Thursday, May 23, 2019

Health policy, law and ethics Essay

For the purpose of this assignment I result look at the level-headed and honorable aspects heterogeneous in the following scenario and this will be dealed. I will take into consideration both the deontological and consequentialism theory. Laws relevant to this scenario will be looked at. ScenarioTo maintain confidentiality the name of the affected role has been changed. The persevering D is 60 years old male who had kidney cancer he had been admitted to the hospital for further treatment. On the following investigation the diligent had been diagnosed with the last stages of cancer which meant it had spread into the surrounding tissue. Prognoses were poor, palliative was to be offered. The family had requested that the patient should non be informed therefore, D was not aware about his current condition. The patient could not understand why medical module only made him comfortable and were not taking a different snuggle to his treatment. Consequently, he disoriented fait h in the staff and his will to live and refused everything that was split upn to him. The nurses made a decision to inform him of his terminal illness, believing this to be in his outmatch interest. He understood the situation and expressed a wish to grumble at home. Legal aspectsThe situation that the nurses faced in this scenario was uncomfortable for both the patient and the health care professionals. The nurses had a dilemma of legal and ethical aspects on one hand, and patients legal rights on other hand. In both tidings of ethical issues in medicine, legal aspects may arise. Both of them set standards of conduct, where constabulary often shows a kind of minimal ethical societal consensus (Emanuel et.al. 1999, p2). The study of law expresses a process of legal thinking and applying legal doctrine to the real-life situation in the healthcare setting (Flight and Meacham 2011). A deontology comes from the Greek term deon, meaning work (Jones and Beck 1996). White and Baldw in (2004) state, deontological is fundamental in medicine as it means do no harm and act in the patients best interest (p.54). Using deontology approach in this encase, healthcare providers were following the rule Act in the patients best interest. The problem that occurred in this situation is that it was difficult for the healthcare professionals as from a legal point of view thepatient had a right to know the truth if he wish.The NHS Constitution (2013) states, that a patient has the right to be involved in discussions and decisions about his the health and care, including end of life care, and they be given information to enable the patient to do this (p.9). Healthcare professionals were acting according to the Hippocratic Oath and following a set of rules, which are established as a framework of the NHS. One of the rules states, that nurses must safeguard and promote interests of individual patients and thickening ( tremble and Cribb 2007, p.16). Medical professionals must al ways act in the best interest of the patient. However, difficulty may be experienced in certain situations as the margin between legal issues and ethics is narrow. The beta professional concept of nursing is accountability for their actions to deliver appropriate care for their patients. This accountability is applicable in the legal context and important professionally, it is based on knowledge and understanding.Therefore, legally it is closely related to negligence and duty of care (Young 1995). In this scenario the nurses felt that they were acting as an advocate for the patient by following the rules. Montgomery (1995), state that accountability, responsibility and duty of care are closely linked. Irrespective of professional standing responsibilities, healthcare staff are still accountable, with regard to duty of care within the expectation of their job (Fletcher and Buka 1999). In this case, the patients anxiety could have been amend if he had been fully informed of the sev erity of his medical condition. This would then enable him to understand and accept this news, and would not lead the further complications in his psychological condition. Kravitz and Melnikow (2001) designate that patients participation in the decision making process about their care is necessary.Analysing this situation I felt that patient D had a lack of familiarity. A patient should be fully informed about the diagnosis, and consent should be obtained for the treatment proposed otherwise the autonomous being would be do by (Fletcher et al 1995). The importance of patient shore leave came from Nuremberg Trials codes of ethics, which was established in 1948 and stated that The voluntary consent of the human subject is absolutely essential (Washington 1949 p.181). The autonomy of D was disregarded by his family as they believed it would not be beneficial for him to know the truth. However, D had the capacity to make autonomousdecisions, such as whether or not he wanted to recei ve information about his current condition.Ethical aspectsThe issue that medical staff came across was to respect patients autonomy that had been breached in the draw situation. Pearson et al (2005) states that patients are individuals, they have the right to be involved in making the decision process about themselves and their future. This belief refers to patient autonomy which is defined as freedom of making decisions within their limits of competency. Being unaware of his medical condition patient D had been deprived of his autonomy. Hendrick (2004) described autonomy as the ability to think about their lives and act accordingly to a chosen set of rules. Respecting autonomy means treating a person as an individual, involving