Ethical principles in health care in the US

Contents
Abstract    1
Ethical principles in health care    1
Ethical issues in patient care    2
Health care delivery issues    3
Professional roles and resources    4
Quality improvement in patient care service delivery    6

Abstract

The healthcare sector has experienced rapid growth and evolution over time. This sector is charged with delivering the best services to all patients without violating their rights. Growth experienced in the sector has been in terms of invention of new treatment methods especially due to advancement in technology. Earlier, choice of the treatment procedure was determined wholly by the medical officer in charge of the patient. A great and significant change has occurred in the way decisions about a patient’s medical care are made. Rules and regulations involving the doctor patient relationship have been made to regulate and give all the medical practitioners a direction on how to carry out their daily operations. This ensures that medical care is delivered in the most efficient way without violating the rights of patients.

Ethical principles in health care

Various ethical principles have been formulated to govern the behavior of medical facilities’ staff towards their patients. They have been broken down to ensure every kind of interaction has been catered for with an expected methodology. This ensures that the needs of the patient are adequately catered for. Respect for the patient must be ensured and the risks involved in a certain medical treatment made aware to the patient. Patients’ privacy should be maintained and any information about them should be confidential. These principles are as explained below.
The first principle is non-maleficence. This principle stipulates that health care workers should ensure that their treatment plan does not cause any harm to their patient. It forbids medical care providers from using ineffective therapies whose risks to the patient are more than the benefits. It also forbids use of malicious methods of treatment that may intentionally be used to cause injury or further suffering of the patient. The principle protects patients from any form of exploitation financial, sexual or emotional by medical practitioners (Alexander, 2013, 18). An example of violation of this principle is when a medical officer uses administers a drug on a patient that may interfere with other body working systems.
The second one is the principle of utilitarianism. It states that the decisions made by the medical practitioner against a patient’s problem should be done in good faith to bring a long term solution to the patient. The practitioners’ actions should shoulder the patient’s burden. An example is when a surgeon decides to permanently remove a group of abnormal cells in the tissue of a patient and hence protecting the patient from occurrence of cancerous cells in the future.
The third is the principle of justice. It enhances on fair treatment of patient by the medical personnel. All practitioners have a moral obligation to treat their patients without discrimination or favour. Medical resources should be distributed equally among the populations especially where they are scarce. Doctors should eliminate any personal differences they may be having with the patient before treatment (Ball and Laurence, 2011). When a medical officer who is the only one trained to perform major surgeries formulates a clear schedule of operations, the principle of justice is said to have been practiced.
The fourth one is the principle of fidelity. This principle states that the medical officer in charge of a patient should remain royal and faithful. They should keep their promises and maintain a great respect for their patients. This hence binds the patient and the doctor together as one and denies the individuals to make any decisions on matters of the patient’s health.
The fifth principle is that of veracity. It’s a principle that requires all medical practitioners to remain truthful to their client. It calls for openness of all actions taken by doctors and nurses which ensures that their patients get a glimpse of what is going on (Alexander, 2013, 19). Therefore medical personnel should maintain standards that uphold their integrity and accountability in the delivery of their services. An example of this is when a doctor informs a patient of the side effects of a given drug.
Autonomy is also a bioethics principle. This principle restricts medical practitioners from coercing their patients in making a decision. It gives the patients a moral obligation of making their own independent decisions without being forced to. However the medical personnel should provide detailed information to their patients to enable them make sober and informed decisions (Alexander, 2013, 19). The decisions of patients should respected by the medical staff they are dealing with. For instance, it’s the moral right of the patient to decide whether to undergo an operation or not.

