...children who is particially dependent upon welfare takes it upon herself to pay privately for a single treatment of Invitro Fertilization (IVF). This mother is implanted with several embryos and chooses not to reduce the number of fetuses and successfully delivers multiple premature babies. We must take into account the cost of delivery, care in a Neonatal Intensive Care Unit (NICU), and future cost to the Welfare system for all of this mother’s children. Reviewing this issue from a health care professional’s point of view, the four basic principles of ethics, beneficence, autonomy, nonmaleficence, and social justice, are part of this issue. The Four Basic Principals Autonomy Medicine Net (2011), defines autonomy as the right of a patient to make decisions about the care received without influence from a health care provider. Providing education to a patient is allowed as part of autonomy. Autonomy does not allow the provider to make decisions for the patient. Kapp states that “in addition to exercising the right to make choices about which diagnostic or...
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...Hippocratic oath, and it is for this reason that many physicians refuse to support legalization of the practice. The Hippocratic oath is a promise, regarding the ethical standards of medicine, that all physicians swear to uphold. The classical oath asserts that “[the physician] will neither give a deadly drug to anybody who asked for it, nor will [the physician] make a suggestion to this effect]” (Ruggles). On these grounds the oath, developed in the late fifth century BC, directly prohibits the practice of physician-assisted suicide. It is for this reason that some physicians so vehemently oppose...
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...According to Clinical Ethics network, “Respect for autonomy is one of the fundamental guidelines of clinical ethics. Autonomy in medicine is not simply allowing patients to make their own decisions. Physicians have an obligation to create the conditions necessary for autonomous choice in others. For a physician, respect for autonomy includes respecting an individual’s right to self-determination as well as creating the conditions necessary for autonomous choice. Beneficence is action that is done for the benefit of others. Beneficent actions can be taken to help prevent or remove harms or to simply improve the situation of others” (University of California Regents School of Medicine, 2015). Thinking as a practitioner, in my opinion...
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...Running head: PREGNANCY TERMINATION AT WEEK 27 GESTATION Ethical Dilemma: Pregnancy Termination at week 27 Gestation Ethics: Case study week Ana Alberto Pacific College November 9, 2012 Professional Code of Ethics and client advocacy: The ethical dilemma regarding these two parents pertains to whether or not to terminate this pregnancy at 27 weeks, which is after the 24 weeks fetal viability period. Finding out a child carried to term is harmed is nothing less than jarring, to the parents, family, and physician. In this scenario we have a couple who’ve worked hard to conceive and carry a child to that point; any choices made will be very emotional. They now have to make a very big decision that can be very devastating to the family’s future. This can also be hard for the clinicians working with this family as we also have beliefs and values that can impact our ability to care for the family if the decision being...
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... Tabatha Romero Autonomy Intro to Radiography Spring 2016 Autonomy Intro to Radiography Spring 2016 In the article “Autonomy vs. Beneficence” by Steve Pantilat, MD, “Autonomy is the ‘personal rule of the self that is free from both controlling interferences by others and from personal limitations that prevent meaningful choice.’ Autonomous individuals act intentionally, with understanding, and without controlling influences” (Pantilat, Steve). In a different article “Supporting Patient Autonomy: The Importance of Clinician-patient Relationships” by Vikki A. Entwistle, it is stated “a principle of respect for autonomy is also invoked in discussions about confidentiality, fidelity, privacy and truth-telling, but is most strongly associated with the idea that patients should be allowed or enabled to make autonomous decisions about their health care.” In Health Care Autonomy can be a blessing and also a hardship, depending on the situation in which one is acting on their autonomy right. When a patient is using autonomy the physician must make sure that the patient knows the effects of their choice, they have to be choosing from themselves personally and not an outside source pressuring them or influencing them, the physician themselves have to respect the patient in the decision they make, and lastly the physician has to stay with in the code of ethics. The importance of autonomy in health care is that...
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...Contents: Topic Page Number Glossary Of Terms 1 Introduction 2 Aspect Of Care 3 The DNACPR Policy 4 Ethics 7 Patients Consent 9 Withholding Information 14 Informed Choice 17 Forcing Information Upon Patients 20 The Nurses Role 22 Conclusion 25 References 26 Appendix 27 Glossary of terms CPR: Cardiopulmonary Resuscitation. DNACPR: Do Not Attempt Cardiopulmonary Resuscitation. NMC: Nursing & Midwifery Council. GMC: General Medical Council. BMA: British Medical Association. GP: General Practitioner Introduction The Aim of this module is to encourage me to enhance my personal and professional skills, to increase the efficacy of patient care and interaction. Also to make me more aware of the legal, professional and ethical implications of practice. The module allowed me to further develop my knowledge of these topics: Ethics & Accountability, Legal Aspects of Practice, finally Accountability & Professional Practice. I was then asked to submit an essay of 4500 words based on the following: “Critically analyse an aspect of care from your practice setting that encompasses the ethical, professional & legal role of the nurse. Issues of accountability should be incorporated into this essay”. Aspect of care The aspect of care I have chosen to include in my essay is the “Do Not Attempt Cardiopulmonary Resuscitation (DNACPR)” Adult Policy...
