Clinical Practice in Medical Imaging - Report Example

Clinical Practice in Medical Imaging Clinical Practice in Medical Imaging Introduction The world would be anarchical if there were no rules, guidelines, norms, values, ethics and morals that govern behavior. Such guidelines exist to give life meaning. In the same way, ethical rules and guidelines govern systems in society, and society as a whole. Medical Imaging is guided by ethics that ensure professionalism among physicians and protection of patients’ lives (Heifetz 1996). Ethics implies the right way of doing things. Ethical values are therefore those values that are generally accepted in society, in an organization or institution that govern operation. Codes of statements of ethical statements are over 2500 years old, their purpose being to ensure the community receives the highest standards of care and doctors are prevented from abusing trust and care granted to them by the community (Breen, Pleuckhahn and Cordner 1997, 98). While on clinical placement, I experienced a scenario that has become increasingly common. A patient was denied a brain PET scan to evaluate active tumor versus radiation changes. Dreading competition, the neurosurgeon whom the patient consulted, was reluctant to send the patient to a competing hospital to get a PET scan ran. The scan was in the patient’s best interest. By failing to advice the patient to get a scan, the doctor denied the patient the best care suitable for his condition. Instead, the doctor made the patient undergo complicated neurosurgical procedure which revealed that there was only scar tissue. The doctor ought to have considered beneficence and non-maleficence by providing acceptable treatment; and not acting with malice against the patient. The doctor failed in his duty to inform the patient on options and alternatives which would enable the patient to give valid consent. He therefore denied the patient autonomy to make an informed decision. The process was rather unnecessary. This indicates negligence on the part of the doctor. The doctor ought to have referred the patient to the hospital and made the patient undergo PET before the surgery and after follow-up. Thus, he deviated from normal practice. He failed the Bolam test because he did not do what a reasonable person would in the circumstances. This scenario shows how vulnerable patients are to unethical and unprofessional physicians. In most cases, patients cannot be sure whether the physicians they entrust their lives with are unethical or not. That is why there is need to emphasize ethical values in Medical Imaging. Ethics protect patients from harm when accessing medical assistance. The aforementioned scenario decreases patients’ confidence in doctors, leads to unnecessary financial costs and increases unnecessary surgical procedures. Professionals in Medical Imaging need to be accountable to their patients, colleagues, employees, and themselves. The above case study, involving radiologic imaging elaborates the importance of ethical issues and Codes of Practice. This may raise legal issues and the patient could charge the doctor for negligence; and failing to seek the patient’s informed consent in performing the surgery. If the patient had been accurately informed about his decision, he would not have undergone the surgery. The doctor failed to disclose the risks and benefits of his diagnosis to the patient. The chances of dangerous physicians endangering the lives of innocent patients have led to the creation of legal and ethical codes to protect patients. Registry of Radiologic Technologists (ARRT) in liaison with American Society of Radiologic Technologists (ASRT) has established ethics governing radiologic imaging. These ethics aim to promote the four main concepts outlined in medical ethics which include: beneficence, non-maleficence, justice and respect for patient autonomy (Heifetz 1996, 102). Physicians must act in the best interests of the patient and society, take a Hippocratic Oath, promote justice, and respect patient’s decisions on the kind of medical care they need; and fairly promote and give healthcare services. AART and ASRT assert that Physicians must act professionally in rendering quality services to patients. Full respect for humankind must be observed. The above scenario portrays lack of professionalism on the physician’s part. The case illustrates professional misconduct in that the doctor failed to follow the ideal procedure when handling the patient. He denied the patient an opportunity to offer his consent for the surgery. The doctor also showed a high degree of negligence. While the physician may have offered quality surgery on the patient, it beats logic to undergo such a lengthy complex task, with total disregard to a shorter easier method. The scenario also shows that the doctor had no respect for either the patient or fellow doctors. Professionalism calls for integrity, honesty and competence, values which the doctor failed to illustrate. A physician must support access to medical care for all people regardless of the physician’s prejudices and interests. A physician’s role is to preserve sanctity of life which is a great responsibility. Hence, these are matters that are to be taken with great seriousness. A small mistake may be very costly. Secondly, radiologists must offer services without discrimination on the basis of gender, race, creed, religion or socio-economic status (Kohn and McKechnie 1999). Also, the services must be rendered without focusing on the nature of the illness. All patients must be treated with equal respect and all diseases must be given the same attention. In this case, the doctor failed to treat the disease the way he would have normally been treated. He Deviated from normal practice and disregarded the standards of care. Instead of referring the patient to a competing hospital to enable the patient to undergo normal medical procedure, the doctor opted to manipulate the patient in order to maximize his profits, and beat competition. The doctor compromised ethical values of honesty, integrity and fidelity. Thirdly, radiologists must use equipment that is relevant and consistent with their duties. In relation to the deontological view, morality of their actions must be based on adherence to rules that guide their work. They should enforce appropriate procedures and technology in handling patients. Competence, decision making capacity, and ethical aspects go hand in hand in using technology to provide medical care to patient (Kuczewski and Pinkus, 1999, 123). In this