Ethical issues in patient care

The health sector has adopted various rules which give an outline on how a patient should be handled. This enables the doctor to give a treatment that is preferred by the patient and does not violate the patient’s beliefs and preferences. One of these issues is advance directives. The issue is as discussed below.
Every individual has the legal right to make decisions on the kind of treatment to be administered to them. This right enables the patient to accept or decline a medical or surgical procedure. An advance directive is a written document by an individual which consists of their preferred treatment or rather medical procedures. The document is similar to a will in that it puts the wishes of an individual on a written document. These medical wishes document is kept safely and retrieved in case of inability of an individual to make sound decisions (Birley, 2011). It gives the medical practitioner an idea on the preferred medical treatment procedures of the patient at hand.
An advance directive can be made by any person who is not a minor and is of sound mind. It is important to have this document as it allows easy decision making when one is ailing and is not in the capacity to make sound decisions. It also saves families conflicts which would have arisen from arguments on the best treatment procedure to be administered on one member of the family. A living will is an example of an advance directive. It is a legal document in which one individual delegates another to make healthcare decisions on their behalf when they are not in the capacity to do so (Chinn, Smith and Kagan, 2013). The living will gives the other party the durable power of the attorney. This power of the attorney is as described below.
The power of attorney enables any individual to choose a preferred person called a health care agent, to make health care decisions on their behalf when they are ailment is intense and they cannot make decisions on their own. The decisions made on behalf of the ailing person are based on their written decisions which are filled in a form. One should designate their acquaintances to be their health care agents as they understand them better. The legal document can be revised or entirely canceled from time to time. The document should be safely kept in a location where it is easily retrievable preferably with one’s personal lawyer or a family member. The power of the attorney is essential as it ensures that one’s values and preferences are upheld even when one is not is not in a stable condition to make solid decisions.

Health care delivery issues

Health care enterprises are one of the most important parts of the United States social system (Kovner and knickMann, 2010). The federal government for the state of Georgia maintains that a healthy nation promotes the growth of all the sectors of the economy. Numerous health care providers exist in this state. The federal government has established medical facilities like referral hospitals, clinics and psychiatric centers. Private investors have also established medical health care facilities in most parts of Georgia. Emory health care is the biggest and the most resourceful and comprehensive hospital in Georgia. Some of the services offered are as indicated below.
Nutrition and food services, palliative care, pharmacy services, mental health services, psychological medical care, surgical services, gynecological services, family planning health facilities. Home based care is also done via home telehealth programs.
Despite the services offered, the state of health care in this federal state has not reached the expected standards, particularly Atlanta (Kovner and KnickMann, 2012). According to a survey done on the healthcare in all federal states of America, Georgia particularly the southern part lagged behind. Many initiatives have been put in place by the federal government to curb that problem. New establishments of healthcare facilities have been made. Various regulations have been made to ensure health care facilities are more accessible to the people. The affordable care act which came to effect in the year 2010 states that all medical facilities should be affordable to all people.
Various regulations dictate the code of conduct of the nurse practitioners. The first one is the health act that controls the behavior of all professional health workers of which nurses are. The second is the registered and nurse practitioners regulation. Al nurses are restricted to working in accordance to these preset rules. Al the nurses were expected and have the moral obligation of adhering to the ethical principles of healthcare in all their interaction with their patients.

Professional roles and resources

Advanced practice registered nurse must have attained a doctorate degree to bear that title. These nurses are endowed with specialized and advanced knowledge on various scopes of nursing. They have multiple approaches to solve various health problems they are faced with at an advanced level. They are able to collaborate with the patient clearly identify the problem and give a suitable solution. They also create a supportive environment to their colleague nurses who may not have advanced their nursing knowledge to their level (John, 2013, 106). They are constantly engaged in activities that improve the nursing practice as a whole. However different advanced practice registered nurses have different areas of specialization as shown below.
A nurse anesthetist mainly has a role in administration of anesthesia in surgical procedures which are more advanced. Clinical nurse specialists also represent a group of advanced practice nurses. Their role in the nursing sector is to integrate care across through the general nursing practice. They work to improve patient outcomes and nursing care. The certified nurse-midwife is specialized in provision of healthcare services to delivering women. They closely work with the gynecologists and obstetricians. A nurse practitioner is another specialist whose ability is far beyond a registered nurse (Chinn, Smith and Kagan, 2013). They treat mental and physical disorders and provide recommendations for a wide range of chronic and acute disorders. Various institutions support these advanced practices as indicated below.
The role of advanced emergency nurses has been felt in countries particularly in the US despite confusion arising about their titles, job and clinical accountability. They have continued to offer high quality and cost efficient health care services to the public. Numerous educational institutions have come up with a curriculum for these advanced nursing courses. Websites and blogs that speak of the good of emergency nursing practice have been created by the nurses themselves and other professionals who have been pleased by their roles. Non-governmental organizations have not been left behind. They have been offering resources to the emergency nurses and offering scholarships to registered nurses to upgrade their skills. Socialist groups have also yielded great support to the advanced practice nurses (Chinn, Smith and Kagan, 2013). Medical practitioners and dentists association have also supported the bid to have many advanced emergency nurses.

