNR will be thoroughly examined. In line with this, my personal thoughts regarding the framework in analyzing DNR policy will be provided together with the rationale for choosing the framework. Likewise, detailed information with regards to the institutional, professional, and personal ethical standards and dilemmas with respect to termination or refusal of care will be thoroughly discussed. Application of the Australian Policy Cycle on DNR Order The Australian policy cycle which was tackled in the Australian Policy Handbook can be applied as a framework when designing a health policy for DNR order. (Althaus, Bridgman, & Davis, 2007) Basically, the policy cycle can be use as a guide and analytical tools in the local hospitals to assist the health care professionals in making a sound decision on how to respond to emergency situation whenever a patient’s heart stops beating or is suffering from respiratory failure. In line with this, the policy cycle which can be used in addressing hospital problems related to DNR order encourages the health care professionals to follow steps which include the necessary procedures and processes, rules, and conventions (p. 29). The Australian policy cycle is composed of steps which can be broken down into eight major elements known as: (1) identifying important issues that needs to be addressed (i.e. DNR order in a hospital); (2) analyzing the proposed health policy; (3) policy instrumentation; (4) consultation; (5) coordination with the rest of the health care team; (6) decision making process; (7) implementation of developed strategies to solve the problem; and (8) evaluation of results (Althaus, Bridgman, & Davis, 2007, p. 37). One of the advantages of using the Australian policy cycle is that this particular health policy method is broken down into smaller components making it easier for health care professionals to use this model. These smaller components which are arranged into eight steps should be followed in sequence. Since some of the smaller components may not be applicable when designing a hospital policy for DNR, the absence of flexibility when using this policy framework may cause problems to the person who is trying to use the Australian policy cycle. In general, the process of preliminary analysis for the Australian policy cycle should go through five stages which include: (1) formulating the problem; (2) setting out the hospital objectives and goals; (3) identifying decision parameters; (4) search for alternative solutions; and (5) propose a solution for the problem (Althaus, Bridgman, & Davis, 2007, p. 60). In line with this, formulating the problem is similar to the first step in the Australian policy cycle whereas the implementation of developed strategies to solve the problem in Australian policy cycle is similar to the fifth stage of preliminary analysis process which is to propose a solution to the problem. As part of the health care institutional, professional, and personal ethical standards, health care professionals are expected to respect the patients’ decision-making for their own treatment. The patient should also be informed with the general facts concerning the process of their treatment. Aside from autonomy, other health care professional ethics includes: the practice of non-maleficence – the obligation to avoid injuring the patient, beneficence – to do only good actions which may contribute to the welfare of the patient, and justice – obligation to be fair to all. (Bailey, 2007; Tuckett, 2005) In line with this, it is but ethical for any health care professionals to seek informed consent directly from the patient provided that the patient is an adult and is capable of making a sound decision for his own treatment and care or the patient’s family members in case the patient is no longer capable of deciding for his own treatment and care. For example: Hospital X acknowledged that the need for the health care professionals to develop health policy that will prevent them from having to face legal problems associated with DNR order. As part of the policy instrumentation, health care professionals who are caring for a terminally ill patient should seek advance care and treatment instruction from the patient including the option for a DNR order. In line with this, the early written notice signed by the patient will be the basis in case the patient’s heart stops beating. To make the implementation of health policy on DNR successful, each of the health care professionals should consult and coordinate with the rest of the health care team regarding the DNR status of a terminally ill patient. In case the terminally ill patient signed an advance notice for DNR order once his heart stops beating, health care professionals should respect the patient’s decision not to give CPR. On the contrary, health care professionals should make an effort to revive the patient if there is no DNR order from the physician or in the patient’s chart. As a rule, reviving a terminally ill patient is allowed only when the patient do not agree to have a DNR order. As part of evaluation, health care professionals should take note of any incidence wherein CPR was given to a terminally ill patient with DNR order. Any time the health care professionals try to revive a terminally ill patient with DNR order means that the health policy on DNR has not been successful. Sources of Information Useful in Analyzing the Health Policy The sources of information useful in analyzing the health policy in preventing the spread of RVS in hospital settings include the NHS, National Institute for Health and Clinical Excellence (NICE). The NHS in UK provides the public with a comprehensive health care information and medical advices to promote the health and wellness of the people (NHS, 2009b) whereas NICE is an independent organization that provies the public with national guidance on health promotion including disease prevention and treatment (NICE, 2009). Discussion When implementing health policy on DNR, health care professionals including the physicians, surgeons, nurses, and nursing aides should be alert and know when and when not to revive a terminally ill patient who is breathless and pulseless. Conclusion The application of Australian policy cycle is easy and is applicable to hospital issue related to DNR order. When designing a health policy on DNR order, health care professionals should follow the five sequence for policy analysis which includes the process of formulating or identifying the problem, setting out objectives and goals; (3) identifying decision parameters; (4) the search for alternative solutions; and (5) propose a solution to the problem (Althaus, Bridgman, & Davis, 2007, p. 60). *** End *** References Althaus, C., Bridgman, P., & Davis, G. (2007). The Australian Policy Handbook. Allen & Unwin. Bailey, G. (2007). NASW Standards for Social Work Practice in Palliative and End of Life Care. Retrieved November 7, 2009, from National Association of Social Workers: http://www.naswdc.org/practice/bereavement/standards/default.asp NHS. (2009b, May 6). Retrieved November 7, 2009, from About NHS Choices: http://www.nhs.uk/aboutNHSChoices/Pages/AboutNHSChoices.aspx NICE. (2009). Retrieved November 7, 2009, from About NICE: http://www.nice.org.uk/aboutnice/ Tuckett, A. (2005). The Care Encounter: Pondering Caring, Honest Communication and Control. International Journal of Nursing Practice , 11(2):77 - 84. Read More