Ethics and Professional Codes in Healthcare - Essay Example

Critical reflection on modules The concept of healthcare in a professional capacity would always be irrevocably linked to the dual issues of ethics and of legality. Like every other individual at the start of the module I had certain notions about the constituents and the role of ethics and of law in the professional practice of healthcare. The following is a compilation of the ruminations that I had in a personal capacity along with the changing notion of concepts over four modules. At the end of the discussion I would conclude by outlining some of the things that I would expect would be the greatest challenge to me in the course of my practice. Module one introduced me to law, ethics and professional codes. Before I started this unit I knew that by law health care professionals had a duty of care to provide for their patients. I said that I learnt about a duty of care and what this entails. I also wrote about the standard of care that is involved with a duty of care- the fact that the duty exists between the health-carer and the patient that moment the former offers to treat. Pozgar (2004) states that this arises even if the doctor or nurse stops to help in an accident or in another form of emergency. The fact of the matter is that at the very introduction of the four standards of morality. The idea is based on the idea that the patient’s relevant preferences are unknown. The duty of care would entail that it is the responsibility of healthcare professional to ensure that he is able to observe three essential principles in the observation of duty of care in the ethical and legal capacity: 1. Autonomy: This refers to an individual’s ability to come to his/her own decisions and requires the healthcare professional to respect the choices that the patient makes about his/her life 2. Beneficence and non-maleficence: This imposes a duty to do good and avoid or minimize harm to patients. It obliges the healthcare professional to help patients and clients by promoting and safeguarding their welfare. 3. Justice: in simple terminology justice would require equal treatment of equal cases. This would therefore be concerned with the allocation of health resources and means that there should be no discrimination on the basis of sex, age religion and so forth. The idea is that the contentious issues that the health care professional would have to deal with is that of autonomy in cases where the decision making hinged on the inability of the patient and the surrogate is the decision maker. The idea on the part of the health care professional would automatically would then be to ensure that maximum benefit is given for the patient from the range of available choices. This involves assessment of the benefits and burdens of each therapeutic alternative, including considerations of pain, disability, and quality of life. Such judgments are teleological in nature, and are driven by the principles of beneficence and non-malificence. On the basis of a best interest standard, a surrogate decision-maker must decide which treatment is clearly beneficial (and therefore is morally required), futile (and therefore to be withdrawn or withheld) or uncertain (and so dependent upon the subjective assessment of the decision maker). Kerridge, Lowe and McPhee (2005) analyse these concepts and look at how this duty might be upheld by means of standards, and how those standards are determined. The second module focused on more explicitly on the aspects that are concerned with the practicable application of the duty of care and the basic ethico-legal dilemmas that would face a nurse in the day-to-day execution of her duties. McLean, McLean and Mason, (2003) state that a healthcare professional is expected to have the standards of a reasonable professional. The concept that has been stressed in this module was clarify the issue that there would invariably be a problem of conflict between the written codes of law and the ethically correct course of action that a nurse would face. Mason and Whitehead (2003) argue that this could be a large tangible problem like the execution of the nurse in a duty to warn in cases like abortion or even HIV and the ethical responsibility of the nurse to respect doctor’s wishes and to ensure that her actions are taken in the larger benefit of the patient at hand. In this context I have understood one would have to follow the four basic codes of conduct that one could understand more in the context of responsibility I would have to fulfill rather than rights or duties that are more encoded. One could understand the fact that there are many codes of nursing that begin with an encoding of these very responsibilities. The idea would be to 1. To promote health 2. To prevent illness 3. To restore health and; 4. To alleviate suffering The idea that the module has helped me in absorbing and understanding correctly is that the statements that ate encoded in the Codes of Nursing and their interpretations provide essentially guidance for the conduct of relation ships in carrying out nursing responsibilities that are consistent with the ethical obligations of professional care. According to Rumbold (1999) the exercise of responsibility is quite different from acting in accordance with duty. The concept is in essence a lot wider than duty which is duty which is generally linked to something that has been prescribed and is a part of a contract. What I understood from the video, and the case studies is that fact that responsibility as a nurse, as a healthcare professional is linked to freedom and to rightness. The exercises of this responsibility would mean making decisions about the right and the wrong course of action based on a calculated outcome-the deciding judgment would have to based on a situation and an anticipation of the alternative outcomes that would most benefit the patient. Module three informed me about confidentiality, consent, assault and restraint and additional information on the subject of negotiated outcomes. Before commencing this unit I was aware that in the health care profession not all patients are compliant and some patients can become very abusive and difficult to manage. The module three notes taught me the legal ramifications of three issues that often emerge when interacting with a difficult or abusive patient: voluntary & adequate consent, issues of assault, and the legal ramifications of applying restraint. I found that Kerridge (p.223) describes consent and the importance of consent especially before touching a patient or carrying out any procedures with them. I also understood the fact that confidentiality and consent are possibly two of the most revered principles in medical ethics and form the basis at times of the professional-patient relationship. Brandt and Rozina (1997) argue that confidentiality in its hardest forms refers to respecting other people’s secrets. Consent on the other had is again deeply linked with the concept I discussed initially-that of autonomy. Despite the fact that the two are deeply revered, it would have to be understood that both are overridden time and time again in favor of ensuring the patient’s well being. Confidentiality for example could never be absolute especially in a medical setting while the concept of consent is one that is frequently overridden. I also understood that a healthcare professional would have to go into the deeper ramifications of the positive consent and the negative consent in order to arrive at a decision on whether or not it would be justifiably overridden in favor of the patient’s well being. Finally, Module four covered topics such as decisions at the end of life in the ordinary context, decision-making by proxy, the limits of medical care and negotiated outcomes. In this module I learnt that for many people the pathway to death is far more frightening than actual death itself. I also learnt from the case study the importance of dignity for patients at the end of their life and the decision not to suffer at the end of their life but rather die peacefully. The idea that the module perpetrates is the fact that a nu7risbg professional would have to be capable enough of making decisions and stresses the importance of clinical decision making along with the ability to sift and synthesize information and appropriately implement these decisions. I understood the fact that it is the patient’s wishes and best interests that would need to be the most important components of my decision making and the fact that less important should be the benefits and risks of the intervention, family wishes, and health status; little emphasis was accorded to religious affiliation and extra cost to agency. In this context the primary issues that would face me as nursing professional in the longer run would be issues like 1. Protecting patients’ rights and human dignity; 2. Staffing patterns that limit patient access to nursing care and 3. Use/non use of physical/chemical restraints. In conclusion therefore it may be reiterated that over the period of study in the four modules I have learnt the issues and the factors that would need to go into my decision making process. This has also helped me in my perception of the challenges that I would face as a nursing professional and given me an idea on how to deal with these. References: Kerridge, I., Lowe, M. & McPhee, J. 2005, Ethics and Law for the Health Professional, 2nd edn., Federation Press, Sydney, pp. 134 – 156. McLean S A M, McLean S and Mason J K, (2003), Legal and ethical aspects of healthcare, pub, Cambridge University Press, p74 Rumbold G, 1999, Ethics in nursing practice, pub, Elsiver Health Sciences, p259 Mason T and Whitehead E, 2003, Thinking nursing, pub, McGraw Hill International, p253 Brandt A M and Rozina P. (1997). Morality and Health. Pub, London Routledge, p58 Pozgar G D, Legal aspects of health care administration, pub, 2004, pub, Jones and Bartlett, p38 Johnstone, M. 2004, Leadership ethics in nursing and health care domains. In Daly, J., Speedy, S. and Jackson, D. (eds), Nursing Leadership. Pub, Churchill Livingstone: Sydney Read More