The Opinion of the Health and Disability Commission - Coursework Example

Health Law and Policy Customer’s Name Customer’s Grade Course Customer tutor’s Name 11th April, 2011 Health Law and Policy: Introduction The law may affect individuals at any given time when correct guidelines that are outlined are not followed. This may happen in normal duties as well as application of work procedures. Several undesired consequences follow law breakers. These may include paying of fines as well as prosecution. Attorneys who practice health care law usually encounter diverse issues. They therefore represent clients who seek medical care. With these diverse arrays of issues, the healthcare law is changing continuously as healthcare policies keep dominating (Keenan, 2010). My paper will try to outline and articulate the basic principles of healthcare law. This essay will analyse the opinion of the health & disability commission and privacy commission for the case studies 03HDC00153 and 95042 [2008] NZ Priv Cmr 1- DHB respectively, the function of health disability commissioner and privacy commissioner and also the implication of rights 4(1) of health act and section 22F of the health act in rule 11(4) (b) of the health information privacy code upon my specific practice as an oral health practitioner as well as upon this specific case studies. Brief Summary of the Cases i.e. Case Number 03HDC00153 and 95042 [2008] NZ Priv Cmr 1- DHB With regards to Case Number 03HDC00153, is that on the 6th of January of the year 2003 the Commissioner received a complaint from Ms A regarding the services which had been provided to her husband, Mr A, by Mr B, who was an ambulance officer, and an Ambulance Service. The complaint raised was that on January of the year 2002 Mr B failed to appropriately assess and review Mr A. All this started at approximately 2AM on the 9th of January the year 2002 when Mr A, who at that time was 55 years old had woke up from bed experiencing a lot of pain in his chest and stomach. The pain kept on increasing and by around 3AM, Mr A was becoming quite distressed. His wife, Ms A, called 111, and an ambulance crewed by Mr B, team leader, and a volunteer ambulance officer, was dispatched to come and attend to him at 3.23AM that same night. The ambulance got to Mr A’s house at 3.29am. Mr B established that Mr A was in a troubled state and Mr. B recorded that Mr. A appeared to be hyper-ventilating. Mr B asked the patient in this case Mr B where he was feeling pain. Mr A indicated that he was feeling some crumpling and tingling feelings in his fingers and arms. Ms A indicated that Mr A who was her husband was a French man and that could only respond to the questions asked by Mr A by just pointing to the affected areas. But all the same it ended up her nor her husband not mentioning that Mr A was experiencing cramps. While all this was going on, the volunteer ambulance officer went forward and used a pulse oximeter to check Mr A’s finger and it derived a reading of ninety eight percent. Mr B also went a head and derived Mr A’s pulse and established it to be eight which he noted that it was a regular pulse. Using this findings Mr B made a decision that there was hence no need of getting to establish Mr A’s blood pressure and so he left without transporting Mr a to hospital. About 10 minutes after that Mr A collapsed in his house. Ms A again called the ambulance to retuned back to her husband’s attention and the same ambulance officer that had attended to her husband earlier was the one that come. As soon as Mr B had arrived he began to resuscitate Mr A and later on transferred him to the Public Hospital. Following this incidence Mr A was in a state of coma forty six hours and he suffered brain damage that led to his paralysis. With Regards to Case Number 03HDC00153 and 95042 [2008] NZ Priv Cmr 1- DHB, A 14 year old boy suffered from life threatening psychological condition and was hospitalized. His parents were at this point separated from him although they had actively been involved in his care ever since the problem had begun. Differences of opinion arose between the boy’s father and the doctors at the district health board about that kind of treatment the boy was receiving and the father’s level of involvement in that treatment was also discussed. The boy’s father requested that he be allowed to access all the information that the district health board held about his son. The district health board in response provided most of the information, but withheld some of the information on the basis that if they disclosed that information it would lead to a contravention of the boy’s interests. Health Law Implication of the Above Discussed Two Cases These rights give obligations and duty on all health providers to respect. Any breach of these rights can put the health provider to a risk of being in the courts or to disciplinary action (Johnson, 2004). “The Code of health and Disability Services Consumers’ Rights (“the Code”) became law on 1 July 1996” (Johnson, 2004, p.8). The Act requires the Commissioner to form an opinion of whether the action is a breach to the rights or not (Skegg & Paterson, 2006). In this case studies two rules are applicable: In Case Number 03HDC00153, there was a breach of this right because Mr B should have provided Mr A with service which should have been reasonable with a lot of