him in discussion about his planned treatment, allowing him make his own decision. This is an essential part of any document of patients rights. OConnell et al (2010) states that there are some ethical principles in nursing which include two important eleme nts such as beneficence and non-maleficence.Both of them have significant implications for nurses. Hendrick (2000) supporting this view states that, in healthcare settings beneficence appears to be a straight forward term, and means to do good. In this situation there had arisen a massive ethical dilemma, and to discern the right approach to do good was not very easy for nurses. From one side, we had the patient who was not suitable for any medical treatment, as he was terminally ill but still had the right for palliative care, hence staff had to comply with all ethical principles. One of them was beneficence, as it seemed beneficial in the beginning not to tell the patient the truth about his condition, according to his family wishes. The family believed that patient Ds unawareness of reality would help him cope with his state-of-the-art illness. However, nurses whose responsibility it was to protect the patient from psychological stress and follow another ethical principle, whic h is non-maleficence. Beauchamp and Childress (2009) state that, the principle of non-maleficence dictates an obligation not to harm.Both beneficence and non-maleficence were described in the Hippocratic Oath as I will use those dietary regimens which will benefit my patients according to my greatest ability and judgement, and Iwill do no harm or injustice to them (Greek medicine 2010). The patient Ds reaction to the atmosphere surrounding him determined the medical staff to change the original approach to his care and give him the correct information about his prognosis. Respect should be shown to the patient a simple obligation to give him a realistic picture of his condition. The patient had a right to know the truth, as he was approaching the end of his life. He might need to discuss some questions with his family and carers in order to arrange his affairs (Nicoll 1997). Basford and Slevin (1999) state, the principles of autonomy and justice as, are vital in healthcare practice and are dominant in many arguments within medical and nursing ethics. Consequently, there is a conflict between the patients right to know and the carers duty of care. Honesty is an important part of any relationship. Jeffrey (2006) suggests that communication would become meaningless if there was no overriding moral obligation to be truthful (p. 64).ConclusionIn any ethical dilemma healthcare staff should follow the government polices according to the Code of Conduct. As they are responsible for peoples health and have an honour to fabricate the National Healthcare Service, therefore, they cannot take any situation emotionally and personally. The healthcare professionals attitude to clinical judgement seemed to have increased during the last decade. Considering this, healthcare staff were taking into account new views of recognition of patient rights, to make an autonomous choice. The patient D had an opportunity for choice and made a decision to die at home. The argument in this situation was that all medical professionals should be telling the truth whether or not the patients family agreed. In this case I believe the medical staff were acting professionally and the patient received the attention he required in time, and there were no dec afterwards.ReferencesBasford and Slevin (1999) Theory and practice of Nursing Cheltenham UK Beauchamp and Childress (2009) Principles of biomedical ethics (6th edition) New York US Emanuel L, von Gunten C and Ferris F (1999). The Education for Physicians on End-of-life Care (EPEC) curriculum US Fletcher N, check off J,Brazier M and Harris J (1995) Ethics, Law and nursing Manchester UK Flight M and Meacham M (2011) Law, Liability, and Ethics for Medical Office Professionals Delmar (5th edition) US Greek Medicine (2010) Hippocratic Oath translated by North M Online at https//www.nlm.nih.gov/hmd/greek/greek_oath.html Accessed on 21/03/14 Hendrick J (2000) Law and ethics in nursing and healthcare Cheltenham UK Hendrick J (20 04) Ethics and Law Cheltenham UK Jones R and Beck S (1996) Decision making in nursing Delmar US Kour N and Rauff A (1992) Informed patient consent-historical perspective and a clinicians view Singapore Med 33(1) 446 Kravitz R and Melnikow J (2001) Engaging patients in medical decision making. British Medical Journal 323 584-585. Nicoll L (1997) Perspectives on Nursing Theory New York US OConnell S, Bare B, Hinkle J, and Cheeveret K (2010) Textbook of Medical-surgical Nursing (12th edition) Philadelphia US Pearson A, Vaughan B, Vaughan B, FitzGerald M and Washington D (1949) Trials of state of war Criminals before the Nuremberg Military Tribunals under Control Council Law 10 (2) 181-182 Online at http//history.nih.gov/research/downloads/nuremberg.pdf Accessed on 11/03/2014 The NHS Constitution (2013) Online at http//www.nhs.uk/choiceintheNHS/Rightsandpledges/NHSConstitution/Documents/2013/the-nhs-constitution-for-england-2013.pdf accessed on 10/03/2014 Tingle J and Cribb A (2007) Nu rsing law and Ethics (3rd edition) Oxford UK White S and Baldwin T (2004) Legal and Ethical aspects of Anaesthesia critical care and perioperative medicine. Cambridge UK BibliographyGeorge J. Annas Edward R and Michael A. Grodin (1992) The national socialist Doctors and the Nuremberg Code Human Rights in Human . Oxford US Morrison E (2010) Ethics in Health Administration A Practical Approach for Decision Makers (2nd edition) capital of the United Kingdom UK

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