The Ethics and Principles Governing the Health Care Practitioner - Term Paper Example

The Ethics and Principles Governing the Health Care Practitioner You’re Name University The Ethics and Principles Governing the Health Care Practitioners Introduction Within the realm of health care, with particular emphases on the doctors themselves, there are many laws, ethics, and principles that govern over their practice and what is required of them in regards to providing proper and adequate medical care for all people. The issues of equality among different ethnicities, and mental health patients is crucial in ensuring that all citizens in the UK feel that they are receiving the same standard of care that natural citizens have available to them as well. Of course it is also one of the problems that are in the practice of medicine and therefore there have been many laws and policies that have been intertwined with the health care model to try and maintain a sense of equality instead of inequality among the people. Not only do health care practitioners have to be careful in regards to this area of ethical and mental health care considerations but they also have a myriad of other applicable influences that legally reside over their medical interactions as well. These vary from consent by a patient, to everyday clinical situations as well. So while the medical profession is complex due to the laws it is essential to have in providing proper health care services to those in need of it. Medical Responsibility and the Law In regards to consent by patients to medical care from a physician the law is quite clear in how this must be carried out. Any health care practitioner should be fully aware of the necessary protocols to follow if they have knowledge of the UK’s Health Care Reference Guide which discusses the common laws associated with common law practices and consent for examination by the patient (Worthington 2002, p. 377). English law in particular is meant to try and rectify any weaknesses that might exist in the health care procedures for patients that are elderly and not as mentally competent as a younger individual might be. However the law is not only meant for the elderly but has protective barriers to ensure the safety and well being of patient care from all angles, including competent adults as well. Therefore when a treatment refusal from a patient presents itself medical health care providers still have an obligation to the patient to provide health care and search for an alternate means of treatment to safeguard the patients’ present health condition from deteriorating and getting progressively worse (Shea 2005, p. 21). In this regard the basic laws are what govern the medical practice and this coincides everywhere around the world with regard to consent procedures and how the law is applied. In situations such as these the practitioner has to be especially careful not to place him or herself at any legal risk due to the patients’ refusal of essential treatment. They can try educating the patient as to why the treatment is crucial to their recovery but if the patient still refuses then legally a medical professional must have some form of consent from the patient in existence to provide viable proof that he or she was following along the wishes of the patients preferred method of care. This is to safeguard the position of the physician from any adverse legal action that might present itself but also to give accountability of the physicians’ actions as well. However there is more to this scenario than simply filing paper work and educating the patient. Doctors have to go over the consequences of refusing a specific form of treatment so that they are aware of what the outcome might be and in that regard the physician can not be held responsible for any negativity in the patients’ health that might arise. The following stipulates what must be discussed with the patient: Information must be shared with the patient in regards to the associated risks of refusing treatment The health care provider must take into account the patients personal statement towards the information provided The patients mental status must be fully evaluated to ensure competency at the time the decision to refuse treatment is made The doctor must express to the patient what the final outcome might be due to the patients refusal of treatment (Shea 2005, p. 22). These guidelines provide legal medical protection to the physician and his or her staff so that again they can not be held liable for any adverse health complication of the patient. Also the Human Rights Act of 1998 has power over situations such as these as well as other medical issues in regards to specific forms of patient care, specifically intensive care procedures (White & Baldwin 2002, p. 882). The Human Rights Act of 1998 was incorporated into the medical care policy in 2000 and it is found that it has specific legal powers over circumstances that are associated with patient consent, disclosure of patient medical records, and the type of access that patients have to proper health care (White & Baldwin 2002, p. 882). This act protects patients in a medical context from being discriminated against, degraded, or faced with inhumane medical treatment such as negligence or other adverse care which is a major plus for the citizens of England in particular as beforehand the medical world had the freedom to make their own decisions of care for patients without any direct form of approval by legislation or any other governing legal body. In that regard there was not as much protection for patients as there exists now and therefore physicians have to safeguard themselves as well due to the legal framework that has now taken precedence in the medical world. Furthermore, the HRA is a regulating body between patients, doctors, and the legal system. It allows patients who feel that their rights have been violated to have recourse of action to the UK courts where they can file a grievance and pursue some form of compensation for how they might feel they have been treated (White & Bland 2002, p. 884). One example of how the HRA has an impact on medical care is in regard to infectious disease control, for a clearer idea the following information gives a better impression: Article 5 of the HRA states that everyone has the right to liberty and security of person but allows for the