Health policy, law and ethics Essay

For the intent of this assignment I will look at the legal and ethical facets involved in the undermentioned scenario and this will be discussed. I will take into consideration both the deontological and consequentialism theory. Laws relevant to this scenario will be looked at. Scenario

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To keep confidentiality the name of the patient has been changed. The patient D is 60 old ages old male who had kidney malignant neoplastic disease he had been admitted to the infirmary for farther intervention. On the undermentioned probe the patient had been diagnosed with the last phases of malignant neoplastic disease which meant it had spread into the environing tissue. Prognosiss were hapless. alleviant was to be offered. The household had requested that the patient should non be informed hence. D was non cognizant about his current status. The patient could non understand why medical staff merely made him comfy and were non taking a different attack to his intervention. Consequently. he lost religion in the staff and his will to populate and refused everything that was given to him. The nurses made a determination to inform him of his terminal unwellness. believing this to be in his best involvement. He understood the state of affairs and expressed a want to decease at place. Legal facets

The state of affairs that the nurses faced in this scenario was uncomfortable for both the patient and the health care professionals. The nurses had a quandary of legal and ethical facets on one manus. and patient’s legal rights on other manus. In any treatment of ethical issues in medical specialty. legal facets may originate. Both of them set criterions of behavior. where jurisprudence frequently shows a “kind of minimum ethical societal consensus” ( Emanuel et. Al. 1999. p2 ) . The survey of jurisprudence expresses a procedure of legal thought and applying legal philosophy to the real-life state of affairs in the health care puting ( Flight and Meacham 2011 ) . A deontology comes from the Grecian term “deon” . intending “duty” ( Jones and Beck 1996 ) . White and Baldwin ( 2004 ) province. deontological is cardinal in medical specialty as it means “do no harm” and “act in the patients’ best interest” ( p. 54 ) . Using deontology attack in this instance. health care suppliers were following the regulation “Act in the patients’ best interest” . The job that occurred in this state of affairs is that it was hard for the health care professionals as from a legal point of position the patient had a right to cognize the truth if he wish.

The NHS Constitution ( 2013 ) provinces. that a patient has the right “to be involved in treatments and determinations about his the wellness and attention. including terminal of life attention. and they be given information to enable the patient to make this” ( p. 9 ) . Healthcare professionals were moving harmonizing to the Hippocratic Oath and following a set of regulations. which are established as a model of the NHS. One of the regulations provinces. that nurses must “safeguard and advance involvements of single patients and client” ( Tingle and Cribb 2007. p. 16 ) . Medical professionals must ever move in the best involvement of the patient. However. trouble may be experienced in certain state of affairss as the boundary line between legal issues and moralss is narrow. The of import professional construct of nursing is answerability for their actions to present appropriate attention for their patients. This answerability is applicable in the legal context and of import professionally. it is based on cognition and apprehension.

Therefore. lawfully it is closely related to carelessness and responsibility of attention ( Young 1995 ) . In this scenario the nurses felt that they were moving as an advocator for the patient by following the regulations. Montgomery ( 1995 ) . province that answerability. duty and responsibility of attention are closely linked. Irrespective of professional standing duties. healthcare staff are still accountable. with respect to responsibility of attention within the outlook of their occupation ( Fletcher and Buka 1999 ) . In this instance. the patient’s anxiousness could hold been alleviated if he had been to the full informed of the badness of his medical status. This would so enable him to understand and accept this intelligence. and would non take the farther complications in his psychological status. Kravitz and Melnikow ( 2001 ) suggest that patient’s engagement in the determination devising procedure about their attention is necessary.

Analyzing this state of affairs I felt that patient D had a deficiency of liberty. A patient should be to the full informed about the diagnosing. and consent should be obtained for the intervention proposed ; otherwise the independent being would be disregarded ( Fletcher et al 1995 ) . The importance of patient liberty came from Nuremberg Trials codifications of moralss. which was established in 1948 and stated that “The voluntary consent of the human topic is perfectly essential” ( Washington 1949 p. 181 ) . The liberty of D was disregarded by his household as they believed it would non be good for him to cognize the truth. However. D had the capacity to do independent determinations. such as whether or non he wanted to have information about his current status.

Ethical facets
The issue that medical staff came across was to esteem patient’s liberty that had been breached in the described state of affairs. Pearson et Al ( 2005 ) provinces that patients are persons. they have the right to be involved in doing the determination procedure about themselves and their hereafter. This belief refers to patient liberty which is defined as freedom of doing determinations within their bounds of competence. Being unaware of his medical status patient D had been deprived of his liberty. Hendrick ( 2004 ) described liberty as the ability to believe about their lives and act consequently to a chosen set of regulations. Respecting liberty means handling a individual as an person. affecting him in treatment about his planned intervention. leting him do his ain determination. This is an indispensable portion of any papers of patients’ rights. O’Connell et Al ( 2010 ) states that there are some ethical rules in nursing which include two of import elements such as beneficence and non-maleficence.

