...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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...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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...Nursing Roles and Values Task One Western Governors University State Regulations and Nursing Standards The State of Tennessee Board of Nursing’s Rules and Regulations of Registered Nurses, Rule # 1000-01-.13-1r states that unprofessional conduct is defined in part by "failing to take appropriate action in safeguarding the patient from incompetent health care practices" (State of Tennessee, 2011). There are a number of arguments in this case study that incompetent health care practices are being performed, from the decision to place a patient on a ventilator for an oxygen saturation of 88%, circumventing the patient’s written and verbal advanced directives, utilizing an unauthorized family member to get consent for a medical procedure, and discussing confidential medical information in a public location and with and unauthorized family member. The nurse clearly violated this rule because the nurse did not take any action at any point to stop the physician from taking these incompetent actions. Implications Rule # 1000-01-.13-1r applies because, as mentioned above, the nurse failed to take any action to prevent the physician from performing a number of incompetent acts related to the healthcare of the patient. First and foremost, the patient likely does not even need to be placed on the ventilator. The physician’s decision to place the patient on the ventilator is based on an oxygen saturation of 88%. Although the patient’s oxygen saturation does need...
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...empathic relationship between the client and the counsellor to provide a framework for emotions to be delved into, as well as behaviours and thinking patterns. This would improve the client’s condition through the facilitation of benign changes. However counselling does not solve the client’s problem, counsellors merely serve as guides, assisting the client through their problems. Counselling can stretch over any period of time. Counselling typically uses a theory-based approach, usually with the psychoanalytic, person-centred, cognitive behavioural and psychodynamic theories being utilised. Depending on the theory or theories used, the counselling could either be directive or non-directive. Directive counselling refers to the counsellor advising and helping the client to realise his goals, while the non-directive approach, predictably does the opposite. Counselling would require a large amount of formal training. Peer counsellors, who can be friends, colleagues and family members, are non-professional counsellors. They cannot counsel others as they already know who the client is and have an impression of the person. This would lead to them being biased, due to the perception that they already possess of that individual. Paraprofessional...
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...Ethical Decision-Making in the Military Decision-Making Process Contribution to the JSCOPE 2000 Conference “Moral Considerations in Military Decision Making”. Dr. D. (Desiree) Verweij Lieutenant Colonel G.A.A.M. (Gérard) Cloïn (drs.) Major E.C. (Erhan) Tanercan MED (drs.) E-mail: ilmo@army.disp.mindef.nl Tel: +31 76 527 46 53 begin_of_the_skype_highlighting +31 76 527 46 53 end_of_the_skype_highlighting Introduction A great deal has changed in the Royal Netherlands Army (RNLA) in recent years. Not only has the task of the RNLA changed, but so has its composition. To begin with the first aspect: the task of the RNLA and that of the armed forces as a whole has been extended. This means that operations outside the Netherlands in all manner of international frameworks, such as the UN and NATO, have become the rule rather than the exception. The composition of the RNLA and of the armed forces has also changed. We no longer have conscripts in our army; we have all-volunteer forces, forces that wish to reflect society on a number of important counts. One of the significant consequences of the changes in respect of the new task and composition of the armed forces is the confrontation with different cultures and with different and new values and standards. To ensure that military personnel are able to deal with this situation in a professional manner, education in ethics is extremely important. This article elaborates on...
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...PESTLE Analysis Strategy Skills Team FME www.free-management-ebooks.com ISBN 978-1-62620-998-5 Copyright Notice © www.free-management-ebooks.com 2013. All Rights Reserved ISBN 978-1-62620-998-5 The material contained within this electronic publication is protected under International and Federal Copyright Laws and treaties, and as such any unauthorized reprint or use of this material is strictly prohibited. You may not copy, forward, or transfer this publication or any part of it, whether in electronic or printed form, to another person, or entity. Reproduction or translation of any part of this work without the permission of the copyright holder is against the law. Your downloading and use of this eBook requires, and is an indication of, your complete acceptance of these ‘Terms of Use.’ You do not have any right to resell or give away part, or the whole, of this eBook. PESTLE Analysis Table of Contents Preface 2 Visit Our Website 3 Introduction 4 PESTLE Analysis 6 PESTLE Factors 10 Political Factors 12 Economic Factors 13 Social Factors 15 Technological Factors 16 Legal Factors 18 Environmental Factors 20 Summary 22 Other Free Resources 23 References 24 ISBN 978-1-62620-998-5 © www.free-management-ebooks.com 1 PESTLE Analysis Preface The PESTLE Analysis is a useful method to use in order to identify the external factors that influence...
