...Ethics Case Study: Dax’s Case Cindy Siegel Did Dax have an ethical right to refuse care? A legal right? Why/why not? Using the Ethical Analysis Paradigm from class slides; there are four principles that need to be addressed in order to reach an ethical decision. • Medical Indications – diagnosis, prognosis, treatment option o Dax had severe burns to 65% of his body, including his face, hands, eyes o Without treatment and allowed to return home, would likely result in death from infection • Patient Preferences – preferences and values, capacity to decide, informed o Repeatedly demanded that treatment be discontinued o Demanded to be discharged to home o Informed of risks and refused treatment o Had capacity to make and communicate decisions • Quality of Life – as experienced by patient o Excruciatingly painful treatments o Amputation of several fingers – minimal use of hands o Blind o Dependent on others • Contextual Factors – family, law, financial o Legal right to refuse treatment At issue is Dax’s ethical right to refuse care. While he may not have made the choice that physicians and/or hospitals would, he has a fundamental right to make choices concerning his treatment and there should be respect for his autonomy in doing so. Physicians, who take an oath to “First do not harm...,” may struggle with their ethical viewpoints, however, this decision is about Dax’s ethical right, not theirs. Since Dax is presumed competent, he does have the ethical right to refuse care,...
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...Treatment of anorexia nervosa against the patient's will: ethical considerations. Adolesc Med State Art Rev. 2011;22(2):283-8, x. Adolesc Med 022 (2011) 283–288 Treatment of Anorexia Nervosa against the Patient’s Will: Ethical Considerations Tomas J. Silber, MD, MASS* Director, Pediatric Ethics Program, Division of Adolescent Medicine, Children’s National Medical Center, Professor of Pediatrics, George Washington University, 111 Michigan Avenue NW, Washington, DC 20010 INTRODUCTION Practitioners of adolescent medicine are frequently the medical consultants responsible for determining the hospitalization of patients with anorexia nervosa (AN), deciding whether they may require nasogastric tube feeding, and potentially recommending measures that may restrict their freedom. Thus the treatment of adolescents with AN can include ethically concerning practices such as privation of liberty, nonacceptance of treatment refusal, and limits on privacy and confidentiality, to name a few. Treating professionals are thus often caught between the conflicting values of respect for patients and their duty to prevent nutritional injury and even death. Therefore there is always a potential tension between obtaining the patient’s trust (fiduciary fidelity) and having to make recommendations that threaten this working relationship (fiduciary protection). In many, if not most, instances of treatment for AN, patients receive some form of treatment against their will. The situation can...
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...Ethical Health Care Issues Robyn Moses HCS 545 / Health Law and Ethics Professor Laughon March 16, 2015 Health Care Issues One of the current health care issues that I chose to write about is euthanasia. I will examine and evaluate how the four principles of autonomy, nonmaleficence, beneficence, and justice apply to this issue. The most recent person that exercised her autonomy to choose how she died and the time of her death was Brittany Maynard. Brittany died in Oregon, a state which allows physicians to assist terminally ill persons by prescribing life-ending medications (Egan, 2014). Is the right-to-die with dignity by choice ever going to be acceptable in the health care community? Euthanasia is defined as the act of being put to death painlessly by refusing treatment or the withdrawing of life support to avoid suffering the effects of a debilitating illness or incurable disease. According to the legal system, euthanasia is considered murder when assisted and suicide when patients take their lives. In many countries, euthanasia is not allowed and is punishable by law. Oregon became the first state in the United States in 1997 to make physician-assisted suicide legal. Attempts to have the law in Oregon overturned have been unsuccessful (Britannica, 2015). As more consumers become educated on diseases and their debilitating effects, more consumers may choose euthanasia as an alternative to suffering. Autonomy is the act of making one's choices without...