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...in their final year of life, and most of that money goes for care in their last couple of months, which is of little apparent benefit (p. 3). Even more concerning is the suffering that many patients are forced to endure due to the lack of other options. Patients must have the right to make autonomous decisions regarding the end of their lives. They need to be confident that those decisions will be upheld, even if they conflict with the wishes of their families or physicians. However, patient confidence in knowing that their final wishes will be met is complicated by a lack of education and empowerment for those who face these difficult decisions (Frank & Anselmi, 2011). The purpose of this essay is to discuss the benefits to patient autonomy and the Medicare budget, by the legalization of physician-assisted suicide and voluntary euthanasia. Legalizing Euthanasia: A Practical Approach Imagine that your beloved pet suffered a stroke and could no longer eat, drink, walk, or care for itself the way it had been able to do previously. Would you have a feeding tube inserted into him and care for his every personal need? The answer to this question may seem obvious when discussing a pet, but what...
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...TOPIC #4: Human Experimentation PRO: Prisoners should be allowed to participate in human research CON: Prisoners should not be allowed to participate in human research History and definitions Dating back to 1965, seventy-five prisoners at Holmesburg prison in Pennsylvania were purposely exposed to a poisonous agent. This study was conducted to determine the effects of dioxin, a potentially harmful substance. Dermatologist Dr. Albert Kligman, exposed prisoners to a dosage 468 times greater than the required dosage for the experiment. All evidence has been destroyed; however, participants are still experiencing dermatologic issues. As a result of research and experiments like these conducted in prisons, the Department of Health, Education and Welfare terminated the use of prisoners as subjects. Shortly after, the federal government passed strict guidelines limiting the scope of experimentation among prisoners. These guidelines passed, codified at Title 45 of the Code of Federal Regulations, in 1978. Although prisoner research has been outlawed decades ago, it is far from over (Reiter, 2009). Certain guidelines are in place to protect human subjects in research. “The Common Rule” provides for the proposed research to be reviewed by the institutional review board (IRB) in addition to requiring informed consent. A review body, known as the Institutional review board (IRB) was established to protect the natural rights and welfare of persons subjected to scientific research...
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...In this essay I will explore the issues of law, accountability and ethics raised by prescribing on behalf of others. The legal system of England and Wales has two branches of law; criminal and civil Criminal Law: Statues are acts of parliament which are presented via the House of Commons moves to the House of Lords where amendments are made, returns to House of Commons, for final discussion when complete the Bill is given Royal Assent and passes into law. Criminal law involves offences against the state, it is usually the Crown that brings the action against the defendant (Gagan 2010 cited by Courtnay & Griffin). In terms of non-medical prescribing there are two important statues The Medicines Act 1968 this regulates the licensing, supply and administration of medicines. The misuse of drugs Act 1971 this is a provision with respect to dangerous or otherwise harmful drugs. Breach of these acts or regulations are criminal. 2 Following the Nurses Registration Act 1919 nurses in Britain achieved the status of an accountable profession and therefore comes under...
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...discuss confidentiality and how it pertains to reasonable limits. Finally I will be discussing a case in which cultural values relate to and influence healthcare. This case describes Mrs. Z, who just moved to the United States two years ago with her family, who finds out she has a positive breast biopsy and does not want to inform her family nor pursue treatment. Deontology is defined as, “a group of ethical theories based upon the rationalist view that the rightness or wrongness of an act depends on the nature of the act, rather than the consequences that occur as the result of it.” (Burkhardt, 2008) This simply means that a person needs to uphold one’s duty. An example is a parent has an obligation to take care of a child. Or in medicine if a nurse witnesses a medication error, she has the duty to report it to the manager, even know it might get the other nurse in to trouble. This is important in healthcare because we need to uphold our practices to ensure the patients are safe at all times. In the case presentation, the Dr. F must uphold her medical duty to take care of Mrs. Z. The doctor has a duty to follow up with Mrs. Z. and provide her with all of the pro’s and cons of the treatment options that would benefit Mrs. Z. the most. Utilitarianism is defined as, “a theory which holds that an action is judged good or bad in relation to the consequences or outcome.” (Burkhardt, 2008) This theory wants to use the greatest amount...
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...This essay will demonstrate that it is not “always morally worse to kill than it is to let die”. It will be argued that passive euthanasia (i.e. letting someone die) is not morally wrong and that active euthanasia (i.e. accelerating their death) is no less moral. However, the many complications associated with the legalisation of active euthanasia (and euthanasia in general) must be identified and addressed. These identified complications may be eliminated with an appropriate regulatory regime. Assuming that identified complications can be overcome, and having established that it is not always morally worse to kill than to let die, it will be demonstrated that active euthanasia should not be banned. Morality, as defined by the Oxford Dictionary, is “principles concerning the distinction between right and wrong or good and bad behaviour”1. Hinde states that the principles are influenced and changed by one’s society and culture but also “based in human nature”2. As morality is influenced by society, public opinion is important when it comes to controversial issues. Morality differs from place to place and evolves over time. To compound this diversity, changes in medical treatment, and discoveries which enhance medical knowledge evolves rapidly and what was not even conceivable in some cultures or at certain points in history are now commonly accepted. Developments in end of life care fall within this category. With our increased ability to prolong life, arguments can now be made...