Both of them have important deductions for nurses. Hendrick ( 2000 ) back uping this position states that. in healthcare scenes beneficence appears to be a consecutive forward term. and means to make “good” . In this state of affairs at that place had arisen a monolithic ethical quandary. and to take the right attack to make “good” was non really easy for nurses. From one side. we had the patient who was non suited for any medical intervention. as he was terminally sick but still had the right for alleviative attention. hence staff had to follow with all ethical rules. One of them was beneficence. as it seemed good in the beginning non to state the patient the truth about his status. harmonizing to his household wants. The household believed that patient D’s unknowingness of world would assist him get by with his progressive unwellness. However. nurses whose duty it was to protect the patient from psychological emphasis and follow another ethical rule. which is non-maleficence. Beauchamp and Childress ( 2009 ) province that. the rule of non-maleficence dictates an duty non to harm.

Both beneficence and non-maleficence were described in the Hippocratic Oath as “I will utilize those dietetic regimens which will profit my patients harmonizing to my greatest ability and opinion. and I will make no injury or unfairness to them” ( Grecian medical specialty 2010 ) . The patient D’s reaction to the ambiance environing him determined the medical staff to alter the original attack to his attention and give him the correct information about his forecast. Respect should be shown to the patient ; a simple duty to give him a realistic image of his status. The patient had a right to cognize the truth. as he was nearing the terminal of his life. He might necessitate to discourse some inquiries with his household and carers in order to set up his personal businesss ( Nicoll 1997 ) . Basford and Slevin ( 1999 ) province. the rules of liberty and justness as. are critical in health care pattern and are dominant in many statements within medical and nursing moralss. Consequently. there is a struggle between the patient’s right to cognize and the carers’ responsibility of attention. Honesty is an of import portion of any relationship. Jeffrey ( 2006 ) suggests that “communication would go nonmeaningful if there was no overruling moral duty to be truthful” ( p. 64 ) .

Decision

In any ethical quandary healthcare staff should follow the authorities constabularies harmonizing to the Code of Conduct. As they are responsible for peoples’ wellness and have an honor to stand for the National Healthcare Service. hence. they can non take any state of affairs emotionally and personally. The health care professionals’ attitude to clinical opinion seemed to hold increased during the last decennary. Sing this. healthcare staff were taking into history new positions of acknowledgment of patient rights. to do an independent pick. The patient D had an chance for pick and made a determination to decease at place. The statement in this state of affairs was that all medical professionals should be stating the truth whether or non the patient’s household agreed. In this instance I believe the medical staff were moving professionally and the patient received the attending he required in clip. and there were no declinations afterwards.

Mentions:
Basford and Slevin ( 1999 ) Theory and pattern of Nursing Cheltenham: UK Beauchamp and Childress ( 2009 ) Principles of biomedical moralss ( 6th edition ) New York: US Emanuel L. von Gunten C and Ferris F ( 1999 ) . The Education for Physicians on End-of-life Care ( EPEC ) course of study: US Fletcher N. Hold J.
Brazier M and Harris J ( 1995 ) Ethics. Law and nursing Manchester: UK Flight M and Meacham M ( 2011 ) Law. Liability. and Ethical motives for Medical Office Professionals Delmar ( 5th edition ) : US Grecian Medicine ( 2010 ) Hippocratic Oath: translated by North M Online at: hypertext transfer protocol: //www. nlm. National Institutes of Health. gov/hmd/greek/greek_oath. hypertext markup language [ Accessed on: 21/03/14 ] Hendrick J ( 2000 ) Law and moralss in nursing and health care Cheltenham: UK Hendrick J ( 2004 ) Ethics and Law Cheltenham: UK Jones R and Beck S ( 1996 ) Decision doing in nursing Delmar: US Kour N and Rauff A ( 1992 ) Informed patient consent-historical position and a clinician’s position Singapore Med 33 ( 1 ) : 44–6 Kravitz R and Melnikow J ( 2001 ) Prosecuting patients in medical determination devising. British Medical Journal 323: 584-585. Nicoll L ( 1997 ) Perspectives on Nursing Theory New York: US O’Connell 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 War Criminals before the Nuremberg Military Tribunals under Control Council Law 10 ( 2 ) : 181-182 Online at: hypertext transfer protocol: //history. National Institutes of Health. gov/research/downloads/nuremberg. pdf [ Accessed on 11/03/2014 ] The NHS Constitution ( 2013 ) Online at: hypertext transfer protocol: //www. New Hampshire. uk/choiceintheNHS/Rightsandpledges/NHSConstitution/Documents/2013/the-nhs-constitution-for-england-2013. pdf [ accessed on 10/03/2014 ] Tingle J and Cribb A ( 2007 ) Nursing jurisprudence and Ethics ( 3rd edition ) Oxford: UK White S and Baldwin T ( 2004 ) Legal and Ethical facets of Anaesthesia critical attention and perioperative medical specialty. Cambridge: UK Bibliography:

George J. Annas Edward R and Michael A. Grodin ( 1992 ) The Nazi 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 ) London: United kingdom

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