lawful detention of persons for the prevention of spreading of infectious diseases, of persons of unsound mind, alcoholics or drug addicts, or vagrants (White & Bland 2002, p. 883). To extend these points further, there is also a right to life where medical practitioners are suppose to promote life and try to prolong it as long as humanly possibly, of course to a humane context. There are cases where prolonging life goes against medical ethics as the case of the 19 month old toddler demonstrates. It was found that this toddler was suffering from an intense and extensive form of pulmonary failure, had Dandy Walker syndrome, and also suffered with lissencephaly. Doctors felt that it was futile to prolong the child’s life or to resuscitate the child upon his death but the parents disagreed with the physicians’ opinion on the medical treatment being given. The courts however agreed with the attending physician and did not find any legal reason why it would be unethical to not resuscitate the child (White & Bland 2002, p. 884). So this case gives emphases to the fact that there are times in providing intensive medical care where physicians rule that it is useless to continue specific forms of treatment. Also, in providing accountability of the physicians’ actions it has been determined by the courts that if it can be verified the physician did what was in the patients’ best interest by all medical and legal standards then they will rule in favor of the medical provider because there has to be a point of logical reasoning. In this case the parents simply did not want to let go of their son so were not competent enough to make a correct decision, as the court emphasized. The practicing doctor did what he felt was in the best interest for the child, which is how the law dictates that certain types of medical care with regard to specific cases have to be gauged in this manner to reach a humane decision on the appropriate care being given. There is no point in continuing a patients suffering if it isn’t going to change the outcome of death in the conclusion of the care. This same type of philosophy is found within the idea of a breach of duty as well. If a doctor feels that a patient is deliberately trying to make other people sick with his or her illness then they have the right to disclose the information to public authorities without facing any legal ramifications due to their actions. This is because the physician is doing what is in the best interest of those in society in attempting to contain a serious disease outbreak. So although there are various laws they are approachable in different ways and are flexible depending upon the circumstances surrounding the medical case. In regards to cases where patients feel that they have been treated in an inhumane or degrading fashion the law is very clear. If it can be proven that the medical care consisted of instances such as the ones defined in the follow bulleted paragraph then a physician can face legal charges for the interactions that created adversities for the patient. Cases of excessive pre-operative fasting A failure to provide the necessary analgesia A failure to provide the patient with alternative therapies for drug addiction which would follow before and after surgery Prevention of awareness during anesthesia An inappropriate early discharge from an intensive care medical unit A failure by staff to respect the personal dignity of a patient (White & Bland 2002, p. 885). These are all serious offenses against a patient in a medical environment and therefore medical staff and the physicians have to be very careful to respect all wishes of the patient so that there won’t exist a feeling of inadequate, unfair, unequal, or inhumane treatment occurring. This at times can be very difficult to avoid due to the competency levels of some of the patients. However a clinical governance over the residing physician could help to prevent issues like these from occurring as often times a second view point can change scenarios such as these quite drastically. Furthermore, in issues where patient competency is involved in the treatment process, clinical governance is of an even higher importance in physician/patient care (Singh 2003, p. 412). One of the main issues in mental health care involves the various conflicts that can arise due to the misunderstandings of managerial and professional care due to the limited amount of resources that have been found. Mental health care is quite an expense as it consumes 5% to 12% of the health care budget in England annually. Therefore there needs to be not only clinical governance over the resources and physician care but also of clinical auditing as well. This is because of what has already been stated. When there is a limited supply of medical care and the necessary resources then there comes a point where there needs to be a rationing or an accountability of what is being served in regards to patient care (Singh 2003, p. 413). This is why this issue is of such importance in the medical field as well. For example there are various issues that define exactly how much funding should be given to mental care in particular and how the services should be doled out, which as was said can lead to many conflicts as mental health care is one of the priorities in England since it is so prevalent. Therefore there has been an increase in the pressure on managers in charge of regulating mental health care because many patients feel their needs aren’t being met adequately enough. This then leads to conflict with the clinician who is then faced with the ethical dilemma of providing services yet trying to contain the cost as well (Singh 2003, p. 413). However, items such as league tables can benefit the health care providers as it shows them exactly what they can provide to their patients with acceptable costs. So thereby, the governance as well as the auditing of medical care costs is good to keep in check the amount of expense that is going in and coming out of the health care budget and of which affects the physicians as much as the patients. In the area of physical health care, such as with surgical procedures, clinical governance also has a part to play in this area as well which is of crucial relevance to the physician as well (Spark & Rowe 2004, p. 167). Surgeons in particular are heavily affected by clinical governance because