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...Resuscitate (DNR) order. Practical Problem What is the best course of treatment for Mr. Clark? Analysis In case of Mr. Clark, the principle of respect for person applies. Autonomy- As defined in Medical Ethics by Pence, autonomy is individual’s right to make decisions for his/her life and body without being coerced by others (Pence, 2010). Mr. Clark has right to make decision on his own care with cancer treatments as he has stated that he would like continue with treatment as long as possible while he was at VA hospital. Although Mr. Clark’s wishes are known to VA physician, without advance directive or presence of medical durable power-of-attorney (MDPOA), the ED physician is not bind to his request but he is obligated to provide the best care possible under the circumstance. As a counterargument, is it possible that Mr. Clark may be somewhat abusive of autonomy? VA physician has explained to Mr. Clark, his prognosis with end-stage pancreatic cancer and it may not make any difference with treatment. Does Mr. Clark fully understand his condition, if he does, is his request for “seeking treatment as long as possible” over demanding of autonomy? When to draw line whether to honor his autonomy vs. unrealistic demand for autonomy? Paternalism- The principle of paternalism is allowing physician to practice medicine to the best of interest for the patient. Contrary to the patient wishes, if there is evidence of patient’s inability to make decision for himself/herself physician may...
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...WORD COUNT 3846 Introduction The aim of this assignment is to consider whether mental health patients have autonomy or do staff and the healthcare environment merely allow them a measurable quantity of autonomy based on legal, ethical and moral restrictions, if this is the case, is this autonomy at all? Placement experiences will be given in relation to patient autonomy and related ethical, legal and professional issues will be supported and/ or contrasted by relevant literature. Patient autonomy and capacity, consent, compliance, coercion and paternalism with be considered. In an attempt to show a deeper understanding and ability to apply theory to practice, the moral theories of liberal individualism, utilitarianism, Kantianism and communitarianism will be discussed in relation to patient autonomy. Attitudes, values, assumptions related to patient autonomy, implications for practice and care provision will also be reviewed. This topic has been chosen, due to personal interest following practice experiences on an adult acute mental health unit. All identifying factors relating to the patients have been changed to maintain client confidentiality (Nursing and Midwifery Council’s (NMC) Code of Professional Conduct 2002). A conclusion will be offered to evaluate findings, finalising with a reflective summary focusing on the process of enquiry. Autonomy Autonomy means self rule (Dworkin 1988). It as the ability to think, choose and act freely and independently (Gillon 1992)...
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...inform the reader about the four ethical principles and the methods of ethical decision making, which all will assist with resolving ethical dilemmas. Ethical principles are the establishments of moral examination since they are the perspectives from which direction can be gotten along the pathway to a choice. “Ethical principles assist care providers in making choices based on moral principles that have been identified as standards considered worthwhile in addressing healthcare-related ethical dilemmas” (Pozgar, 2011). The four ethical principles are autonomy, beneficence, non-maleficence, and justice. There is a 96 year old male who has been diagnosed with terminal liver cancer. Currently the patient is admitted to the ICU for the proper treatment. The patient is confused and disoriented, very skinny and appears underfed, and is covered with bruises, which are common in patients with liver disorders. “The principle of autonomy involves recognizing the right of a person to make one’s own decision” (Pozgar, 2011). This suggests that people should have control over their lives light of the fact that they are the main individuals who totally comprehend their way of life. Here, the patient is unable to make decisions for himself and the daughter is the next in line to make decisions on his behalf. Beneficence requires one to...
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...professionalism, recognized by society. Professionalism in nursing has been evolving since the days of Florence Nightingale. For most of the 20th century nursing was considered a profession in progress by sociologists (Bucher & Strauss, 1961; Etzioni, 1969). Nurses have been striving toward professionalism and the autonomy that defines it for decades. Society, nursing shortages, the healthcare industry’s need to provide save, quality health care while maintaining financial stability, and many other factors have shaped a path of opportunities for nurses today. Advanced Practice Nursing has been evolving to meet our society’s healthcare needs for decades. Nurses have been and will continue to be the driving force of these changes and our ability to manage change and move to a new conceptualization of advanced practice nursing will define our success or failure in meeting societal needs in the future (Denisco & Barker, 2013) Society and the healthcare industry have offered opportunities for recognition of and institutional credentialing of Advanced Practice Nurses. The role of the Advanced Practice Nurse has expanded well beyond initial expectations due to nurses seeking more autonomy and society’s need for more healthcare professionals to meet the needs of the public. Initially educational standards evolved in different ways. Standardization of education, regulations, and practice have enhanced the recognition of Nurse Practitioners and Clinical...
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