Inter-Professional Approaches to Ethical Issues in Health Care Practice - Essay Example

Inter-Professional Approaches to Ethical Issues in Health Care Practice Name Institution Name Introduction Health care professionals and/or practitioners are required to follow ethical codes of practice in their practice. Ethical codes govern each and every activity that health care practice. For instance, both national and international health care coded are designed to make sure that professionals in this field treat patients according to the set ethical standards and principles (Nursing and Midwifery Board of Australia, 2008a). This paper compares and contrasts inter-professional approaches to ethical issues in their practice; nursing in paediatrics and midwifery professions are used in this paper. In a nutshell, the paper discusses national and international frameworks for health care and how they influence ethical decision making in practice. The paper also explains the code of ethics relevant to nursing in paediatrics and midwifery. The differences between ethical and legal issues in health care with regard to vulnerable patient cohorts are also discussed. And lastly, the paper identifies social and spiritual factors that influence the health professional values and beliefs in ethical decision making. National and International Ethical Frameworks for health care that influence ethical decision making Health care practitioners are bound by ethical frameworks which are used as the basis for their decision making. The national ethical framework is usually designed in a manner that is in line with the international or ethical frameworks that are globally accepted. In Australia for instance, the Nursing and Midwifery Board of Australia (NMBA) has a singular objective of regulating midwives and nurses in Australia and proving registered nurses with national competency standards (Nursing and Midwifery Board of Australia, 2008a). These competency standards are principle-based and hence are dynamic in nature to empower nursing practitioners and nurse regulators to use them for competency assessment. Accordingly, these national competency standards are core to nursing performance assessment in order to obtain and retain the certificate of a registered nurse in Australia (Nursing and Midwifery Board of Australia, 2008b). With regard to these competency standards the registered nurse should demonstrate competence in providing nursing care as stipulated in the registration requirements, the standards and codes of the National Board, educational preparation, context of care as well as with relevant regulation (Consumers Health Forum of Australia, 2013). In essence, these national competency standards require nurses to perform their duties independently and interdependently whereby they are responsible and accountable to their actions as well as care delegation to enrolled health care workers and nurses. The registered nurse’s national competency standards dictate that the professional practice of a registered nurse should be legally and ethically accepted (Nursing and Midwifery Board of Australia, 2008a). In essence, the practice should be practiced in line with the legal regulations affecting the nursing practice and the larger health care practice. Accordingly, the nursing practice has to be practiced within a professional and ethical nursing framework. In the same line of discussion, it should be practiced within an evidence based framework. From this analysis, it is clear that the Australian national ethical framework dictate that all health care decisions made by any health care practitioner must be ethically and legally acceptable. Internationally, health care frameworks are require to put the patient’s interest first, support ethical research and innovation, ensure independence and ethical conduct, and more importantly, promote transparency and accountability in health care practice. For instance, the World Health Organization International Rights of Children demand that no consent should be given for anything that is not in the best interest of the children or impede or hamper their ability to achieve their full potential (Nursing and Midwifery Board of Australia, 2008b). This ethical code is in line with Australian national competency standards for nurses. Similarly, Australian Nursing Midwifery Board is also a signatory to the International Federation of Midwives which is the basis of their ethical code. Given this establishment, both the national and international health care ethical frameworks have massive influence on health care decisions made by the health care practitioners. Notional ethical frameworks are developed based on the international ethical frameworks. Code of Ethics relevant to different health disciplines Paternalism in paediatrics Paternalism is ethically acceptable in paediatrics given the fact that for children under the age of 16, parents are legally responsible for giving their informed consent. Paternalism is used across the board in paediatrics. It is only in some instances that children aged between 10 and 16 are allowed to make their own decisions; chronic health (Nursing and Midwifery Board of Australia, 2008b). Children of ages between 10 and 16 can be deemed to be potentially competent and thus can make their own informed consent regardless of not being legally allowed to give