...Terri Schiavo provides a valuable case study. The conflicts and misunderstandings surrounding her situation offer important lessons in medicine, law, and ethics. Despite media saturation and intense public interest, widespread confusion lingers regarding the diagnosis of persistent vegetative state, the judicial processes involved, and the appropriateness of the ethical framework used by those entrusted with Terri Schiavo's care (Fine, 2005) On March 31, 2005, Terri Schiavo (born December 3, 1963) died -- the final complication of a cardiac arrest on February 25, 1990. Her death was preceded by the withdrawal of artificially administered hydration and nutrition through a feeding tube. Prior to her death, Terri's saga was the focus of intense medical, ethical, and legal debates in the United States and elsewhere. These debates were characterized by confusion about the facts, ethical principles, and laws relevant to the case. Much of the confusion revolved around a number of ethical and legal questions including: Is it ethically and legally permissible to withhold or withdraw life-sustaining treatments from patients who do not want the treatments? Is withholding or withdrawing life-sustaining treatments the same as physician-assisted suicide or euthanasia? Is artificially administered hydration and nutrition a medical treatment or mandatory care akin to bathing? What were Terri's values, preferences, and goals regarding life-sustaining treatments? Several issues raised...
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...Title: Medical Ethics: History and Guiding Principles Author: Alan J. McGoldrick Course: Medicine, Disease and History Instructor: Professor Foss Date: June 15, 2012 Medical ethics are the moral guidelines and ethical laws that help to prioritize a medical professional's work responsibilities. The code of medical ethics outlines the proper conduct between medical professionals and their patients, communities, and colleagues. Each country has a different code of medical ethics, though most contain the same basic principles, and all share the same history of evolution, according to the World Medical Association. Medical ethics refers to the discussion and application of moral values and responsibilities in the areas of medical practice and research. While questions of medical ethics have been debated since the beginnings of Western medicine in the fifth century B.C., medical ethics as a distinctive field came into prominence only since World War II. (Porter, 1998) This change has come about largely as a result of advances in medical technology, scientific research, and telecommunications. These developments have affected nearly every aspect of clinical practice, from the confidentiality of patient records to end-of-life issues. Moreover, the increased involvement of government in medical research as well as the allocation of health care resources brings with it an additional set of ethical questions. Emerging Medical Ethics Through the Ages Ancient Medical Texts ...
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...Running head: APPLYING ETHICAL FRAMEWORKS IN PRACTICE Applying Ethical Frameworks in Practice Grand Canyon University Applying Ethical Frameworks in Practice Implications of a breach of confidentiality In the NBC’s ER: Betraying trust or providing good care? A14 year old girl Andrea came to trust the nurse that was caring for her and after being told that the information would be confidential, disclosed that she had been sexually active. When it became apparent that she had cervical cancer and needed treatment which required parental consent; Nurse Carol Hathaway faced a dilemma of remaining true to her promise and allow Andrea to possibly go untreated or break confidentiality and inform the parents. The purpose of confidentiality between patient and medical care provider is to gain trust and provide the patient with privacy regarding their medical care and allow the patient assurance that personal matters will remain confidential. When private information is disclosed without the patient consent this is regarded as a breach of confidentiality and is morally, ethically and legally wrong. The implications are a lack of trust between the patient and the healthcare provider and the patient may not disclose vital information regarding their condition thereby may not receive adequate care.(Nathanson, 2000). There are exceptions which “require physicians to report certain infectious diseases to public health authorities to protect the health of the community”...
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...HCE 430: Healthcare Ethics Regis University October 10, 2012 Introduction To die with dignity should be a given. Death will present itself to everyone eventually and presumably no one in their right mind would choose not to die with dignity. That being said why is it that so many people who would choose to die a good death are no allowed to. For some people no death is a good death, but that is silly because as everyone knows death is inevitable. No one can escape this fact. The controversy herein lies within the circumstances people who are suffering or lingering with a terminal illness that debilitates them such that they have no quality of life are not afforded the comfort of dying with dignity. It seems that this high merit is available to our beloved pets, but not our beloved family members. Aunt Bessie is forced to endure unrelenting pain from here incurable pancreatic cancer. No amount of pain medication is available to treat her pain and allow her to maintain consciousness. She knows her time is limited and she does not feel she should have to wait out the inevitable in such a terrible state. At the same time the family pet Bassett hound is found to have a mass in her intestines. She cannot eat and barely moves as she is in so much pain. The veterinarian has given the option of putting her to sleep or euthanizing her to put her out of her misery as she is suffering so. This sits well with most people. Aunt Bessie requesting euthanization though is out of the...