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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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...The Case of Hillary Hillary is a 6-year-old with severe cerebral palsy and cognitive disability. Hillary has been attending a private school for children with developmental disabilities and severe handicaps for the past 2 months. According to her record, the student has a history of oral-pharyngeal dysphagia with silent aspiration and several bouts of pneumonia in the past 2 years. She has a PEG tube by which she receives her nutrition, hydration and medications. One morning Hillary’s home-room teacher approached the speech-language pathologist with a note written on a prescription paper ‘ordering’ oral feeding for Hillary while she is at school. The speech-language pathologist, John, is very concerned. He feels that it would be against professional standard to allow Hillary to eat orally. John feels that Hillary’s mother and physician do not have the student’s best interest at heart. Dysphagia Intervention in Schools As more students with chronic conditions receive their care in a traditional school setting, the speechlanguage pathologist is required to have a medical knowledge base for pediatric communication and swallowing disorders. Dysphagia intervention is becoming a more prominent component of the caseloads of speech-language pathologists who practice in the school setting. While this can be a rewarding challenge, scenarios in which clinicians find themselves can also have a more acute feel when managing a feeding tube and/or risk for aspiration...
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...Guide Queensland Health Guide to Informed Decision-making in Healthcare Disclaimer The information within the Guide to Informed Decision-making in Healthcare is intended as a guide to good clinical practice. The law and service delivery environment is constantly evolving, so while every attempt has been made to ensure the content is accurate, it cannot be guaranteed. The information within this document should not be relied upon as a substitute for other professional or legal advice. ISBN 9781921707391 ©State of Queensland (Queensland Health) 2011 First edition February 2012 This work is licensed under a Creative Commons Attribution Non-Commercial 2.5 Australian license. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc/2.5/au/ In essence, you are free to copy, communicate and adapt the work for non-commercial purposes, as long as you attribute the Patient Safety and Quality Improvement Service, Queensland Health and abide by the license terms. For further information, contact: Informed Consent Program Manager Patient Safety and Quality Improvement Service Centre for Healthcare Improvement, Queensland Health PO Box 152 Herston Queensland 4029 tel (+61) (07) 3646 9715 psq@health.qld.gov.au www.health.qld.gov.au/chi/psq/ For permission beyond the scope of this license contact: Intellectual property Officer Queensland Health GPO Box 48 Brisbane Queensland 4001 tel (+61) (07) 3234 1479 ip_officer@health.qld.gov.au Forward Patient-centred...
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...Ethical Organization Profile Maltie Ramjattan, Stuart Copenhaver, Judith Sturdivant, Anthony Cortez Sr. MGT 216 September 27, 2010 Ethical Organization Profile Global Oil Company has to be able to watch and take into account all problems that an employee gives them. Global Oil Company about 20 years ago did not have this in place and caused a big issue at one of their plant. This company did not listen to their employees and was only worried about the profits that then what was happening around them. They could have just fixed the problems and still could have been profitable, but would just not have made as much money. Because they did not listen to their employee’s part, one of the plants exploded and caused major property damage and employees to get hurt. This is why the code of ethics had to be put in place to prevent this from happening again. This company is not going to let what happened 20 years ago happen again. The Ethics Code of Global Oil Company is built around 10 key concepts that demonstrate the companies’ dedication to doing business ethically. 1. Building Reliability and Trust with Employees, Customers, and Shareholders – Building Reliability and Trust is integral to ensuring that our employees know they can rely on each and trust in their fellow employees, ensure that customers view our products as a flagship of reliability, and trust that we will treat them fairly in all business dealings, and ensure that the shareholders...
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...OB EXAM STUDY NOTES Motivation Motivation – the extent to which persistent effort is directed towards a goal - Effort, persistence, direction Intrinsic motivation – self applied, form the inside, stemming from the direct relationship between the worker and the task Extrinsic motivation – stemming from the work environment external to the task, usually applied by others (managers), not long lasting Content theories of motivation – WHAT motivates (Maslow’s theory, Alderfer’s ERG theory, McClelland’s theory) Process theories – focus on the underlying processes involved in motivating employees – HOW motivation occurs (Expectancy theory, equity theory, goal setting theory) Maslow’s Hierarchy of Needs Physiological Needs – food, water, warmth, rest Safety Needs – security, safety Belongingness and Love Needs – relationships, friends Esteem Needs – prestige and feeling of accomplishment Self Actualization – achieving one’s full potential, including creative activities - Once a need is satisfied, attention is turned to the next highest level (the satisfied need is no longer an effective motivator, except self actualization) Alderfer’s ERG Theory 1. Existance Needs 2. Relatedness Needs 3. Growth Needs - The more lower level needs are gratified, the higher level need satisfaction is desired - The less higher level needs are gratified, the more lower level need satisfaction is desired McClelland’s Theory Need for Achievement - Prefer work where they...
