Health Care Ethics Free Essay
A) While ethics and religion are intertwined in various moral and ethical interpretations; the composition of the hospitals ethical committee does not require the participation of religious leaders. Inviting Father Cuiatkowski and Rabbi Berstein to lead the committee would affect the committee’s duty as an ethical committee. Religious leaders would try to put into effect their religious convictions and practices as the basis for ethical standards and practices. The invitation for religious leaders as the hospital’s ethical committee leaders creates room for the development of ethical unfairness in hospital practices.
Ethical decision making processes would significantly rely on religious morality, beliefs and teachings; as a result, critical professional ethics based on natural reasoning would be in conflict with faith-based ethics. However, different religious beliefs can be represented in the ethical committee in a contributing capacity but not in a capacity to influence the nature and extent of ethical decision making within the hospital. In light of this, Father Cuiatkowski and Rabbi Berstein should not lead the ethical committee; however, they can be appointed as members of the committee. Their function would be to support and help in ethical decision making. However, they should not be allowed to influence decision making processes since not all people share similar religious convictions and beliefs.
B) Presence of legal representation in the hospital’s ethical committee is important; it ensures that the hospital does not take part in practices that may lead to legal liability. Legal representation is critical in ensuring that the hospital does not enforce policies, procedures or practices that are against the law. However, the presence of legal representation in the ethics committee should not be seen as a basis for leaving standard ethical decision making processes. Therefore, the presence of legal representation in the ethics committee should be in an advising capacity but not as a basis for making an ethical decision.
This is because of the existing difference between the Legal practice and ethical practice. Though the identification of moral or ethical duty with a legal duty is necessary, important differences arise in the identification of legal and ethical practices. As such, laws are not necessarily clear on an ethical view point and a moral act may involve an illegal act; hence it is also possible to act unethically while following the law. In light of these, the presence of legal representation is important in the identification of likely ethical practices that may involve legal liability. However, legal representation should not be used as a reason for abandoning professional ethics in preference of legal considerations.
C) Institutional Ethics Committees (IEC) are important in the development of ethical standards and decision making processes. A hospital that depends on its staff to make individual decisions as far as ethical and professional conducts is concerned is open to malpractice suits. In the absence of institutional safeguards and control measures such as institutional ethical committees, employees are left to make ethical decisions that may affect the hospital. Significantly, the absence of an ethical body creates room for unethical practices and personal judgments that affect the entire hospital.
An IEC ensures that employees act in the right way and in agreement with their professional ethical standards. IEC enables the making and implementation of decisions that include the patient’s well-being, applies professional conduct and safeguards the hospital’s integrity. The decision not to create an Institutional Ethical Committee is wrong and makes the hospital exposed to various legal and ethical liabilities. Though employees are required to behave in a professional and accountable manner, such conduct may not mean ethical practice.
Therefore, the rate of unethical practices and decision making processes will increase. Ethics committees act as oversight functions that ensure employees act in an ethical and professional manner. Thus, challenging ethical decisions are not left to individuals but are made collectively by the ethics committee. This ensures that all scenarios and possible outcomes are evaluated before a decision can be made; hence a decision that is in the patient’s best interest is made with a view of ethical and legal requirements.
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In the course of regular duty, professional skills and competence plays an important part in demonstrating stating ethical conduct. Therefore, Amy Z is presented as an effective and skilled smoking cessation therapist to her patients. However, she does not extend the same level of professionalism to her colleagues. The fact that she does not indulge in smoking prior to conducting smoking cessation classes illustrates Amy as a professional individual. However, her ethical decision making only extends to her patients; therefore, she is merely fulfilling her role as a smoking cessation therapist. The assumption that in performing her professional role as a smoking cessation therapist requires fulfilling both her professional duty and ethical conduct is wrong. In order for her to act in an ethical manner, Amy should extend the same courtesy of not smoking in front of her patients to other members of staff both smokers and non-smokers.