Quality improvement in patient care service delivery

The institute of medicine (IOM) is a non-governmental organization in the United States of America which was founded in the year 1970.  It is part of the United States National academies. This N.G.O is currently headed by Harvey fineberg. The institute of medicine is charged with the duty of giving national advice to the united states on matters concerning; health, medicine and bio-medical science (Kovner and KnickMann, 2012). Its main aim is to improve the national health in the United States. Its roles are carried outside the federal government framework whereby it works on a national basis. It has a workforce of volunteers who offer their knowledge in science and more so to the health sector. New members are enrolled on the basis of achievements they have made in fields that are relevant to the institute of medicine’s mission.  It has been termed as the most authoritative advisory body on matters of.

The two trends in the improvement of quality in health care services have been adequately discussed above. Ethical issues and improvement of professionals and resources in the health sector are both meant to improve the quality of services delivered in this sector. The two approaches are different in that the ethical approach dwells on the betterment of the medical practitioner to the patient relationship in a bid to improve the quality of service offered. This approach depends greatly on the preferences and value of the patient which gives the medical officer an outline on how to handle their patient (Ball and Laurence, 2011). On the other hand improvement of professional roles majorly deals with the professionals in the health sector who works to better the quality of service delivered through enhancing their professional skills.

An example of a quality improvement project developed and implemented by an advanced practice nurse is to introduce advanced practice in endoscopy nursing. The project commenced on February 2012. Its aim is to increase the workforce productivity by expanding the scope covered by nurses. The advanced practice in endoscopy nursing project has the following objective. Identify changes in the workforce that will promote improvement in service quality. The advanced emergency nursing has been effective in various ways.

In august 2011 the American nurses association established a new cache to emergency nursing when it was declared a specialty.  Attaining the specialty status of an advanced emergency nursing is an achievement by itself as it’s a tedious process that calls for a lot of proof. Provider of acute care must have successfully completed the doctor of nursing practice degree also called DNP. This ensures that the graduates have the knowledge to provide advanced level of nursing care to communities or individuals. This practice of advanced acute care by advanced emergency nurses has been so effective in reducing the mortality rate among the patients with terminal illnesses. It has also enabled the nurses to save lives of persons involved in serious accidents and sustained serious injuries on their bodies.

The practice has shaped dynamic nurses who are able to offer quick medical services in emergency settings. Emergency nurses have been continouslyassisted doctor in treating a wide range of urgent illnesses or injuries that call for acute care. Advanced emergency nurses have also been of help in emergency surgeries that require critical care. The intensive care unit requires critical care for all the patients admitted in this section. Advanced emergency nurses have always chirped in where specialized doctor’s presence has been missed. Since establishment of this specialty, they can boast numerous achievements especially where the patient’s life was in danger.

In summary the new trends in health care have brought massive improvements in the value of service offered in the medical field. Ethical issues have enabled the patients to choose their predicament rather than relying wholly on the decisions made by the medical personnel in charge. On the other hand advancement of the knowledge in the medical field especial in nursing has also played a big role in quality upgrading. Formation of professional bodies like the institute of medicine in the United States has impacted positively towards quality improvement through their voluntary and professional advisory services to the entire nation. All this factors together has worked hand in hand in improvement of the medical care services.

References

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Chinn, P, Smith, M and Kagan P. (2013). Philosophies and practices of emancipatory nursing. London: Routledge.
Francoise, B and Barry, H. (2012). Health care ethics in Canada. Ottawa: Nelson college publisher.
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Willey, J. (2012, July). Advanced practice nursing. Journal of advanced nursing. Volume 68. Issue 8. 78-95.
John, B. (2013, July).Medicine and medical subspecialties. The Southern medical journal. Volume 106. 107-105

KnickMann, J and Kovner, A. (2012). Health care delivery in the United States. New York: Springer publishing company.