care and skill. Although the ambulance officer had tried his best to protect life there are issues which he did not address. He needed to find out how the patient felt by carrying out an extensive information search and probing because the patient had called for acute medical assistance. Mr B should have given much attention to reflux exhibited by Mr A’s self-diagnosis since Mr A had admitted ever been utilizing bicarbonate of soda and Gaviscon. Mr B also should have made sure that he understood fully the fact that Mr A had not had an experience of hyperventilation, and should also had asked Mr A and Ms A why they had seen the need of seeking medical assistance. Following the fact that Mr A had talked about chest pain, Mr B should straight away have put into consideration the possibility of Mr A having a cardiac-associated condition. It would have wise for Mr B to transport Mr A to the public hospital for further diagnosis and investigation of his condition. A diagnosis of reflux in addition to hyperventilation condition is always uncommon and this could have necessitated the fast decision making by Mr B to make quick transportation of Mr B to the hospital. Although Mr B said that he had advised Mr A and Ms A about the option of hospital admission putting a side the fact that Ms A was adamant about admitting that Mr B had given them this option, Mr B should have put much emphasis on the need of transporting Mr a to the hospital in a sufficiently strong manner and if it could be done this way then Mr A could not have deny the advice of being transport to hospital for further assessment. In the opinion of the commissioner following a critical analysis of all that went on, Mr B should have made more investigation into Mr A’s prevailing condition and immediately transport him to the public hospital in order to facilitate the chances of Mr A getting full assessment of his fatal condition. By not doing this Mr B failed to give services to Mr A with required skills and care and so he breached Right four (1) of the Code (Dute, Michael, and Koziol, 2004 p.324). Also by failing to fully put in writing all the prevailing situation he failed to adhere to professional standards and so he breached Right four (2) of the Code (Dute, Michael, and Koziol, 2004 p.324). The privacy commissioner was satisfied that, the district health board has balanced the father’s rights with the needs to withhold certain information. The district health board gave the father most of the information it held about the son, and that it also involved the father in meetings, provided summaries, updates and so on. It withheld some of the wholesome information on medical grounds. The son’s doctors made a carefully decision that giving the father the remaining information would lead to the violation of the son’s interests. The reason was that it could have in away influenced the recovery of the sick son in case the father was allowed to fully access all the information about his son’s medical progress and condition. It would have been inappropriate for substitution of non-medical; view for this properly considered medical opinion. The boy’s father was his son’s representative, and agency had the authorization of refusing to allow a representative’s request in some instances. Those circumstances are specific in section 22F of the health act in rule 11(4) (b) of the health information privacy code. Other Vulnerable Populations The laws implicated in the above discussed cases are also applicable for another vulnerable of population for example children, spouses and relatives who are taking care for the sick person and anyone else who might come into contact with the sick person. Children for example have not had the capacity to weigh up the information and consequently to give consent. The parents or caregivers legally can give the consent for any treatment to be performed for their children (Burgess, 2006). Spouses and relatives of the sick who at times serve as care givers of the sick should also participate in history taking of the medical condition of the sick person in order to assist the health professional to make appropriate judgement in order to save life of the sick. In my field as an oral health of practitioner even after obtaining the consent from the parent, it still important to provide the children with the information appropriate to their age and their ability to understand. Spouses and caregivers should also participate actively in history taking in order to enable the information for the medical condition the patient is suffering from to be fully known by the medical practitioner such as oral health practitioners. Individuals with disability, for example individuals with learning disability are another example who is incapable of giving consent or refusing the treatment, that vulnerable group is protected by the Code (Diesfeld, 2001). Disabled individuals who are not mentally challenged should give their own consent so as not to feel that they are being discriminated. Health workers should be aware of the legal implications of any procedure they conduct and in case the clients are not comfortable about their actions they should be ready tom explain why they acted the way they did and give legal backing to justify their deeds and in case the matter is taken to court they should be ready to justify themselves and stand by what