they are providing a service to the patient that can seriously affect their quality of life for years to come. Therefore with clinical governance it helps them to ensure that the medical care they are providing is high quality and free from negligence or misjudgments as well. The guidelines of surgeons are strict as the following bulleted points show, Surgeons and other physicians are required to fully participate in a clinical audit They are required to use and support evidenced based practice which must include risk management, quality assurance and clinical effectiveness Surgeons and other doctors are required to carry out a professional demeanor at all times with all patients (Spark & Rowe 2004, p. 167). Of course it is quite understandable why clinical governance should exist in medical care as it not only guarantees the doctors will be on their toes in providing responsible care but it safeguards the patients well being as well. For example breast screening and cervical cancer screening are done to try and detect these forms of cancer early to provide the best and most reliable way of combating them in order to guarantee a decent quality of life for the patient after recovery. However there have been instances of severe fault in these screenings in the past but with clinical governance these can be corrected by reducing poor performance from occurring among medical professionals. Thereby the screening outcomes can be better guaranteed in accuracy, so the relevance is quite obvious and the impact on doctors quite natural as well as they should always be prepared to provide correct and accurate testing of disease to begin with (Spark & Rowe, p. 168). In fact clinical governance is not meant to stress the doctors and other medical personnel but rather it is meant to promote positivism in the NHS and make everyone feel more positive about its capabilities with patients and medical staff alike as the following quote shows, Clinical Governance is a framework through Which NHS organizations are accountable for Continuously improving the quality of their Services and safeguarding high standards of Care by creating an environment in which Excellence in clinical care will flourish (Bunch 2001, p. 533). This dictates the positive impact that clinical governance brings to health care and physicians in particular. Where some would view it as an intrusion it should rather be viewed as a great amenity to the NHS and medical professionals. Personally I feel that the medical environment and the care that patients receive have changed a great deal within the past ten years. However, I do believe that clinical teaching is still a good aspect to have in the medical profession even after physicians are practicing medicine. As the article by Prideaux et al (2000) points out, there is always room to learn more and gain more knowledge in the medical profession because there isn’t one doctor or physician that is 100% in their care of patients all the time. Also I feel that developing a stronger framework of understanding among doctors, nurses, and trainees would benefit the interactions among these three professional groups much more reliably. For example, with the idea of clinical teaching that I mentioned it can assist medical professionals in sharing knowledge with one another and therefore promote better teaching excellence to the trainees of nurses and interns in particular. Also role models can develop out of this idea and define the standards that are expected of those entering into the medical profession as well. Therefore ensuring that this implementation is incorporated into the medical teaching structure more solidly would provide better reliability in medical care I believe. Also another good method to make health care better that I believe would help many people who have problems gaining access to health care due to their geographic location lies with the idea of Telemedicine. This is a new idea that is developing in the UK but I feel it would be worthwhile to see it spread all across the globe. The definition of telemedicine shows that it is a powerful means to combat communication barriers and other adversities in the environment preventing proper medical treatment to many people in the UK (Burton et al 2000, p. 351). I feel strongly that incorporating this into the current NHS could change many lives and they could finally feel a sense of equality due to the possibility of finally have access to healthcare. This is a new and changing wave of medical care that is hoped to eventually remove many barriers that are in the way of proper medical access. In conclusion, this research has defined the many different aspects that affect physicians in health care today. It has defined the standards that are expected in medical care and it has also pointed out the various rights that patients now have of protecting their own health and making logical decisions in their health care plan. These various changes are not negative but in fact very positive in providing physicians with a new attitude and new ideas to provide the highest quality of health care that is humanly possible. Notes 1. Bunch, Christopher, “Clinical Governance,” British Journal of Hematology 112 (2001): 533-540. 2. Burton, Rouzanna & Boedeker, Ben, “Application of Telemedicine in a Pain Clinic: The Changing Face of Medical Practice,” Journal of Pain Medicine 1 (2000): 351-357. 3. Prideaux, D.& Alexander, H.& Bower, A.& Dacre, J.& Haist, S.& Jolly, B.& Norcini, T.& Rothman, A.& Rowe, R.& Tallet, S., “Clinical Teaching: Maintaining an Educational Role for Doctors in the New Health Care Environment,” Medical Education 34 (2000): 820-826. 4. Shea, Mary Anne, “Treatment Refusals: The Process and the Proof,” Journal of Legal Nurse Consulting 16 (2005): 20-23. 5. Singh, Bruce, “Why Clinical Governance is Important: An Approach to the Resolution of Managerial and Professional Conflict in Mental Health,” Australasian Psychiatry 11 (2003): 412-417. 6. Spark, James & Rowe, Siobhan, “Clinical Governance: It’s Affect on Surgery and the Surgeon,” ANZ J. Surgery 74 (2004): 167-170. 7. White, S.M. & Baldwin, T. J, “The Human Rights Act 1998: Implications for Anesthesia and Intensive Care,” Journal of Anesthesia 57 (2002): 882-888. 8. Worthington, R, “Clinical Issues on Consent: Some Philosophical Concerns,” Journal of Medical Ethics 28 (2002): 377-380. Read More