...PATIENT AUTONOMY Respecting patient autonomy is dominant to nondirective counseling. It has no requirement to value-neutrality. The counselor’s values are expressed to undermine patients’ ability to make decisions for them. Autonomy respect in genetic counseling requires no greater circumspection about values than in any other counseling in health care (Robert Wachbroit & David Wasserman, 1995). Value neutrality is argued to be neither possible nor desirable but arises from conceptions of fewer objectives and less suitable values for public discourse. Nondirectiveness requires the counselor to adopt the most effective methods in ensuring that the choices of the patients about genetic testing are well informed and voluntary. Patients should be made to understand and appropriately respond to the results of genetic tests and diagnoses. The nondirective approach stipulates that the appropriate response is the one from the patient herself as long as it results from the fact that she understands the facts and reflects her values truly. Nondirective genetic counseling ensures that patients are well aware of genetic risks and their freedom of choosing whether or not to go for testing and ways of responding to positive test results. This is the respect for patient autonomy. On the contrary, value neutrality...
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...Everyday patients place their trust in the hands of their doctors. Maintaining confidentiality ensures quality care by showing that patients can rely on physicians to cherish the bond of trust between the patient and doctors, and maintain privacy. When breaching confidentiality, professionals will need to make judgments about the significance of the information to both patients. The right to Helen’s confidentiality should be protected because the potential harm caused by breeching her confidentiality outweighs the potential benefits of Penelope being informed. Helen has a 4 year old son that has been diagnosed with Duchenne Muscular Dystrophy (DMD), which is an x-recessive genetic condition that is carried by girls but with very rare exceptions boys are affected. Helen is a carrier for the mutation, but it is said that only half of the women carriers’ sons will inherit it from them and will be affected. Helen has a sister, Penelope that is 10 weeks pregnant and is worried that her fetus may have the genetic problem. However, there is a one in four chance that a female will inherit the gene and become a carrier. Helen is aware her sister is pregnant and she feels if she tells her sister of her and her son’s diagnosis, Penelope would likely terminate the baby. Helen speaks to her medical providers and decides she wants the results to remain confidential and not be disclosed to her sister. Although it might seem morally right for Helen to share her medical information with her...
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...Ethics 7 Patients Consent 9 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...
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...rely on the ability of caregivers to make the right choices using the wisdom of Solomon to do good. An ethical dilemma has risen here in given situation. It can occur whenever a choice involves giving up something good and suffering something bad, no matter what course of action is taken. Ethical dilemmas often require caregivers to make decisions that may break some ethical norm or contradict some ethical values. In the given situation, decision must be made depending upon various dimensions of dilemma and the issues related to the same; and of course the ethical principles: base for decision making. Dimensions of given Ethical dilemma: * Relevant information Here, the information given about the patient includes that a male patient is 96 years of age and having a terminal liver cancer admitted in Intensive care unit (ICU). If we take a look on his physical dimensions; he looks very skinny, underfed and also covered with bruises. Information about his caregivers include his own daughter, a naturopathy physician. She wants to cure his father with some tar like substance which smells like feces. While on the other hand, other...
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...the greatest advances in medicine have been achieved by biomedical research. Biomedical researchers have been able to find cures or eliminate diseases, create vaccines, and medicines that heave cure and protected the health of millions of people. The National Institute of Health (NIH) is the federal Government’s primary agency for advancing knowledge in the biomedical and behavior sciences in order to understand and treat human disease. In the past, research process often involved many unethical practices where the research participants lacked adequate protection. To protect human research participants from undo harm, biomedical researchers must follow the four basic ethical principles on which standards of ethical research are based: autonomy, beneficence, nonmaleficence, and justice. Such ethical requirements on biomedical research are found in documents such as the Declaration of Helsinki or the Belmont Report. The four principles and Institutional Review Boards (IRBs) are the principal regulations and ethical protocols when conducted human research. In the United States, the National Institute of Health (NIH) is the primary agency responsible in enforcing ethic in human research but the IRBs falls within the authority of the Food and Drug Administration (FDA). In other countries, different names might be used, such as research ethics committees or ethics review committees. Where ever human research is conducted, either within the US regulations or internationally...