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...However the preparers have their own objectives, which often are quite different from those of the users. The financial statements can play a very important role in helping the enterprise’s management to achieve its objective. If the accounts show that the enterprise is doing well, the shareholders will be happy also the market price of the company’s shares will remain high. Since the accounts are prepared under the direction of the management there is a temptation for the management not to present the full truth about the enterprise in the financial statements, particularly when the company is doing badly. The paper examines the behavioral aspect of accounting with emphasis on the need of ethics; the methodology used is purely content analysis, using secondary data. The study reveals that unethical behavior is less prevalence in the organization that has adopted corporate code of ethics. Therefore, it is recommends that corporation without formal code of ethics should adopt it in order to mitigate the unethical behavior while users of financial report should possess analytical ability in order to have a better understanding of financial information and use it wisely for optimal decision, Key...
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...this journal is available at www.emeraldinsight.com/0143-7739.htm LODJ 33,1 Are ethical theories relevant for ethical leadership? Michel Dion ´ Universite de Sherbrooke, Sherbrooke, Canada Abstract Purpose – The aim of this study is to know if ethical theories could be connected to some leadership approaches. Design/methodology/approach – In the paper eight leadership approaches are selected: directive leadership, self-leadership, authentic leadership, transactional leadership, shared leadership, charismatic leadership, servant leadership, transformational leadership. Five western ethical theories (philosophical egoism, utilitarianism, Kantianism, ethics of virtue, ethics of responsibility) are analyzed to see to what extent their basic concepts could be connected to one or the other leadership approach. Findings – A given ethical theory (such as philosophical egoism) could be suitable to the components of various leadership approaches. Ethical leadership does not imply that a given leadership approach is reflecting only one ethical theory. Rather, ethical leadership implies that for different reasons, various leadership approaches could agree with the same ethical theory. This is what we could call the “moral flexibility of leadership approaches”. Research limitations/implications – This study focuses on western ethical theories. A similar study should be undertaken for Eastern ethical theories coming from Buddhism, Hinduism, Confucianism, or Daoism. Practical implications...
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...Original article | Published 3 February 2011, doi:10.4414/smw.2011.13157 Cite this as: Swiss Med Wkly. 2011;141:w13157 Do not attempt resuscitation: the importance of consensual decisions A qualitative study Lorenz Imhofa, Romy Mahrer-Imhofa, Christine Janischb, Annemarie Kesselringc, Regula Zuercher Zenklusend a b c d Zurich University of Applied Sciences ZHAW, Institute of Nursing, Winterthur, Switzerland Department of Education, Training and Professional Development, Stadtspital Waid Zurich, Switzerland Institute of Nursing Science, University of Basel, Switzerland Department of Medicine, Pourtalès Hospital, Neuchâtel, Switzerland Correspondence: Lorenz Imhof PhD RN Zurich University of Applied Sciences Institute of Nursing School of Health Professions Technikumstr. 71 CH-8401 Winterthur Switzerland lorenz.imhof@zhaw.ch pivotal. Therefore, leadership by experienced senior physicians and nurses is needed and great efforts should be made with regard to multidisciplinary education. Key words: decision-making; multidisciplinary collaboration; end-of-life issue; resuscitation orders Introduction Since the 1980s, “do-not-attempt-resuscitation (DNAR)” orders have become common in medical practice. DNAR orders are given for 50–60% of patients who die a non-sudden death, with wide variations among countries. DNAR orders apply to only 19% of hospitalised patients in Italy, but to as many as 83% in Sweden and 86% in Switzerland [1, 2]. The frequency of DNAR decisions in...
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... 3) ETHICAL THEORY 4) ETHICAL DECISION MAKING 5) NEGLIGENCE 6) CONSENT IN COMPETENT ADULTS 7) CONSENT IN CHILDREN 8) CONSENT IN INCOMPETENT ADULTS 9) CONSENT CONCERNING UNUSUAL IDEAS 10) ADVANCE DIRECTIVES 11) CONFIDENTIALITY 12) CONFIDENTIALITY AUDIT 13) EUTHANASIA 14) ABORTION 15) BIOTECHNOLOGY 16) SUGGESTED READING ONE – INTRODUCTION (Registrar) The importance of Ethical thinking in General Practice is becoming more and more apparent. It should not be thought that Ethics merely relates to the “Life and Death” issues in our Professional life – Abortion, Contraception, Euthanasia and the like. Ethical issues affect some part of almost every consultation, even if the ethical issue is something more mundane like obtaining adequate consent for an examination or respecting a patient’s dignity. Indeed, it could be argued that the Consultation skills that we foster so assiduously are actually Ethical skills – and that we need to know the patient’s “Ideas, Concerns and Expectations” in order to respect his Autonomy as well as in order to improve the outcome of the Consultation. In the 1998/99 academic year, I was appointed the deanery’s Medical Ethics fellow with a bursary from the MDU. I developed an approach to the teaching of GP ethics based on two half day sessions, which I presented in each VTS scheme in the deanery. The first session involved a consideration of Ethical theory....
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