case, the doctor did not use relevant and consistent equipment when attending to the patient. It is the duty of physicians to safeguard patient’s dignity and humanity. Often when patients become ill, they become vulnerable to the exploitative tendencies of unethical doctors. Wesley (2000, 91) notes that people become aware of medical discrimination for the first time when they or a loved one experience a health care crisis. Ethics ensures job security of an upright doctor who maintains honesty, competence and integrity in his duties. Such a doctor is able to maintain his patients because he is more trusted with people’s lives. Doctors with good ethical standing work effortlessly to protect patients. As patients get more confident of the doctor’s work, they develop a sense of security. Physicians hold the power to preserve life. Heifetz (1999) argues that doctors should use this power bestowed on them to safeguard lives. Fourthly, radiologists must act in the best interest of the patient. He or she must take responsibility on decisions he makes. The decisions should be elaborative of genuine concern for the patient’s well being. It is the duty of the radiologist to get adequate clinical history in order to achieve accurate diagnosis. Documentation of this history is important as a reference point that guides the patient’s treatment. Procedures involved in treatment must be clearly explained to patients to enable them give informed consent on the treatment they receive. It makes the patient more comfortable and prepares the patient for the anticipated experience. It is the job of radiologists to ensure no extra harm to the patient. Non-maleficence must be observed to refrain from ineffective treatment or acting with malice towards patients. In this case, the doctor negligence made the patient undergo pain that he would have forgone. Surgery requires adequate healing time. Instead of subjecting the patient to surgery that would require plenty time to heal, the doctor ought to have advised the patient to undergo PET scan which would have been equally successful and more beneficial. It is the doctor’s duty to care for the patient and to avoid foreseeable risks of mis-advising the patient. Patients should be allowed to make informed autonomous decisions regarding their health. Autonomy is the capacity to think, decide and freely act on the basis of such thought (Singleton and McLaren 1995, 107). It is the doctor’s duty to inform the patient on his condition and necessary treatment, which empowers the patient to make informed decisions. Lastly, radiologists are guided by expected standards of practice. Doctors should provide high quality examinations as this greatly influences the patient’s diagnosis. In this case, the doctor did not render quality examination on the patient. Instead, he chose to forego relevant examination and undermined reasonableness regarding treatment. This led to misdiagnosis and later unnecessary surgery which was a foreseeable and an unnecessary harm. It led to delayed care, examination and treatment. Quality examination saves time, reduces cost and enhances doctor’s credibility. By not advising the patient to undergo PET test, the doctor showed lack of care towards the patient. Physicians need to care. McKechnie and Kohn (1999, 71) point out that care is affective and effective; and may be conceptualized as a duty, as a responsibility, as a professional task, as a labor of love. The benefits of ethics cannot be overemphasized in Medical Imaging. Gunderman (2011) highlights seven benefits of teaching ethics in radiology. First, it prevents misconduct by physicians. Secondly, it helps protect and promote the stature of nuclear medicine and radiology. Third, it fosters achievement of professional excellence. Fourth, it promotes a sense of professional aspiration. Additionally, it helps trainees recognize and seek aspects that are key to their career. Also, it enables trainees blend their professional lives with their personal lives. Lastly, it enables physicians to internalize fundamental ethical issues such as informed consent and patient confidentiality. Conclusion In conclusion, this case offers great insights on patient care and treatment. It highlights the need for doctors to ethically and professionally perform their duties when caring for patients. ethics in Medical Imaging enables doctors to offer exemplary services to their clients. There is a need to reinterpret new puzzles in clinical situations from within moral history (Radest 2000, 137). Ethics promote security on the side of patients and on the side of doctors alike. To patients, ethical doctor are priceless. Their services have the power to restore health that would otherwise elude patients if they are left in the hands of dangerous doctors. Ethics are the pivot on which Medical Imaging balances. It is ethics that knits together the values that enable doctors to put a smile on patient’s faces. It is ethics that enables doctors to go out of their way in ensuring that patients’ healthy lives are restored (Singleton and McLaren 1995). An ethical doctor, guided by honesty, integrity and competence is an asset in society. To his patients, such a doctor means less cost in medical bills and confidence in the doctor’s work. In a nutshell, physicians under the umbrella of Medical Imaging ought to observe the four main concepts outlined in medical ethics which include: beneficence, non-maleficence, justice and respect for patient autonomy (Heifetz 1996). Otherwise, Medical Imaging would lose meaning. Ethical awareness can minimize our false starts and backtracking (DePender and Ikeda-Chandlere 1990, 89). Bibliography Breen K., Plueckhahn V., and Cordner S. 1997. Ethics, Law and Medical Practise. St. Leonards N.S.W: Allen and Unwin. . DePender W., and Ikeda-Chandlere W. 1990. Clinical Ethics: An Invitation to Healing Professionals. Westport: Praeger. Heifetz, M. 1996. Ethics in Medicine. New York: Prometheus Books. Kohn T,. and McKechnie R. 1999. Extending the Boundaries of Care: Medical Ethics and Caring Practices. New York: Berg. Kuczewski M. Pinkus R. 1999. An Ethics Casebook for Hospitals: Practical Approaches to Everyday Cases. Washington: Georgtown University Press. Radest H. 2000. From Clinic to Classroom: Medical Ethics and Moral Education. Westport: Praeger. Singleton J. and McLaren S. 1995. Ethical Foundations of Health Care: Responsibilities in Decision Making. St. Louis: Mosby. Wesley J.ed. 2000. Culture of Death: The Assault on Medical Ethics in America. San Fransisco: Encounter Books. Read More