consent due to the fact that they are neither considered adults nor young adults. However, in the event of chronic health, they can be given an opportunity to make their own decision (The Medical Insurance Group, 2011). No consent and its influence on decision making and patient care (ethical dilemma) In paediatrics, there are instances where a child can be taken care of by health care practitioners without the parent’s consent (Nursing and Midwifery Board of Australia, 2008a). For instance, in cardiac surgery; in the event that there is a child who had previously undergone an elective or non-elective surgery on the ward, and this child requires going back to theatre, it is almost impossible to get parents to obtain informed consent. In this scenario, the child is usually taken to the theatre without the parents consent (Nursing and Midwifery Board of Australia, 2008b). Providing health care in emergency situation, health care practitioners are ethically allowed to provide care without the informed consent. The only thing to be considered in such situations is that, the health care practitioners are working to save a life. Paternalism in Midwifery Paternalism is not ethically justifiable in Midwifery. In this area, it is understood that no health care practitioner knows what is best for the patient and thus they are required to think of the patient as a competent individual. Accordingly, it is highly recommended that if the patient if does not want what she is being advised by the health care provider, and the provider deem that she truly knows and understands the advise, the provider should accept the patient’s decision. This is based on the fact that, the patient is making the decision from an informed point of view. No consent and its influence on decision making and patient care (ethical dilemma) In Midwifery, there are a few instances where care is given without obtaining an informed consent from the patient; this usually occurs during urgent emergency situations. For instance, in the event where there is prolapsed cord and/or the cord has dropped in front of the child’s head prior to birth (Speech Pathology Australia, 2010). This situation is extremely dangerous particularly to the baby due to the fact that cold air can cause blood to stop flowing through the cord from the placenta to the baby. Without proper blood flow, the child can instantly die; given this understanding it is paramount to deliver the child quickly using any means possible. The woman can be taken to the C- section and the decision for taking her there explained later. The health care practitioners are ethically allowed for this particular procedure; it is assumed that the woman would give consent to that situation because it is emergency in nature. Ethical and legal issues in health care in consenting vulnerable patient cohorts Paediatrics context Vulnerable groups in paediatrics come about in the event where there are “children of parents.” When parents are considered not competent and do not that level of understanding enough to give informed consent or what they are consenting for, children of such parents are considered vulnerable (Nursing and Midwifery Board of Australia, 2008a). Their informed consent is left to be given by people regardless of being their parents and required to their child’s supposed interest at heart, they not competent and knowledgeable to make informed decision. In this regard, health care practitioners are required to be extremely careful about these vulnerable groups of children. Vulnerable group of children mostly come from low socio-economic backgrounds and/or they have immigrant origins something that makes them vulnerable particularly when it comes to cultural clashes (Nursing and Midwifery Board of Australia, 2008a). Cultural clashes is an enormous issue and thus immigrants in Australia having other beliefs and rights regarding child upbringing in most cases clash with the Australian way of nurturing children. In addition to this, in Australia there are some cultures that still practice female circumcision to young African girls; this occurs without their consent. This also comprise another vulnerable group and thus health care practitioners need to come up with measures of protecting these vulnerable groups (Nursing and Midwifery Board of Australia, 2008b). Midwifery Context In this context, all pregnant women are considered a vulnerable group given the fact that they are carrying a life and thus they are exposed to various views from the larger population with regard to how they should behave. They are continuously given advise with asking; different commends are made regarding a woman’s belly particularly when she is pregnant (Nursing and Midwifery Board of Australia, 2008b). Other groups may become judgmental about the pregnant woman’s behaviour, for instance it expected in the society that a pregnant woman should not drink alcoholic drinks (The Occupational Therapy Board of Australia, n.d.). In essence, pregnant women are vulnerable to people’s judgmental behaviour especially at this time. Health care practitioners in this field in Australia take care of women from different ages and walks of life and thus they are required to be respectful particularly to their cultural beliefs (Physiotherapy Board of Australia, n.d.). In Australia, women from non-English speaking backgrounds