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...Applying Ethical Frameworks in Practice Richard Doria Grand Canyon University NRS -437 V Nov 16, 2014 Applying Ethical Frameworks in Practice Patient confidentiality can be often breached without the intention of doing it. This happens when staff discusses patient information in crowds or small groups, patient notes on the computer being left open and unattended, and documents that are not being filed properly and stay visible to the next patient. Confidentiality is not necessarily absolute even though it is a patient’s right. Certain situations exist where medical staff is obligated to breach confidentiality, especially when they feel that it is in the patient’s interest to do so. The following are implications of breaching confidentiality: “1) breaching confidentiality fails to respect patient autonomy, 2) violation of patient confidentiality is a form of betrayal, and 3) patients have a right to confidentiality that has frequently been demonstrated in common law and in some specific areas outlined in statute law” (ministryofethics.co.uk, 2010). Confidentiality is a principle in nursing that makes nurses preserve the privacy of their patients and grant them their autonomy. Respect for the patients is being shown while maintaining confidentiality. This task makes nurses, physicians, and other medical staff accountable. Breaching confidentiality has a major tendency to cause harm or the patient refusing further medical care. “Undue harm can be described as embarrassment...
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...standard offers a framework that stipulates...
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...CASE SCENARIO Leo R. is a 45-year-old patient with diabetes and is a widower with three young children. Two of Leo’s children suffer from chronic medical conditions. His oldest daughter, like Leo, has insulin-dependent diabetes. His only son suffers from grand mal epilepsy, which is poorly controlled by a plethora of medications. Leo works for a small printing business, a job he enjoys, but one that makes it difficult for him to make ends meet. With only six employees, the company’s owner cannot afford to offer health insurance. Leo’s annual salary of $30,000 allows him to purchase only the most basic of health plans, one that does not include coverage for prescription medications. Leo frequently must decide between medications and food, often opting for cheap junk food that is neither nutritious for his young family nor appropriate for a diabetic diet. Leo has recently applied for and been offered several other jobs, but at a lower salary and with no health insurance coverage. Recently, Leo’s diabetes has worsened. He has developed a serious infection that has led to lost wages and, far worse, the loss of his right leg below the knee. Leo is weighing his options. He has heard about a new clinical research trial open to insulin-dependent diabetics that pays $100 a week to research subjects. He has also been quite depressed and begun to wonder if his children might not be better off without him. He has several life insurance policies that would pay off generously if something...
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...From time to time human beings experience health challenges, whether physical or mental. On its part, medical practice has made considerable progress towards combating or controlling many of these challenges. It is through research that the nature, symptoms and effects of ailments can be ascertained and remedies discovered. Medical researchers engage in both therapeutic and non-therapeutic research. Therapeutic research is that carried out with the purpose of treating disease. On the other hand, non-therapeutic research is aimed at 76 Adebayo A. Ogungbure furthering the frontiers of knowledge about human health. Furthermore, researchers and physicians often use human beings as objects of scientific investigation, raising certain ethical concerns, including the issue of informed consent and how consent is obtained, selection of participants in research, the welfare of human subjects involved in a research project, what the goals of research ought to be, and what ought to constitute proper procedure for an ethical research. These issues are central to an aspect of applied ethics which is now commonly referred to as research ethics. The aim of research ethics is to ensure that research projects involving human subjects are carried out without causing harm to the subjects involved. In addition, it provides a sort of regulatory framework which ensures that human participants in research are not exploited either physically or psychologically. The need for ethical guidelines...
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...principles to protect human participants in biomedical research from undue exploitation by researchers. However, in the “Tuskegee Study” in the US, these principles were grossly violated. The task of this paper is to critically examine the ethical implications of that study on future practices in biomedical research, and to suggest ways of ensuring that such practices comply with appropriate ethical values. Key Words Bioethics, Biomedical research, clinical research, Tuskegee Study, paternalism, morality Introduction From time to time human beings experience health challenges, whether physical or mental. On its part, medical practice has made considerable progress towards combating or controlling many of these challenges. It is through research that the nature, symptoms and effects of ailments can be ascertained and remedies discovered. Medical researchers engage in both therapeutic and non-therapeutic research. Therapeutic research is that carried out with the purpose of treating disease. On the other hand, non-therapeutic research is aimed at 76 Adebayo A. Ogungbure furthering the frontiers of knowledge about human health. Furthermore, researchers and physicians often use human beings as objects of scientific investigation, raising certain ethical concerns, including the issue of informed consent and how consent is obtained, selection of participants in research, the welfare of human...
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...“It is a mistake to reject religious principles in favour of secular/ethical principles for guidance in medical ethics” A religion such as Christianity has rules and guidelines that are made by the Church using teachings and bible scriptures so that Christians can live a moral life to achieve an afterlife. An example of this is the Ten Commandments that was given to Moses which contain laws such as ‘thy shall not steal’ and ‘thy shall not kill’. These laws were giving to Moses so that people would do the right and good things. Secular principles such as Utilitarianism and laws made by the government for non-religious people to use as guidance to outline the right and wrong. Within this essay, I will examine how religion is a part of the rationing and prioritising sector when it comes to healthcare resources as well as the advantages and disadvantages when using non-secular principles when distributing resources. Beauchamp and Childress’ Four Principles of Biomedical Ethics are respect for autonomy, beneficence, non-maleficence and justice. This is one of the ethical principles that are being used by the NHS. The four principles are there to be used equally and fair when choosing the best decision for a situation of medical treatment. Autonomy means that you should respect a patient’s decision by giving them all the information they need to make their financial decision. Autonomy suggests that patients should be the ones to make their decisions and not healthcare professionals...
