...2013 Bradley Leedy Workplace Ethical Dilemma This paper will present an argument of how the process of do not resuscitate (DNR) results in an ethical dilemma for workers in the healthcare field. In presenting the argument, this paper will also address the following three course learning objectives: 1) explain the legal rights of individuals as they interact with health care services, 2) analyze the monitoring systems that ensure human rights, legal aspects, and quality health care, and 3) analyze selected ethical and legal case studies that have promulgated precedent setting decisions. Even though the physician may believe CPR would be the appropriate decision, “many a deserving patient loses out on the opportunity for such treatment” as a result of an DNR order (Thomas, 2002, 412). Decisions about resuscitation have become a matter of concern and highly debatable issue because the legality of a patient’s right to request DNR. The order must be approved in advance by a written statements signed by a physician upon order of the patient or surrogate in cases which the patient cannot give consent. A DNR order must not confused with giving care, whereas, do not resuscitate does not mean do not give care. “It means a different kind of care that can best be achieved through end-of-life protocols and education” (Field, 2007, 294). The process causes ethical dilemmas for health care workers in several ways. For example, in cases which surrogates can give consent...
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...challeng- life specialists, and volunteers. ing. As children and their fami- Among the ethical issues they withhold and/or withdraw medi- cal treatment, the implementa- tion of do-not-resuscitate orders, and allocation of resources. In all circumstances the key to achiev- ing the most positive outcome is to prevent ethical issues from Continued on the next page lies struggle to deal with their emotional stress, they can ben- e t from the presence of, and services provided by a trusted interdisciplinary healthcare team confront are what, when, and how much medical care a child should receive. In Katy’s...
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...ETHICAL DILEMMAS FACING NURSES ON END-OF-LIFE ISSUES BASED ON CONFERENCE PROCEEDINGS HELD IN ELDORET, KENYA Author: Kamau S. Macharia: BScN (Moi), MSc (studying) Nursing Leadership & Health Care Systems Management (University of Colorado, Denver), Higher Dip. Critical Care Nursing (Nbi). Graduate Assistant, School of Nursing & Biomedical Sciences, Kabianga University College (A Constituent College of Moi University), . P 0 Box 2030 20200 Kericho, Kenya , Tel +254 722224577, Email: symomash@gmail.com ETHICAL DILEMMAS FACING NURSES ON END-OF-LIFE ISSUES BASED ON CONFERENCE PROCEEDINGS HELD IN ELDORET, KENYA ABSTRACT Problem Statement: A conference to discuss on ethical dilemmas is thought to be a good way of airing out issues. It is unfortunate that at times a patient in our care may die no matter what we do. Profound ethical questions on end of life issues confront the medical personnel as they watch and wait helplessly. This paper touches on ethics, law, social and public policy as they affect nursing practice. Setting: This is a conference proceedings report augmented with a case study of Nelly from a local setting and compares it with two others from elsewhere which were also presented during the conference. Conference was organized by Federation of African Medical Students Associations (FAMSA), Eldoret 2011. The author was a presenter...
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...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 2010 (please see Appendix 1). I decided to choose this topic as there was a situation on my ward recently where a patient discovered a DNACPR form in the front of her nursing notes. The patient...
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...”The basic level of problems concerns the dilemmas which arise for individual professional when they sense that there is a conflict between their private moral convictions and what they believe is required of them…” (Thompson, 1976). Nursing judgment is hard when so many factors are present, from the patient’s viewpoint, to the family/caregiver to the physicians ultimately in charge of the care. Many complicated scenarios can occur for the RN at any time and they must base their decisions on the ethical and legal guidelines that govern the nursing profession. Body In the world of nursing we are faced with ethical decisions on a regular basis but it is how we handle these situations that makes the difference. As a nurse we are bound by the guidelines of the code of ethics. The ANA (2014) states the “Code of Ethics for Nurses is a succinct statement of the ethical obligations and duties of every individual who enters the nursing profession. “It is the profession’s nonnegotiable ethical standard” and “an expression of nursing’s own understanding of its commitment to society”. In the case of the patient admitted with a hemorrhagic stroke whose family disagreed on the plan of care, the code of ethics outlines that the patient is our primary concern. When faced with conflict the nurse should help coordinate discussion with all parties involved. Once the ethics committee convenes the final resolution as per the code of ethics is to do what’s best for the patient. The nurse involved...