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...Health Ethics Assignment 6 * Autonomy Is the personal rule of the self that is free from both controlling interferences by others and from personal limitations that prevent meaningful choice. Personal autonomy is at minimum, self-rule that is free from both controlling interference by others and from limitations, such as inadequate understanding, that prevent meaningful choice. The autonomous individual acts freely in accordance with a self-chosen plan, analogous to the way an independent government manages its territories and sets its policies. A person of diminished autonomy, by contrast, is in some respect controlled by others or incapable of deliberating or acting on the basis of his or her desires and plans. For example, prisoners and mentally retarded individuals often have diminished autonomy. According to this kind of conception, a person’s beliefs, desires, choices, decisions, etc. are autonomous when they fulfil certain procedural criteria. As the above quotation suggests, there can be different views about exactly how these criteria should be formulated. I would however argue that all plausible procedural theories of individual autonomy accept at least the following requirements. If a person’s behavior results from such things as compulsion and weakness of will, then it is not autonomous but heteronomous. If a person’s choices, decisions, beliefs, desires, etc. are due to such external influences as unreflect socialization, manipulation, coercion, etc...
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...causes memory loss, communication problems, incontinence and neglect of personal hygiene (Prime, 1994 p, 301). Mr Moses neglect of his personal hygiene was profound due to his incontinence condition Dignity mean “Being treated like I was somebody” (Help the Aged, 2001).Relating dignity in the care Mr Moses, dignity will be define as care given to Mr Moses that will uphold, promote and not degrade his self respect despite his present situation (being wet with urine and smell of faeces), frail or his age (SCIE, 2006). Mr Moses despite his present circumstance should feel value before, during and after his care (Nursing Standard, 2007). The concept of dignity has to do with privacy, respect, autonomy, identity and self worth thereby making life worth living for them (SCIE, 2006). However, each patient needs is unique, the level of these concept will varies on individual service user, such as the privacy that other service user need will be different from what Mr Moses require at the time of His care. When dignity is not present during his care, Mr Moses will feel devalued, lacking control, comfort and feel embarrass and ashamed (RCN, 2008). Things that emerged in my observation for Mr Moses to be provided with care in a dignified way involves, delivery Mr Moses personal care in a way that maintain his dignity, having support from team members and an up to date training in delivering care, and supportive ward environment (NHS evidence, 2007). I did raise some issues with my mentor that...
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...control the care given by others” This means that the service user should be given independency so that they would feel satisfied not getting helped all the time. For example is letting the service user have their independency like eating on their own. | Empowerment | This enables a person who uses services to make choices and take control of their own life. For example, service users rely on care workers to ensure their independence is not affected.Stretch, B (2010). Health & Social Care level 3 BTEC national. London: Pearson Education Limited. 2721/02/16 | Rights | “Rights are the legal entitlements.” This means being treated as an individual according to their needs and also it is about treating fairly with care and respect. | Autonomy | This means is to ensure the service users know enough to make an informed choice and help to have control over their lives. | Dignity | Dignity in care means the kind of care which supports and promotes a person’s self-respect.An example of dignity in health and social care setting would be is allowing the service user to change their clothes whilst their door is close. | Explain how four of these principles may be incorporated into providing relevant support Rights | The right to be different is one of the rights every people should get and not let others take it away from them because this is what makes people who they are and what they want to be. So it is very important that people don’t take this away from people especially...
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...Tuskegee Syphilis Study Dr. Joseph Costa, D.H.Sc, PA-C Health Policy and Management MPH 525 Jessie McCarty April 2013 Table of Contents Chapter Page 1. Tuskegee Syphilis Study 2 2. Tuskegee Basics 3 3. What Went Wrong? 4 Informed Consent 4 Vulnerable Populations 4 Medical Profession Pursued 5 4. Personal Opinion 7 5. Basics of Research 8 Informed Consent 8 Individual Autonomy 9 Beneficence 9 6. Current Policies 11 Policies 11 Exceptions 11 7. Problems with Waving Consent 13 Flexibility 13 Vulnerable Populations 13 Ethical Dilemmas 14 8. Conclusion 16 Chapter 1 Tuskegee Syphilis Study Throughout the years, numerous research studies have taken place. In the United States, on a daily basis thousands of research studies are being conducted. Some of these studies will greatly influence science, while others will make little impact. Historically, some studies have been remembered not for the results, but for ethical dilemmas surrounding the study. The Tuskegee syphilis study is a prime example of a study which made many people aware of the ethical problems surrounding research. The Tuskegee syphilis study made the government begin to analyze how research was performed in the country, and the study opened many eyes to what changes needed to be made. Analyzing the Tuskegee syphilis study allows for one to understand what went wrong with the study and how this study lead to great changes in the world...