the law says so as to protest their reputation and conduct this also applies in my practice as a dental practitioner. Some of the formulated laws governing the health care system can be interpreted by some clients as not working well for them but the health workers should explain to these clients why that law was formulated the way it is. In matter of compensation the client should seek services of a good advocate to pursue any wrong practice administered to him or for her kin. Sometimes also health workers might think that the law is working against them but in actual sense some of them might be ignorant of the same law or are not doing their work to the best of their knowledge. Therefore I as an oral health practitioner should consider these facts in order to administer better services to my clients without creating and legal or ethical wrong. All legal and ethical strategies should be applied to provide the greatest protection for all the vulnerable populations (Diesfeld, 2000). Ethical considerations From the ethical point, all health providers should do no harm to their patient, which is according to Beemsterboer (2002) known as nonmaleficence principle. All patients when they put themselves under the care of health professionals do not expect any harm to result from any action. Mr B in Case Number 03HDC00153 by inappropriately seeking for information to know what Mr A was suffering from and not transporting Mr A to hospital for further investigation, exposed Mr A to the risk of developing brain damage and paralysis was in conflict with this principle. In my practice as oral health professional if I extracted a baby tooth exposing the child to space loss for the eruption of the permanent tooth with the availability of other options rather than the extraction, then this will be in conflict with this same principle. Beemsterboer (2002) stated that it is the duty for all health providers to provide appropriate treatment for the patients according to the training they received to provide their patient with optimal health and this is known as justice. Another ethical theory could be applied in this case, which is the “Autonomy” which is according to Darr (2005) the respect for the patients to make their decision after providing them with all the information. Recognizing the patient autonomy is the reason that all the health providers should obtain the consent of the patient before admitting any type of treatment. In case 95042 [2008] NZ Priv Cmr 1- DHB the father had a right to be given the information pertaining his son’s medical care but in away the agency had the authorization of refusing to allow a representative’s request to all the information because of the protection of the interests of the son which is well stipulated in section 22F of the health act in rule 11(4) (b) of the health information privacy code. The two cases are exhibiting two different scenarios, one is that case 03HDC00153 (Ambulance Officer – inadequate assessment and transfer to hospital) is potraying Mr, B was on the wrong because he did not do enough enquiry into Mr A’s condition and even facilitate the transportation of Mr, A to hospital so that a full assessment of his underlying medical problem could be established. By not accomplishing this he had failed to give the required service and reasonable care and that he ended up breaching Right 4(1) of the Code. His failure to put into records all the details which were relevant to facilitate appropriate diagnosis and assessment of Mr A, Mr B had terribly failed to adhere to the required professional standards and had also breached Right 4(2) of the Code (Dute, Michael, and Koziol, 2004, 324). The doctors were acting within the law to refusing to allow the father who was a representative to access wholesome information about his son. Conclusion In conclusion, under the Code, all health providers are not expecting to breach any of their duties and obligations (Johnson, 2004). All health providers should put the patient’s interest as primary and provide them with optimal health care according to the training they received. There was negligence by MR. B in case 03HDC00153 as depicted from the way Mr. B had handled Mr. A’s situation while on the other hand there was ignorance of law by the father in Case Note 95042 who had not known that the Doctors stood a right not to allow access to all the information because of protecting the rights of his son. These two cases depicts that law is quit useful in solving some of the issues surrounding the access of healthcare for both the consumers and the professionals. Reference Beemsterboer, P. (2002). Ethics and law in dental hygiene. University of Michigan: W.B. Saunders. Burgess, M. E. (2006). A guide to the Law for Nurses and Midwives (2nd ed.). Auckland: Pearson Education. Dressler, J. (1995). Understanding criminal law. University of California: Matthew Bender. Dute, J., Michael, G. and Koziol, H. (2004). No-fault compensation in the health care sector. Johnson, S. (Ed.) (2004). Health Care and the Law (3rd NZ ed revised). Wellington: Booker’s. Keenan, R. (2010). Health Care and the Law, 4th ed. Wellington: Thomson Reuters. Legal Research Foundation. (2002). New Zealand law review. New Zealand: Legal Research Foundation. Skegg, P. D. and Paterson, R. (2006). Medical Law in New Zealand. Wellington: Thomson and Brookers. Read More