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...The primary aim of my assignment is to look at the issue of end of life care in dialysis satellite units, as these areas tend to be nurse led units. My interest in palliative and end of life care has arisen from the growing number of poorly patients we continue to dialyse, this has proved distressing especially for the patient, who often has unmanaged symptoms and for their families, it is also upsetting for the staff involved in their care, as it is felt nobody is acting as the patients’ advocate and helping the decision to facilitate the withdrawal of what is now an ineffective and unnecessary treatment. One of the latest developments by the Government and Department of health is the concept of Advance Care Planning. I have looked at this from various perspectives and would like to be involved in introducing the process to Sheffield Kidney Institute. In 2004, the number of patients receiving renal replacement therapy in England, Scotland and Wales was 33,511, this figure is sourced from data which has been made available to them from participating renal units throughout the country, the number of patients receiving dialysis since 2000 has risen by 7% (Ansell et al 2005) with it projected to rise by a further 10 percent over the next 5 years (Ansell et al 2005). About 15-29 percent of deaths of patients with end stage renal disease results from a decision to discontinue dialysis (Davison 2006). Importantly we need to explore which patients especially those reaching...
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...Running head: EUTHANASIA Euthanasia: A Silent Plea for Mercy Shannon Curry University of Southern New Hampshire Professor Henson Tuesday December 23, 2014 Euthanasia: A Silent Plea for Mercy All over the world there are amazing technological advances in medicine happening every day, despite that there are neonatal patients suffering from painful life limiting medical conditions that have no treatment or cure. “Advances in medical technology make it possible to extend life, at times, the focus on ‘cure at all costs’ overshadows the obligation to provide dignified, humane, and compassionate care” (Rushton, 2005). In an effort to provide legal, humane and compassionate end-of-life care to infants, the Dutch developed the Groningen Protocol in 2003. Developed in collaboration with the prosecutor’s office, the Groningen Protocol was designed to guide a transparent medical and legal decision making process for parents and their doctors considering neonatal euthanasia (Catlin, 2008; Petrou, 2005). Neonatal euthanasia is the practice of hastening the death of a terminal ill newborn in an effort to relive their suffering. Most countries current laws make it illegal for the neonatal population to benefit from euthanasia. Research is suggestive that albeit in secret neonatal euthanasia maybe disguised and illegally practiced around the world. Legalizing neonatal euthanasia would not only allow transparency...
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...AMELLA, JAMES F. LAWRENCE, & SUZANNE O. GRESLE Medical University of South Carolina, Charleston, SC, USA Abstract Tube feeding can be an appropriate and effective means of providing nutrition for individuals who are unable to achieve adequate nourishment orally because of various medical problems. However, the delivery of nutrients by tube feeding can cause ethical dilemmas in cases where the effectiveness of tube feeding diminishes and medical complications increase. The decision to tube feed is often influenced by regional and cultural preferences, as well as the high cost of providing mealtime assistance. The effectiveness and appropriateness of tube feeding has been the subject of much debate as it applies to those with severe cognitive impairments and those who are in a persistent vegetative state (PVS). Recent research shows that in these vulnerable populations, tube feeding alone does not necessarily prevent malnutrition and risk of infection or improve functional status and comfort. While advanced directives allow an individual to make decisions about his or her care at the end of life, court cases and religious doctrine examine the individual’s right to autonomous decision making in opposition to preserving the sanctity of life. As long as the outcome of this debate is largely undecided, the process of dying may be prolonged for those who can no longer advocate for themselves. Keywords: Enteral feeding, tube feeding, ethics, persistent vegetative state...
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...Chapter 1 Ethical Reasoning: Implications for Accounting Ethics Reflection PENN STATE CHILD ABUSE SCANDAL: A CULTURE OF INDIFFERENCE What motivates an otherwise ethical person to do the wrong thing when faced with an ethical dilemma? Why did Joe Paterno and administrators at Penn State University look the other way and fail to act on irrefutable evidence that former assistant football coach Jerry Sandusky had raped and molested young boys, an offense for which Sandusky currently is serving a 30- to 60-year sentence? According to the independent report by Louis Freeh that investigated the sexual abuse, four of the most powerful people at Penn State, including president Graham Spanier, athletic director Timothy Curley, senior vice president Gary Schultz, and head football coach Joe Paterno, sheltered a child predator harming children for over a decade by concealing Sandusky’s activities from the board of trustees, the university community, and authorities. The Freeh report characterizes the inactions as lacking empathy for the victims by failing to inquire as to their safety and wellbeing. Not only that, but they exposed the first abused child to additional harm by alerting Sandusky, who was the only one who knew the child’s identity, of what assistant coach Mike McQueary saw in the shower on the night of February 9, 2001.1 McQueary testified at the June 2012 trial of Sandusky that when he was a graduate assistant, he walked into the locker room and heard sounds of slapping...
