Professional Accountability - Essay Example

Running head: PROFESSIONAL ACCOUNTABILITY Professional Accountability Discussion Paper Nursing Introduction Every person must have personal and professional integrity in their life. This is being truthful and loyal to himself and to the profession he is engaged. Accountability is another important trait to be practiced by every professional to do justice to his job. Though this is the basic requirement of all the working people, certain fields require extreme responsibility because of the nature of the profession. The one that tops the list is the medical profession as this involves the lives of humans. Doctors and other paramedical staff can never disown or slip away from their responsibilities even for a while as that may result in irreversible consequences to the patients. This discussion is about the professional accountability of persons engaged in the medical profession. Due to the advancements in the medical technology, today doctors are able to offer treatments that cure even the very complicated conditions. People with potentially life threatening conditions are able to prolong their lives due to the remarkable improvements in the treatments. But here doctors are faced with an important issue of explaining to the patient the kind of treatment to be administered, the possible results, side effects that may occur and get the consent of the patient. Obtaining the consent of the patient is very essential to commence any kind of treatment. Patient autonomy which means the right of the patient who is in a sound mental capacity to take the decision whether to acceptor refuse the treatment is given utmost importance. If the patient is not in a state of mind to give his consent, efforts should be made to find out the views expressed by him earlier in this regard or the consent of the closest family member should be obtained. When neither could be done, that situation put doctors in a fix. They land in an ethical dilemma as to whether to save the life of the patient or to respect his own decision even if it would lead him to his end of life. The following problem deals with such a kind. Problem presented You are working in a casualty department of a large hospital. An accident victim is rushed in one evening. He is conscious, but badly injured and desperately in need a blood transfusion. However, he turns out to have religious principles that forbid the exchange of blood. You explain the situation to him, including the very really threat to his survival if he does not have a transfusion. He clearly understands exactly what you are telling him, but still refuses to accept a transfusion, and asks you to do what you can by other means. He then slips into unconsciousness. One of your colleagues suggests that you give him a transfusion while he is unconscious, thereby saving his life. Discussion What is the action to be taken in the above condition? Same as every other profession the medical profession also has its professional rules, ethics and code of conduct clearly laid out. The basic principle of the medical profession is based on two rules – the main aim of medical professionals is to give treatment to the patient so as to remove or reduce the cause that is affecting them and the second aim is in doing so the patient is not suffering. The process of treatment should not be harmful to the patient in any other way. Medial ethics also point out that the patient must be respected as an individual who has the ultimate right to decide what should be done to his body. The above mentioned case presents an ethically difficult situation to handle. The victim is brought to the hospital in a critical state but he is conscious. His medical examination reveals that he is in immediate need of blood transfusion delaying or failing which may prove fatal to him. I immediately explain to him the situation, treatment to be given, futility of the treatment if delayed and the outcome if the blood transfusion is not given. As a procedure I seek his consent for the same. Though he understands the conditions, he has rigid religious principles which forbid him from undergoing blood transfusion .So even after understanding the consequence he refuses to give consent to me to carry out the same but asked about alternative course of treatment which would save him. Before I could tell him anything he slips in to unconsciousness. My colleague suggests me to carry out the blood transfusion to save his life. I am in a dilemma as to what would be my course of action. As a medical professional my immediate aim is to save the life of the patient but at the same time I am bound to follow the codes of conduct of my profession. But he clearly refused the treatment that I suggested. I should respect the decision of the patient. I quickly think of the next course of actions. First I try to think of any immediate treatment that would help him regain his consciousness but not conflicting with his belief. I quickly consult with my colleagues about the same. Failing for any outcome through the above, I consider the following: Even though the patient was conscious enough to understand what I said, the trauma of the accident would have had an effect on him. That would have definitely affected his clarity in analyzing. He must have been keeping faith in his religious principle for a long time. So when I mentioned about blood transfusion, his immediate response was a no. His refusal may have been an impulse reaction. He was not conscious for a long enough to time to be explained again or to think again. Though he refused for the blood transfusion, he asked me about the alternate treatments possible. So he has exhibited a wish to be saved and to live. His religious belief didn’t drive him to the extreme option of choosing death rather than defying his codes. If I don’t do the treatment and that results in his death, then that amounts to letting the patient to die against his wish to live. I would be faltering in my duty. That would amount as a failure to preserve the integrity of medical profession. In the first instant I must respect the decision of the patient. The doctor’s responsibility is offering the best course of treatment possible but the patient has the ultimate right to choose what is best to him even if his decision would lead him to death. But I can overrule his wish and refusal for treatment and carry out the same if I find out certain interests may outweigh his decision to refuse treatment. This has a precedence and approval of the judicial system. They are If he has a responsibility to support his children or elderly parents, who may be orphaned by his death. This is protection of third parties. Preserving his life would serve a better purpose to humanity rather than letting him die. His services are very much needed to the mankind. As he was not conscious enough to respond can I involve any of his immediate family members as to how he would have reacted if the condition had been explained to him again. I understand from the discussion with my colleagues that even in the religious group he follows, there are reforms going on as to how to handle the dying situations of its followers. The followers have given the option to choose or deny blood transfusion. If they accept to undergo the blood transfusion they have a chance to repent their action before getting expelled. Previous court rulings have suggested that the individual’s wish to refuse treatment must be respected even that would result in his death provided the individual is in a competent mental state to understand the consequences. Based on all these I try to come to the following conclusion. Conclusion I cannot do blood transfusion to the patient in his unconscious state as has clearly refused it after understanding the consequences. But as I mentioned earlier, if I can find details about him and his family, and get convinced that his life is indispensable to his family or in other words his decision to die is going to cause a long term suffering, I will go ahead with the blood transfusion. I have precedence to this decision through a court ruling which ordered for a blood transfusion to a single mother against her wish to protect her children who would have been orphaned by her death. If the situation turns out so that if the above could not be ascertained credibly if no other way of regaining his consciousness is possible, no help could be obtained from the family members in this regard Then blood transfusion should not be done to the patient as I have to respect his moral principles and he refused the treatment after understanding the consequence of refusal. 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