Smoking has various health consequences on people; therefore, while Amy observes professional conduct in the presence of her patients, she ignores the fact that though other staff members are smokers; they face similar problems to those of the patients she is treating. Therefore, smoking in their presence is careless and unethical since it encourages the other members of staff to smoke, an aspect her profession seeks to eliminate.
Smoking may affect staff smokers’ health by causing serious diseases such as lung cancer. Therefore, Amy should not make assumptions that other members of staff are not vulnerable to similar issues presented by her patients. Though the staff members are not patients, they should be given similar courtesy and treatment. Since, Amy smokes in the presence of other staff smokers or elsewhere in her own time; she shows a degree of ethical behavior in the fact that she does not practice smoking in the presence of non-smokers.
However, given her professional capacity and role as a smoking cessation therapist, her personal conduct contradicts her professional conduct. Professional roles are among the means within which professionals such as Amy are adapted into their professions. However, the accomplishment of professional roles should not be the basis within which Amy measures her ethical decision making and conduct. Consequently, Amy should use her conduct in the process of fulfilling her role as a smoking cessation therapist to adapt her work ethic into non-work environments.
Amy’s conduct in the presence of her patients and colleagues shows conflicting personal and professional ethics. Though the pre-existing relationship between Amy and other members of staff is professional, she does not act as smoking cessation therapist in their presence as shown by her smoking behavior. Her behavior and attitude before and during the smoking cessation therapy represents dishonest values intended to hide her smoking problem.
The fact that her professional role conflicts with her personal conduct is evident in that she is an effective smoking cessation therapist to her patients yet, she does not apply the same principles in her personal conduct. Her personal conduct may be justified on the basis that it does not reflect or impact her professional conduct. Yet, it is essential that personal and professional ethics be intertwined. Consequently, the separation of professional and personal ethics has made Amy present a dishonest self-image in the presence of her patients which hides her underlying problem. Her self-restraint from smoking before her cessation therapy sessions is aimed at presenting the image of a non-smoker offering therapeutic smoking cessation services to a smoker.
In order for patients to trust and believe in her work, they are presented with the image of a non-smoking therapist. Therefore, her services are based on dishonesty, which is morally wrong but aimed a fulfilling her professional role. Since professional ethics involve a person’s conduct in a professional role or capacity; it differs slightly to personal ethics since it involves a person’s conduct in his/her daily routines. Therefore, personal conduct is significantly influenced through strengthening of professional conduct. Professional and personal ethics should not be separated where a person applies a clear set of ethical standards in the work environment and another set in a personal environment. As such, integration of both professional and personal ethics is necessary in the development of intertwined set of principles and ethics that are widely applicable.
Substance abuse counselors have the opportunity to change people’s lives. However, they should employ professional methods in performing their duties. Substance abuse counselors may choose to use alternative methods aimed at preserving and strengthening the integrity of the recovering alcoholics. Even so, they should not assume all recovering alcoholics are open to the same set of alternative treatment practices. This aspect is represented in James religious convictions as a committed evangelical Christian. The 12 step approach modeled on alcoholic anonymous is made to serve the diverse social and religious beliefs of the participants.
Though religious claims and convictions are thought to be morally upright, James must recognize that being a committed evangelical Christian does not mean that everyone in the recovering program has the same religious beliefs. Therefore, James should consider the diverse religious views of his patients in spite of his need to witness to his faith. James may present his religious convictions; however, he should not use his convictions as a basis within which the recovery process should be established. Religious convictions are often differing and conflicting; therefore, while James may argue his convictions as an evangelical Christian offer sound ethical basis; other participants may have different religious convictions of their own.
In light of this, it is impossible to determine the right religion whose morals are widely acceptable by all and applicable in the 12 step approach alcoholic anonymous recovery process. James should not use the recovery process as an opportunity for converting recovering alcoholics to evangelical Christianity. He should appreciate that the recovering alcoholics have religious diversity; therefore, his religious convictions should only be used to strengthen ethical decision making. In such a situation, the diverse religious convictions of all participants must be recognized; therefore, James should only use his religious convictions as a support to natural reasoning. This ensures that ethical principles and decision making processes that do not involve religious convictions are included in the process. Significantly, the strengthening of natural reason as a basis of ethical considerations ascertains ethics are not unfair towards any religion or philosophical notion.
