Ethical Issues Identified
Discuss about the Essay On Ethical Issues.
Ethics is a pertinent viewpoint in all areas of human involvement and in particular the field of health care. Ethics and professional code have from since time immemorial informed and guided the practice of medical care. However, the practice and administration of medical care have evolved owing to the changing environment, society and institutional structures that have brought on board a variety of human concerns in the field since the Hippocratic teachings (Reddy & Starlin, 2016). The practice of medical care presents both rewards and challenges in equal measure especially in the question of health care ethics. This essay discusses the ethical issues raised up by the essay, analyses them in relation to human dignity, professional codes, and human rights and concludes with recommending ethics for professional practice in health care.
The following are the ethical issues brought out in the essay as elucidated in the 1985 Principles of Biomedical Ethics by Tom Beauchamp and James Childress:
- Justice; in common parlance, justice refers to the administration of fairness/equity. In the healthcare setting, the tenet of justice proposes that fairness in matters of health care is imperative, the distribution, and access to medical care, new treatments, benefits and/or burdens. It also adds that medics should uphold applicable laws and regulations in the practice. The issue of justice reveals itself when Amos is discriminated upon and denied health care for the simple reason that he does not board in the school. That is an unfair choice and out rightly unjust (Beauchamp & Childress, 1985).
- Non-Maleficence; this principle is derived from the Hippocratic teachings and usually implies “to do no harm”. From the events of the case study, the practitioner’s decisions do not achieve the end goal of medical practice. The choices of triage nurse force Amos to return home for help where he dies a little later. This principle is disregarded here since Amos goes through anguish and agony while his family members lose one of their own. Harm, therefore, befalls Amos in the form negligence form the nurse and doctor on duty(Beauchamp & Childress, 1985).
- Beneficence; this tenet asserts that providers of health care ought to act and perform all in their ability for the benefit of the patient in all circumstances. Sending away Amos without attending to him despite his condition is a complete disregard of this principle. They do not do what is of utmost good or benefit to Amos. Moreover, the facility’s lack of enough supplies catalyzes the violation of this principle(Beauchamp & Childress, 1985).
Ethical Issues in connection to Human Dignity.
The idea of human dignity stands out amongst the most imperative professional values and has increasingly gained recognition in the practice of healthcare. Human Dignity infers having regard for human independence/individuality and regarding every person as a special individual. It is also important to note that human dignity does not only gain recognition in healthcare provision but also in all fields of human existence. Human dignity is an aspect of human rights and a moral obligation for health care providers for the full enjoyment and realization of human rights. Recent studies present the finding that human dignity is an absolutely savvy, conceptual, ambiguous, culture-connected, and reciprocal idea which does not have a reasonable definition and is hard to quantify with standard devices and clinical assessment. The studies also affirm that human dignity is a prerequisite for and a human right in itself, and a foundation for medical care and ought, therefore, to be upheld (Baillie & Wainwright, 2008).. Among others, later studies have revealed that the aspects of regard, self-assurance, restraint and condition control, protection and personality are part of the variables connected to advancing or undermining human respect not only for patients but also for nurses. Events of the case study however depict an undermining of human dignity. Amos, regardless of his residential status is entitled to access medical care not only as a student of that school but also as a human being. Thus, upholding human dignity in health care will assist healthcare providers in collaborating to achieving similar ends (Clearinghouse, 2004).
Ethical issues in connection to Human Dignity
From the explanations in the previous section, connections between ethics in health care and human rights have been established. Numerous debates exist on this particular topic, in the definition of human rights, categorization of human rights and pegging the question of whether a right is a legal right or a moral right. In view of the disparities, therefore, finding from studies reveal that health care should enhance and promote the enjoyment of human rights. However, a gross infringement on this right occurs when Amos is sent away without treatment. Although there are exceptions to discrimination, Amos’ residential status is certainly not one. The nurse’s choice fail the principles of medical ethics. Malawi, as in most countries, access to health care is a human right and governments have made remarkable strides to the realization of this important human right (Mann, 2000).
A code of ethics stipulates the duties and obligations of a calling or profession and provides focus to the professional for approaching ordinary ethical questions. A professional is guided by several codes of ethics and models of practice that identify with a professional’s industry, licensure, accreditation and manager relationship (Shahriari, Abbaszadeh, & Bahrami, 2013). Ethics in health care is not an option, and every practitioner is bound by international, national and institutional professional code of ethics and conduct. The facility that received the students certainly prescribes to professional code of ethics and conduct for its health workers either from national or international platforms. Although, an ethical code is not a fix for every ethical question it requires one to exercise judgment about the framework within the ethical question (Pellegrino, 2000). The triage nurse and doctor were morally obliged and had a duty to adhere to their professional commitment. Examples of the professional code of ethics and conduct for health care providers include those of World Health Organization (WHO) and Australian Medical Board Good Medical Practice: A code of Conduct for Doctors in Australia among others.