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...ethical principles to protect human participants in biomedical research from undue exploitation by researchers. However, in the “Tuskegee Study” in the US, these principles were grossly violated. The task of this paper is to critically examine the ethical implications of that study on future practices in biomedical research, and to suggest ways of ensuring that such practices comply with appropriate ethical values. Key Words Bioethics, Biomedical research, clinical research, Tuskegee Study, paternalism, morality Introduction From time to time human beings experience health challenges, whether physical or mental. On its part, medical practice has made considerable progress towards combating or controlling many of these challenges. It is through research that the nature, symptoms and effects of ailments can be ascertained and remedies discovered. Medical researchers engage in both therapeutic and non-therapeutic research. Therapeutic research is that carried out with the purpose of treating disease. On the other hand, non-therapeutic research is aimed at 76 Adebayo A. Ogungbure furthering the frontiers of knowledge about human health. Furthermore, researchers and physicians often use human beings as objects of scientific investigation, raising certain ethical concerns, including the issue of informed consent and how consent is obtained, selection of participants in research, the welfare of human subjects involved in...
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...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 and discussant. This paper is a compilation of the ideas, inspirations and reflections of the significant sessions and also fulfills some of the recommendations resulting from the distinguished panelists. Objectives: - i) To explore ethical dilemma issues on end of life which have a heavy bearing on Nurses and other health care providers. ii) To explain euthanasia as it relates to...
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...Broadcasting Corporation (BBC) webpage, in the section Ethics guides, under the title of Forms of Euthanasia, Religions and Death? (2009), different types of euthanasia are described, such as indirect, active, passive, voluntary, involuntary and non voluntary. On the other hand, assisted suicide is usually performed with the help of a health professional; that is why; it is usually called Physician Assisted Suicide (or PAS). The main controversy is over the different opinions on whether it is the sick patient’s decision or if it is a legal, ethical or religious issue to be considered by a third party. In order to practice assisted suicide in a country where it is legal, many factors should be present, such as the moral and religious beliefs of the patient and the physician or the patient’s family and the physician, as well as the legislation of the country where it is going to be carried out. At present, in countries where euthanasia is not legalized yet, it is very difficult to obtain legal permission to practice it. As regards the ethical field, it is the physician’s responsibility to respect and to be loyal to the Hippocratic Oath, which they swore to respect the moral principles of their medical profession. Most of the times, these principles overlap with euthanasia’s practices, as physicians are faced with a dilemma on whether to respect the patient’s decisions or to abide by the principles of medical ethics, which support...
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...bed mental health residential unit, situated in the North West of England. In addition to providing a summary of the exercise itself, I would also hope to explore the relationship between the clinical audit process and the wider framework for quality improvement in healthcare. The development of regulation and clinical governance systems in the United Kingdom will also be addressed as will the administration of medication as a significant element of nursing practice. Where necessary, use will be made of academic, research and other evidence based material to underscore or augment specific issues or indeed illustrate examples of good clinical practice. The Nursing and Midwifery Council (NMC) standards for conduct, performance and ethics (NMC, 2004) have been diligently applied in the construction of this assignment. Pseudonyms will therefore be used to ensure staff and patient confidentiality, whilst other identifying information will be completely anonymised. Clinical governance, a term first introduced in a government White Paper The New NHS: modern, dependable (Department of Health, 1998) is a notion that has attracted a range of definitions (Nicholls, Cullen, O’Neill and Halligan 2000, Starey, 2001) but can broadly be defined as a comprehensive framework to...
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... Nurses have been playing very important roles in the caring of patients throughout the continuum of life and at the end of life for years. It is the position of the ANA that participation of nurses in euthanasia is prohibited as those acts are in contradiction of the code of ethics for nurses. Nurses have a duty to provide humane, comprehensive and compassionate care in respect to the rights of patients, but maintain the standard of the profession in the presence of chronic, debilitating illness and at the end of life. Voluntary euthanasia is the act of taking a life painlessly especially to relief suffering from an incurable illness, with the consent of a dying patient. Denying people such wishes can lead to unnecessary suffering. There are two types of euthanasia; involuntary, where patients refuse to consent and non-voluntary, patients unable to consent. Euthanasia can have great impact on the society. It affects everyone one way or another. Although a person has autonomy to make decisions about his end of life care doesn’t take away from the fact that their family and friends will be affected with guilt, anger and bitterness. Voluntary euthanasia can hamper efforts to advance medical research in finding cures for diseases (Saunders, 2011). As the nurse taking care of a terminally ill patient, the husband confides in you that he promised his dying wife that he would assist her in taking her own life when the pain became more than she could bear. The ethical dilemma...
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