Step I: Problem Identification
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The identification of the issue is important for Alisha to take the proper steps. As such, an accurate representation of facts that are necessary is required. In this case, the problem presents in that in spite of Alisha’s requests to Mrs. P that no marijuana is used during her visits; no action has been taken. The fact that Mr. P’s son David is found smoking marijuana with his friends is evidence of an existing problem. The fact that the use of marijuana in the house has an effect on Mr. P’s health is a issue that cannot be ignored; therefore, as a caregiver Alisha must take the necessary precautions to protect Mr. P’s health. This is because she has a primary ethical duty and obligation to preserve, improve and protect his health before any other factors.
Step II: Value Identification
Alisha should identify the applicable values that will be impacted by any ethical decision that she makes. Alisha must determine how she will identify and select her values. She must consider her values as a professional home care nurse, her desire to improve Mr. P’s health, her personal trust in Mrs. P to eliminate the use of marijuana in the House, her personal health and well-being and responsibility as a law abiding citizen to report the use of illegal substances. Additionally, Alisha must consider the values concerning those who will be affected by her decision. As such, Alisha must determine which values are more important; preserving Mr. P’s health or her own well-being, reporting David to the authorities or allowing him to continue helping in taking care of Mr. P in spite of his drug problem. The identification of the most important value is necessary; however, all things considered, Alisha’s responsibility towards her patient must be a priority.
Step III: Option Identification
Once the problem and values have been identified, Alisha must identify the viable options available to her. The evaluation of the possible options should not weaken her ability to perform her professional duty. However, the optimal option is necessary to preserve her professional integrity and the integrity of her patient’s health. Alisha could report, David to the authorities, she could request to be reassigned to another case; she could encourage David to join a drug rehabilitation center, or she could do nothing for the time being, monitor the situation to see if things will improve and intervene later. The option that Alisha identifies as the most practical and ideal must seek to improve Mr. P’s health condition.
Step IV: Consequence Identification
Every action taken has consequences which may be positive or negative. Alisha must be aware that any decision and action taken will have consequences; therefore, she should identify the possible consequences of the decisions made. For instance, if, she chooses to report David to the authorities, he may be arrested; as a result, he will no longer be in a position to help Mrs. P in taking care of the sick Mr. P. If she does nothing, the problem might worsen leading to more frequent use of marijuana in the house which will consequently affect Mr. P’s health. If she asks to be reassigned, Mr. P may not have the same level of care and the progress made so far might be affected making his condition worsen even further. The decision that Alisha makes will have consequences which will most likely impact Mr. P’s health; therefore, her decision making must consider the outcomes of such decisions as far as Mr. P’s health is concerned.
Step V: Option Selection
After considering the effects of every option available to her, Alisha must select that option that does not damage the most important values. Therefore, the option selected must have the best possible outcome and consequences. In Alisha’s case, the best option would be to convince David to join in a drug abuse rehabilitation program; hence eliminating the drug problem while preserving the integrity of Mr. P’s health. However, if David is not convinced to take a step that will improve his father’s well-being and his own drug abuse problem; then the next best viable option is taken. In this case, David is reported to the authorities.
Step VI: Documentation
The development of a narrative describing all the steps and contributing factors that led Alisha to make a decision or choice in every step is documented. This shows her explanations and qualifications of every decision that was made. Alisha’s decisions and actions may not be well accepted or understood by some individuals such as David or his mother. However, her ethical decision making process has been directed towards preserving and improving Mr. P’s health condition. Any other authority or institution will agree that her ethical decision making aimed at preserving the integrity of her patient, in this case Mr. P. Meanwhile, the extent within which her decision making process is accepted and approved by relevant authorities will significantly depend on the efforts and carefulness of every step taken.