As countries strive to achieve the best healthcare standards and models, governments and their agencies usually come in to complement, direct and harness already established professional code of ethics and conduct with a view to focusing them to the realization of certain laid out goals and visions of that particular government or in response to international requirements. Similarly, the government might roll out new policies or legislation and professional bodies and institutions must adhere to their stipulations. This kind of relation allows for the accommodation of changing needs, requirements, changing technology and policies regarding the administration of health care. The relevant stakeholders are all brought on board to ensure inclusivity and liaison between necessary parties. An example of such policies is documented in the Australian Safety and Quality Framework for Health Care (2010) that mentions three major guidelines for protected and quality care: Consumer-focused, driven by data, and composed for wellbeing intended for individuals with policy responsibilities in the medical sector.
Ethical issues in connection with Human rights
In view of recommendations made previously by organs such as the World Health Organization in their 2013 Guideline, the ethical principles of Autonomy, Beneficence, Non-Maleficence, and Justice have vocally been noted as a key tool to the administration of holistic medical care, and to the attainment of the end goal of health care. Similarly, the ethical concerns intertwined with human experiences, human dignity, human rights, and adherence to the professional code of ethics and conducts have also been fronted as key to the achievement of universal medical care. This essay equally hails and supports those recommendations. Moreover, owing to the changing environment in the nursing environment, health care provision, advancement in technology regarding health care, dynamic policies and legislation, all stakeholders must respond and work together to ensure that the goals of health care are attained without violating any of the principles of medical care (Werhane, 2009). Probe into the untimely death of Amos would probably reveal a loophole into the adherence of professional code of ethics in that particular facility in Malawi and corrective measures installed. Additionally, broad investigations are essential in this particular subject since extant literature reveal research gaps.
Conclusion
Upon conclusion therefore, I echo the words of Sir William Osler, “The exercise of medicine isn’t a business and can never be one; our kindred individuals can’t be managed as a man bargains in corn and coal; the human heart by which we live should control our expert relations” As noted earlier in the discussion, ethics is not an option for health practitioners (Nelson, 2015). Although ethics do not answer all questions, health care providers must follow the relevant professional code of ethics as in the case of Amos. Developments in science and technology have continually increased the abilities of health care providers to advance their respective fields, and therefore the place of medical care ethics will in like manner change and take root. Continuous professional development for healthcare providers through training is thus an imperative towards better health care.
References
Australian Commission on Safety and Quality in Healthcare Level 7. (2010).Sydney: Darlinghurst NSW.
Baillie, L. G., & Wainwright, P. (2008). Defending dignity: Challenges and Opportunities. London: Royal College of Nursing.
Beauchamp, T. L., & Childress, J. F. (1985). Principles of Biomedical Ethics (Seventh ed.). Oxford: Oxford University Press.
Campbell, L. (2006). Effects of Implementing the Discipline with Dignity Classroom Management Model on the Number of Discipline Referrals in K-2 Classrooms in a Mid-Southern State. Philadelphia: Union University.
Clearinghouse, E. (2004). American Association of Colleges of Nursing. The Essentials of Baccalaureate Education for Nursing Practice. Washington DC: Clearinghouse.
Guidelines, W. H. (2013). Transforming and Scaling up Health Professionals’ Education and Training. Geneva: WHO.
Mann, J. (2000). Dignity and Health: The UDHR’s Revolutionary first article. Human Rights. Washington DC: USNLM.
Nelson, W. A. (2015). Making Ethical Decisions. A Six-Step Process should guide ethical decision making in healthcare. Health Executives Journal, 30, 46-52.
Pellegrino, E. D. (2000). The Commodification of Medical and Health Care: The Moral Consequences of a Paradigm Shift from a Professional to a Market Ethic. Journal of Medical Philosophy, 24, 243-257.
Reddy, M. S., & Starlin, V. M. (2016). HealthCare Ethics and the Free Market Value System. Indian Journal of Psychology AND Medicine, 35(5), 371-375.
Shahriari, M. M., Abbaszadeh, A., & Bahrami, M. (2013). Nursing Ethical Values and Definitions: A literature review. Iranian Journal of Nursing and Mid-Wifery Res, 18, 1-8.
Werhane, P. H. (2009). Business Ethics, Stakeholder Theory, and the Ethics of Healthcare organizations. Cambridge: Cambridge.
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