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...Knowledge Area Module VI Contemporary Issues and the Ethical Delivery of Health Services Student: Harold Taitt, harold.taitt@waldenu.edu Student ID # A00293212 Program: Ph.D. Health Services Specialization: Health Management and Policy Faculty Mentor: Dr. Robert Hoye, robert.hoye@waldenu.edu Faculty Assessor: Dr. Jim Goes, jim.goes@waldenu.edu Walden University May 10, 2013 Abstract Breadth Component In this age of rapidly evolving technological advances, many of the legal and ethical issues that are challenging the delivery of health care and the health care profession are new. As we confront the legal, moral, and ethical aspects of health care, we are seldom faced with decisions that require or are resolved by simple right or wrong answers (Edge & Kreiger, 1998). In the Breadth component of KAM VI, I focus on several ethical theories and how those theories influence the way ethical issues and concerns are addressed and managed in the allocation and delivery of health care services. I critically assess and evaluate those theories, concepts, and derivative principles as they impact important decisions and the implications of those decisions within the context of social change and with special emphasis on health care management and policy. In addition, I discuss the key assumptions on which the selected theories are constructed, compare and contrast the writers’ interpretations across theories, and conclude by providing a critical commentary on the merits of the selected...
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...ram4577X_ch03.qxd 4/16/04 11:50 Page 37 Legal and Ethical Issues in Medical Practice, Including HIPAA AREAS OF COMPETENCE 2003 Role Delineation Study CLINICAL Fundamental Principles ɀ Apply principles of aseptic technique and infection control ɀ Comply with quality assurance practices Patient Care ɀ Coordinate patient care information with other health-care providers GENERAL Legal Concepts ɀ Perform within legal and ethical boundaries ɀ Prepare and maintain medical records ɀ Document accurately ɀ Follow employer’s established policies dealing with the health-care contract ɀ Implement and maintain federal and state health-care legislation and regulations ɀ Comply with established risk management and safety procedures ɀ Recognize professional credentialing criteria CHAPTER OUTLINE ɀ ɀ ɀ ɀ Medical Law and Ethics OSHA Regulations Quality Control and Assurance Code of Ethics ɀ HIPAA ɀ Confidentiality Issues and Mandatory Disclosure OBJECTIVES After completing Chapter 3, you will be able to: 3.1 Define ethics, bioethics, and law. 3.2 Discuss the measures a medical practice must take to avoid malpractice claims. 3.3 Describe OSHA requirements for a medical office. KEY TERMS abandonment agent arbitration assault authorization battery bioethics breach of contract civil law contract crime criminal law defamation disclosure durable power of attorney electronic transaction record ethics expressed contract felony fraud ...
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...THE IMPACTS OF URBAN ABSOLUTE POVERTY ON YOUNG WOMEN: A CASE STUDY OF EPWORTH BY MASARA WIRIRANAI. B. (R121680Y) FACULTY OF SOCIAL STUDIES DEPARTMENT OF SOCIOLOGY 2015 A DISSERTATION SUBMITTED IN PARTIAL FULFILLMENT OF BACHELOR OF SCIENCE HONOURS DEGREE IN SOCIOLOGY (SUPERVISOR Ms CHOGUYA) 1 Dedication I dedicate this research work to my late mother. You influenced every aspect of carrying out this study. It’s sad though that you are not around to witness who I have become. You may be gone but you are never over! 2 ACRONYMS ADB Asian Development Bank CSO Central Statistics Office DESA Department of Economic and Social Affairs Statistics Division ESAP Economic Structural Adjustment Programme FPL Food Poverty Line HDL Human Development Index MPSLSW Ministry of Public Service, Labour and Social Welfare NGO Non-Governmental Organizations PASS Poverty Assessment Study Survey PDL Poverty Datum Line PICES Poverty and Income Expenditures Survey PRD Parliament Research Department PRFT Poverty Reduction Forum Trust TCPL Total Consumption Poverty Line UNDP United Nations Development Programme UNICEF United Nations Children’s Fund UNESASD United Nations Economic and Social Affairs Statistic Department UN-Habitat United Nations Human Settlement Programme USA United States of America Zimstat Zimbabwe National Statistics Agency 3 Abstract The study focused on identifying, measuring and assessing the nature and extent of impacts of urban absolute...