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...My Personal Nursing Philosophy Hope G. Slate Fresno Pacific University NURS/310 August 27, 2012 Brenda Laing, R.N., M.S.N., F.N.P. Abstract “Nursing theories are the creative products of nurses who seek (or sought) to thoughtfully describe the many aspects of nursing in ways that could be studied, evaluated, and used by other nurses. Theories provide structure and order for guiding and improving professional practice, teaching and learning activities, and research.” (Sitzman, 2011) In this paper I will explore nursing theories. I will examine my own personal nursing philosophy based on reading of theorists, personal values and my own personal experiences. Everyone has values, ideas, and beliefs that are unique and different from others. I am challenged to seek and understand how I incorporate my own values into the professional practice. The professional values that guide nurses as listed in (American Association of Colleges of Nursing, 2008), are as follows: Altruism, Autonomy, Human Dignity, Integrity, and Social Justice. My Personal Nursing Philosophy As I attempt to present my own personal nursing philosophy, I contemplate. I close my eyes; dig deeply into my soul as I search for an answer. My heart feels warm and my mind is overwhelmed. Having had many years of working in the nursing profession I have many of experiences. I am challenged to narrow and express my philosophy. I believe that first one must decide what philosophy means to them...
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...pertinent in human research and their applications. It was the professional responsibility of the doctors and researchers involved to abide by previously established ethical guidelines. Respect for Persons Respect for the Persons as it relates to the Barney Clark case can be broken down into three important issues. Autonomy The doctors made the assumption that Barney Clark was a fully autonomous person at the time of the artificial heart experiment. In general it is not in doubt that Mr. Clark was an autonomous being, however his terminal condition could have affected his capacity with in the case. While he might have been autonomous in many areas of his life the issue that is relevant to the case was whether he possessed the capacity to make an informed consent. Informed Consent The nine basic rules4 for an informed consent are 1. Identifying the appropriate decision maker 2. Having the discussion at a time when the patient is not distracted or in great pain. 3. Determine that the patient is communicating voluntarily 4. Disclose a. Nature of the proposed intervention b. The purpose c. The risks and consequences d. The benefits e. The probability that the intervention would be successful f. The feasible alternatives...
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...Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care A Roadmap for Hospitals Quality Safety Equity A Roadmap for Hospitals Project Staff Amy Wilson-Stronks, M.P.P., Project Director, Health Disparities, Division of Quality Measurement and Research, The Joint Commission. Paul Schyve, M.D., Senior Vice President, The Joint Commission Christina L. Cordero, Ph.D., M.P.H., Associate Project Director, Division of Standards and Survey Methods, The Joint Commission Isa Rodriguez, Project Coordinator, Division of Quality Measurement and Research, The Joint Commission Mara Youdelman, J.D., L.L.M., Senior Attorney, National Health Law Program Project Advisors Maureen Carr, M.B.A., Project Director, Division of Standards and Survey Methods, The Joint Commission Amy Panagopoulos, R.N., M.B.A., Director, Division of Standards and Survey Methods, The Joint Commission Robert Wise, M.D., Vice President, Division of Standards and Survey Methods, The Joint Commission Joint Commission Mission The mission of The Joint Commission is to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. The inclusion of an organization name, product, or service in a Joint Commission publication should not be construed as an endorsement of such organization, product, or services, nor is failure...
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...Transcultural Nursing Theory Applied Vulnerable Populations I "Nowhere are the divisions of race, ethnicity and culture more sharply drawn that in the health of the people in the United States. Despite recent progress in overall national health, there are continuing disparities in the incidence of illness and death among African Americans, Latino/Hispanic Americans, Native Americans, Asian Americans, Alaskan Natives and Pacific Islanders as compared with the US population as a whole." --National Center for Cultural Competence Population addressed Population addressed In 1950, U.S.-born whites made up about 90 percent of the U.S. population. By 2000, this number declined to about 75 percent, and by 2050 non-Hispanic whites will be in the numerical minority (U.S. Census Bureau 2001, 2002). This rapid diversification requires healthcare organizations to pay closer attention to cross-cultural issues if they are to meet the healthcare needs of the nation and continue to maintain a high standard of care. Looking at the Country as a whole the current area of discussion for this paper is the area of Western North Carolina and the population of Asheville, which is a melting pot of cultures which the combination they create is unique to no other. According to the 2006 U.S. Census Bureau statistics for Asheville, N.C. the current demographics break down as follows: Asheville [City] Population (current estimate), 70,400. Buncombe County Population (2006), 222,174, county in...