are considered vulnerable due to their is cultural clash between them and care givers, they don’t comprehensively understand everything said by provides and most are times when practitioners make assumption that they understand the Australian health system; this is not the case always. For this reason, midwifes should use interpreters appropriately in order not to make assumptions that are not true by generalizing what they believe (Nursing and Midwifery Board of Australia, 2008b). This must holistically be taken into consideration to ensure that Australian health system effectively and efficiently serve all its citizens without discrimination (Wynia, Kishore & Belar, 2014). Social and spiritual factors that influence health professional values and beliefs in ethical decision making Paediatrics context From the above section, the vulnerable group of children are those who come from low socio-economic backgrounds and/or they have immigrant origins (Nursing and Midwifery Board of Australia, 2008a). These children together with their parents have little knowledge regarding the western way of life this makes them vulnerable particularly when it comes to cultural clashes. Cultural clashes are a significant issue in Australia; immigrants have beliefs and rights of child upbringing which clash with the Australian way of nurturing children. Additionally, some communities in Australia practice African girl circumcision; young African girls are circumcised without their consent due cultural demands (NSW Government, 2012). These are social issues that must be exhaustively addressed by health care practitioners to ensure that such practices are completely abolished to protect these vulnerable groups. Midwifery context There are different beliefs and practices regarding birth in Australia (Stacy et al., 2011). This particular time is essentially significant to all cultural groups in Australia and thus it is recommended that care providers in this field not generalized assumptions because everyone has her unique practices that she follows during this time (Nursing and Midwifery Board of Australia, 2008a). Considering this establishment, each woman should be treated independently as well as be respected for what and who she is without prejudice (Medical Board of Australia, n.d.). For example, due to cultural practice a woman may be required to take the placenta home after birth to perform certain rituals. In the midwifery context, the placenta is considered infectious and should be disposed immediately after birth (Nursing and Midwifery Board of Australia, 2008b). This represents a clash of culture. In this regard, midwifes must be sensitive to such matters in order to appropriately advocate for them in the process of decision making about such (Paramedics Australasia, n.d.). For instance, the placenta can be preserved and/or stored in a manner that is acceptable for it to be taken home to perform the rituals as required by culture. Conclusion The above discussion provides a holistic comparison of how ethics is practiced in different health care professionals; nursing in paediatrics midwifery professions. The paper has discussed national and international health care ethical frameworks and how they influence decision making in health care. The paper has compared and contrasted inter-professional approaches to ethical issues in their practice; nursing in paediatrics and midwifery professions. The code of ethics in nursing in paediatrics and midwifery, Ethical and legal issues in health care in consenting vulnerable patient cohorts, and Social and spiritual factors that influence health professional values and beliefs in ethical decision making have been expansively discussed. References Australian Nursing and Midwifery Council. (2008a). Code of ethics for nurses in Australia. Retrieved from http://www.nursingmidwiferyboard.gov.au Australian Nursing and Midwifery Council. (2008b). Code of ethics for midwives in Australia. Retrieved from http://www.nursingmidwiferyboard.gov.au Consumers Health Forum of Australia. (2013). Informed consent in healthcare: An issues paper. Retrieved from www.chf.org.au Medical Board of Australia. (n.d.). Codes, guidelines and policies. Retrieved from http://www.medicalboard.gov.au/Codes-Guidelines-Policies.aspx NSW Government. (2012). Code of conduct. Retrieved from http://www0.health.nsw.gov.au/policies/pd/2012/pdf/PD2012_018.pdf Paramedics Australasia. (n.d.). Code of conduct. Retrieved from https://www.paramedics.org Physiotherapy Board of Australia. (n.d.). Codes and guidelines. Retrieved from http://www.physiotherapyboard.gov.au Speech Pathology Australia. (2010). Code of ethics. Retrieved from http://www.speechpathologyaustralia.org.au Stacy, M., Lucie Rychetnik, B., Ian, H., Louise, B., Adrian, B., Claire, H., & Avigdor, Z. (2011). Evidence, ethics, and values: a framework for health promotion. American Journal of Public Health, 101(3), 465-472. The Medical Insurance Group. (2011). Fact sheet - Consent to medical procedures for minors. Adelaide: MIGA The Occupational Therapy Board of Australia. (n.d.). Codes and guidelines. Retrieved from http://www.occupationaltherapyboard.gov.au Wynia, M., Kishore, S., & Belar, C. (2014). A unified code of ethics for health professional’s insights from an IOM Workshop. The Journal of the American Medical Association, 311(8), 799-800 Read More