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...Chapter 1: Ethical Theory Meta-ethical positions include: * Ethical non-cognitivism (concept that ethics is a matter of feelings) * Ethical relativism (concept that ethics is relative to a particular point of view) * Ethical objectivism (notion that ethics is objective in nature). Meta-Ethical Positions Ethical Non-cognitivism The basis of ethical non-cognitivism is that ethical disagreement can be a highly emotional affair where no amount of reasoning is likely to convince the other party. * Example: “Let’s just agree to disagree” Ethical Relativism * Ethical relativism says that while ethical statements are cognitively meaningful, they do not hold in any objective sense because they depend on our point of view. * If we accept ethical relativism, then ethical disagreement among people who do not share the same perspective becomes impossible. * It assumes that if people agree on something, then it must be true. * Ethical relativism is suspect for a pragmatic reason: it is fundamentally at variance with our social practice. * Example: “To each his own”, or the belief that what’s right for one group isn’t necessarily right for another Ethical Objectivism * Ethical objectivism holds that right and wrong are objective phenomena. * Example: “I’m right and you’re wrong” What is Ethics? * As a discipline, ethics is a branch of philosophy. * It deals with questions of right and wrong conduct, and with what we ought to do and what...
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...Emergency Medical Technician-Basic: National Standard Curriculum EMT-Basic: National Standard Curriculum Instructor's Course Guide ------------------------------------- EMT-BASIC: NATIONAL STANDARD CURRICULUM PROJECT DIRECTOR David J. Samuels, MBA System Director Samaritan AirEvac/Emergency Medical Services Samaritan Health System Phoenix, AZ CO-MEDICAL DIRECTORS Henry C. Bock, MD, FACEP Emergency Physician Methodist Hospital of Indiana, Inc. Indianapolis, IN Kimball I. Maull, MD, FACS Director R Adams Cowley Shock Trauma Center Baltimore, MD PRINCIPAL INVESTIGATOR Walt A. Stoy, Ph.D., EMT-P Director of Educational Programs Center for Emergency Medicine Research Assistant Professor of Medicine University of Pittsburgh School of Medicine Pittsburgh, PA Contract Number DTNH22-90-C-05189 -------------------------------------United States Department of Transportation National Highway Traffic Safety Administration EMT-Basic: National Standard Curriculum i EMT-Basic: National Standard Curriculum Instructor's Course Guide ------------------------------------- CURRICULUM DEVELOPMENT GROUP James Bothwell, EMT-P National Flight Paramedics Association William Brown, RN, NREMT-P National Registry of Emergency Medical Technicians Ricky Davidson International Association of Fire Chiefs Karla Holmes, RN National Council of State EMS Training Coordinators Richard Judd, Ph.D., EMSI National Association of Emergency Medical Technicians Kathryn Lewis, RN, Ph...
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...The Power of Logic The Power of Logic FOU RTH E DITION Frances Howard-Snyder Daniel Howard-Snyder Ryan Wasserman WESTERN WASHINGTON UNIVERSITY Published by McGraw-Hill, an imprint of The McGraw-Hill Companies, Inc., 1221 Avenue of the Americas, New York, NY 10020. Copyright © 2009, 2005, 2002, 1999, by The McGraw-Hill Companies, Inc. All rights reserved. No part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written consent of The McGrawHill Companies, Inc., including, but not limited to, in any network or other electronic storage or transmission, or broadcast for distance learning. This book is printed on acid-free paper. 1 2 3 4 5 6 7 8 9 0 DOC/DOC 0 9 8 ISBN: 978-0-07-340737-1 MHID: 0-07-340737-2 Editor in Chief: Michael Ryan Editorial Director: Beth Mejia Sponsoring Editor: Mark Georgiev Marketing Manager: Pamela Cooper Editorial Coordinator: Briana Porco Production Editors: Melissa Williams/Melanie Field, Strawberry Field Publishing Cover Designer: Ashley Bedell Cover Photo: © Dan Trist/Corbis Media Project Manager: Thomas Brierly Production Supervisor: Louis Swaim Composition: This text was set in 10.5/12.5 Goudy by Aptara, Inc. Printing: Printed on 45# New Era Matte by R.R. Donnelley & Sons, Inc. Credits: The credits section for this book is on page 647, following the Answer Key in the back of the book, and is considered an extension of the copyright page. ...
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