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...WEEK ONE: LEADING, MANAGING & FOLLOWING (Chapter 1, p. 3-21) 1. Relate leadership and other motivational theories to behaviors that serve as important functions of professional nursing. a. Leadership theories i. Trait theories: 1. 2. Innate leadership skills: being born with a certain set of physical and emotional characteristics for inspiring others to reach a common goal ii. Style theories: 3. 4. How leaders behave in certain environments and situations. a. Democratic: you care about what others think b. Lasae faire: no structure; people can do what they want c. Authoritarian: you are in charge iii. Situational-contingency theories 5. 6. These theories consider the challenge of a situation and encourage an adaptive leadership style to complement the issue being faced. Assess, assess, assess 7. You are typically democratic; you assess the situation and change your style based on what the situation is. iv. Transformational theories 8. 9. Inspires, motivates, empowers, mentors, provides intellectual stimulation and promotes creativity b. Motivational Theories v. Hierarchy of needs 10. 11. Low level needs will always drive behavior before higher levels needs can be addressed. For example, pain level, nutrition...
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...* Terminology Unit 1 * Mental Health- A state of well-being in which each individual is able to recognize his or her own potential, cope with normal stresses of life, work productively and fruitfully, and make a contribution to the community. * Mental Illness- maladaptive responses to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are incongruent with the local and cultural norms, and interfere with the individuals social, occupational and or physical functioning. * Anticipatory grief-when a loss is anticipated, individuals often begin the work of grieving before the actual loss occurs. * Bereavement overload- this is particularly true for elderly individuals who may be experiencing numerous losses- such as spouse, friends, other relatives, independent functioning, home, personal possessions, and pets in a relatively short time as grief accumulates a type of bereavement overload occurs which for some individuals presents an impossible task of grief work. * Ego defense mechanisms-defense mechanisms employed by the ego in the face of threat to biological or psychological integrity identified by Anna Freud 1953. Some of these are more adaptive than others, but all are used either consciously or unconsciously as protective devices for the ego in an effort to relieve mild to moderate anxiety. * Projection: Attributing feelings or impulses unacceptable to one’s self to another person. * Undoing:...
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...Today’s Physical Therapist: A Comprehensive Review of a 21st-Century Health Care Profession Prepared by the American Physical Therapy Association January 2011 Foreword The American Physical Therapy Association (APTA) created Today’s Physical Therapist: A Comprehensive Review of a 21st-Century Health Care Profession to provide accurate information for government entities and the public about the history, role, educational preparation, laws governing practice, standards of practice, evidence base of the profession, payment for physical therapy services, and workforce issues unique to the physical therapy profession. As government, private health care entities, and provider groups pursue solutions to the considerable health care provision challenges the United States faces, it is imperative that accurate information about the qualifications and roles of specific providers, in this case physical therapists, be available to inform all entities as they engage in these discussions. APTA is the national professional association representing more than 77,000 physical therapists, physical therapist assistants, and students nationwide. The association acknowledges and thanks the Federation of State Boards of Physical Therapy, the national organization representing 51 boards of physical therapy licensure, for input and assistance with this document. © 2011 American Physical Therapy Association. All rights reserved. i | American Physical Therapy Association Table of Contents ...
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...the issues in the emergency department of health sector of Pakistan on which we are conducting a research work. As we hear about the problems that occur in this department of health sector and the difficulties that people face we will be looking into the depth of these issues and try to highlight the key points that create such a situation. Our main objective is to find the gap between the perception and reality. We go about in our project first giving a brief introduction of the emergency department of health sector according to the secondary data that we collected. We also discussed the techniques, strategies and standard operational procedures i.e. SOP’s according to which emergencies should operate. Moreover we also discussed emergency ethics that are the first and foremost base to determine how the doctors are expected to behave with the patients and handle their problems. We have also conducted a primary research by observing and interviewing patients to fill out the survey questions. We have also included overviews of the journals taken from the health institutes in countries like USA, and Europe. It will help us get an insight on how these countries emergency departments are operating. The case study on dengue has been...