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...medical knowledge concerning the patient, or to worry more about the financial conditions that are of great concern with the clinic that she is employed by. There will be an analysis of this ethical decision making process to determine what is the best course of action to take concerning this patient with the facts presented. There will be a discussion of the seven ethical principles of nursing in general. There are seven ethical principles in nursing that we will discuss. The seven principles are autonomy, justice, fidelity, beneficence, veracity, nonmaleficence and paternalism. The ethical principle of autonomy is based on the assertion that individuals have the right to determine their own actions and the freedom to make their own decisions (Chitty & Black, 2007, p. 119). Patients make autonomous decisions based on their value’s, the information concerning the issue at the time without undue influence or pressure and time to reason and deliberate on the issue at hand. Autonomy is becoming increasingly important in nursing and health care but there are still instances where it is very difficult to near impossible for the patient to be autonomous. Some examples of this problem are when a patient is unconscious, mentally incompetent and children (Chitty & Black, 2007, p. 119). Every effort should be made to let the competent patient decide their own course of actions if all the elements of facts and consequences have been made available to the patient. The ethical principle of...
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...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 and argued that the central question of the Terri Schiavo case is a struggle between sanctity...
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...The principle of autonomy is the capacity to have the say-so about your own well-being, “the capacity to act on your decisions freely and independently,” (Bueauchamp & Childress 2008). The principle of autonomy holds that a patient has the right to make his or her own decision regarding treatment — including the right to refuse treatment — without being coerced by medical staff or family members. The principle of autonomy does not guarantee a person the right to do harm to oneself, due to the fact that even though the individual has the rational choice to make decisions in the best interest of his or her well-being, doing something harmful to oneself is not in the interest of the individual's well-being, and this harmful act tends to affect others in a negative fashion. An example of this concept, would be an individual severely lacerating his or her face with a razor, this situation will cause a great deal of money to have to be spent in relation to their medical treatment, even if it is spent by their health insurance company, due to the fact that the premiums of other individuals will go up due to excessive usage of insurance coverage. In addition, family members will also tend to suffer emotionally from an individual's self-mutilating actions. Time, effort, and medical supplies, will be used by healthcare professionals in response to this harmful act as well, so a harmful act to oneself, is also harmful to society at large. It is quite clear that an individual has no right...
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...ethical principles beneficence and non-maleficence are strengthened by state nursing practice acts, which mandate that nurses are legally obligated to safeguard patients and the profession (Bjarnason &ump; LaSala, 2011). Furthermore, it is with great purpose that we discuss the two principles beneficence and non-maleficence and their importance to the nursing profession. The principle of beneficence is concerned with a moral obligation to act for the benefits of others (Kennedy, 2004). Additionally, beneficence is the principle consisting of deeds such as mercy, kindness, and charity (Rich, 2008). There are other forms of beneficence including altruism, love, and humanity (Beauchamp &ump; Childress, 2009). We use beneficence in order to cover beneficent actions more broadly, so that it includes all forms of action to benefit other persons (Beauchamp &ump; Childress, 2009). Overall, beneficence implies that an individual takes action to do good by benefiting others and facilitating their well-being. Beneficence also requires that benefits are balanced against risks and costs (Kennedy, 2004). In order for a person to “do good”, they must also consider the values of individual in question (Bjarnason &ump; LaSala, 2011). Health care professionals have a duty to exercise beneficence towards their patients. Nurses have a more stringent obligation to act...
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...and show how they relate to the guidelines set by Nursing and Midwifery Council (NMC). It will also highlight on the relevant underlying legal or ethical principles that applies to the case study and its implications. For instance, ethical principles, such as beneficence, non-maleficence, autonomy, justice, human rights and the best interests of the patient will be explored, in the light of relevant laws, in order to show some of the legal and ethical complexities within this case study, and finally draw a conclusion. For confidentiality purposes, have been changed in accordance to the NMC guidelines. The main professional issue reflected in this case study is the issue of consent. Consent, means to give permission for something to take place or to agree to do something (oxford dictionary 1998). This does not necessitate that, the actions approved have been developed or permission given in the knowledge of possible consequences known as informed consent has been achieved. This goes to show that, for medical purposes, although the patient has the right to refuse treatment, he has to also have the requisite mental capacity (Dimond 2008). This case study brings out a clash between Mr. A’s autonomy and the nurses professional duty of care. Clearly, it is essential for the nurses in charge of Mr. A to take all reasonable precautions to ensure that he has appropriate counselling and all the necessary information in making the decision to undertake his treatment (Dimond 2008). The...
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...includes, respect for autonomy, beneficence, non-maleficence, and justice. Although not one principle has more importance than the next, the topic of autonomy was a main concern discussed through a range of topics from articles about organ transplants, surrogacy, abortion,...
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