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...PHYSICIAN-ASSISTED SUICIDE: LEGALITY AND MORALITY Wednesday - May 8th, 2002 By Martin Levin, 107 Irving Street, Cambridge, MA 02138 (617)-497-6828 mlevin@levinlaw.com On Sunday, June 21, 1992, Jennifer Cowart, age thirty-two, and her brother George Kowalski, age twenty-eight, traveled to Pensacola Beach, Florida, for a day of relaxation. At the end of the day, Jennifer and George were heading back to their vehicle when Jennifer noticed a go-kart track. The two entered the track, bought tickets, and began riding. Within one minute, Jennifer’s go-kart bumped into one of the side guardrails, flipped on its side, and burst into flames. Jennifer was seat-belted in the go-kart and could not get out. George tried to run into the fire to save his sister, but the flames were too intense. Bystanders attempted to use a fire extinguisher, but it did little to lessen the inferno. Jennifer was trapped in the burning go-kart for two minutes when her seat-belt finally burned through and she fell to the ground. George grabbed his sister and pulled her away from the fire. Jennifer was alive. She was lying on the asphalt alert, oriented, and coherent. She had suffered 3rd and 4th degree burns covering ninety-five percent of her body. She was suffering the worst pain imaginable. At the scene, Jennifer begged the rescue personnel to “let me die.” Instead, Jennifer was flown to a burn center in Mobile, Alabama, where she remained for one year until she was overcome by an infection...
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...Quaderer…………………………… 39 11. Bibliography…………………………………………………………………….47 Abstract In this research paper our team will look at the use of Robotic Technology in the medical field, more specifically in the surgical field as well as discuss the issues and implications surrounding the topic. Our discussion will include topics ranging from the history and development of robots that can be found in surgical rooms, political concerns regarding the Food and Drug Administration and their requirements to approve use of these robots, the legal aspect of robotic technology on how to determine which party is held liable in case of accidents or malfunctions that can lead to injury and a legal case that shows the difficulty to prove fault against a manufacturer. Also discussed will be the economic ramifications on our society, psychological, sociological, cultural, moral and ethical impacts on human life, in particular the patients that undergo surgery involving a robotic surgical system, and the environmental impacts of robotics in surgery. It is our hope that through this research paper that we are able to explain to and educate our readers on the impacts of Robotic Surgery as this type of surgery is becoming more popular with doctors in order to...
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...------------------------------------------------- Clinical trial From Wikipedia, the free encyclopedia | This article may be too long to read and navigate comfortably. Please consider splitting content into sub-articles and using this article for a summary of the key points of the subject.(October 2010) | Clinical trials are a set of procedures in medical research and drug development that are conducted to allow safety (or more specifically, information about adverse drug reactions and adverse effects of other treatments) and efficacy data to be collected for health interventions (e.g., drugs, diagnostics, devices, therapy protocols). These trials can take place only after satisfactory information has been gathered on the quality of the non-clinical safety, and Health Authority/Ethics Committee approval is granted in the country where the trial is taking place. Depending on the type of product and the stage of its development, investigators enroll healthy volunteers and/or patients into small pilot studies initially, followed by larger scale studies in patients that often compare the new product with the currently prescribed treatment. As positive safety and efficacy data are gathered, the number of patients is typically increased. Clinical trials can vary in size from a single center in one country to multicenter trials in multiple countries. Due to the sizable cost a full series of clinical trials may incur, the burden of paying for all the necessary people and services is usually borne by the sponsor who may be a...
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...Competencies based on the Performance Management Catalog Competency descriptions: Competency groups listed in bold letters with individual components of the group following each group. Accountability: Accept personal responsibility for the quality and timeliness of work. Can be relied upon to achieve excellent results with little need for oversight. Productivity: Meet productivity standards, deadlines and work schedules. Goal measurement: Understand, communicate and measure goals accurately. Focus: Stay focused on tasks in spite of distractions and interruptions. Time efficiency: Make the best use of available time and resources. Balance quality & deadlines: Appropriately balance quality of work with ability to meet deadlines. Bottom line: Clearly see the “bottom line” of customer expectations and ensure that work products meet that bottom line. Acknowledge & correct mistakes: Do not make excuses for errors or problems; acknowledge and correct mistakes. Assume responsibility: Do not attempt to diffuse blame for not meeting expectations; face up to problems with people quickly and directly. Adaptability/Flexibility: Adapt easily to changing business needs, conditions and work responsibilities. Adapt approach, goals and methods to achieve successful solutions and results in dynamic situations. Anticipate change need: Anticipate and effectively communicate need for change. Alternatives: Identify and provide different alternatives to reach a given end. Strategies/tactics:...
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