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How Ethics and Law Impact Health Care Delivery Services

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How Ethics and Law Impact Health Care Delivery Services

Introduction

Healthcare delivery entails the provision of expert care to patients and the storage of information regarding medical procedures and outcomes for reference and development. Since the delivery of healthcare services is also includes uncertainty of the outcome in certain scenarios and exchange of information, there is a need for formidable external performance evaluation and management. Lack of proper management and oversight systems for healthcare professionals, information systems and medical procedures often results in medical errors. Scholars and policymakers in the healthcare profession have formulated and implemented discordant ethics and legislation that distinguish bioethics and public health ethics. Moreover, the articulation of public health ethics also tends to focus on social justice rather than the predominance of autonomy in the literature about bioethics.

This shift in the emphasis of ethics and legislation in healthcare delivery services means that healthcare institutions accord more significance to social justice and prerogatives of patients compared to the autonomy of healthcare practitioners. As such, as ethics and laws in healthcare delivery continue to evolve public health professionals including policymakers, physicians and scholars will require a more profound discernment of the ethical challenges in the medical profession. Also, scholars and policymakers will need to continuously design useful ethical frameworks that healthcare practitioners may implement to identify and curb these ethical challenges at the workplace. Based on this understanding, the objective of this paper is to explore and analyze the ethical and moral issues that confront healthcare delivery and the impact of the ethical guidelines and laws that relate to these issues.

Literature Review-how Ethics and Law Impact Health Care Delivery Services

Several ethical and moral issues confront the healthcare industry and influence the provision of care by healthcare providers. In his attempt to distinguish between ethics and morality, Sullivan (2001) found through this study that while ethics refers to the systematic and theoretical discernment of the moral life, morality refers to the existing social conventions regarding wrong and right. Based on this understanding, the moral reasoning by healthcare providers and healthcare facilities informs the choices made and actions taken in medical practice. As such, the ethical and moral issues, as well as, legal provisions accompanying these issues in the healthcare industry can be categorized into nonmaleficence and beneficence, justice, right to self-determination and autonomy, right to knowledge and disclosure, and veracity (Muller and Ornstein, 2007).

According to Gelling (1999), the principle of beneficence reiterates the need for doing what is best for the patient and the promotion of good in general. As an ethical precept, beneficence strives to promote benefits to patients through the maximization of treatment outcome while at the same time minimizing risks. On the other hand, the ethical tenet of nonmaleficence points towards the need for healthcare providers not to inflict harm on patients negligently or intentionally (Muller and Ornstein, 2007). Nonetheless, unanticipated errors that occur at the workplace can inflict harm on patients and result in the violation of the principle of nonmaleficence. In his study, Sullivan (2001) took note of this discrepancy and clarified that the duty to promote good authorizes actions while the obligation not to harm patients prohibits actions from certain individuals. Thus, it is incredibly vital for healthcare professionals to ensure that their medical errors, should they occur, do not harm the patients.How Ethics and Law Impact Health Care Delivery Services

According to Wheat (2009), the objective of justice as an ethical precept is to ascertain how the interest of a particular patient is balanced against another patient’s interest. As such, the justice moral tenet ensures that each patient receives equal treatment and the costs and benefits of care provided by the physicians are distributed and communicated fairly. When it comes to the right to self-determination and autonomy, Henry (2005) denotes that every patient has the prerogative to hold views, make choices and take action based on his or her personal beliefs and values. Legislation regarding the ethical precept of autonomy, that is, veneration for persons, links it to discordant concepts such as voluntariness, selecting one’s own moral stance, privacy, self-mastery and accepting the responsibility of one’s decision (Gelling, 1999). As such, healthcare providers must follow laws such as  protecting the confidentiality and integrity of personalized health information, assisting patients make vital decisions regarding interventions, revering the privacy of patients, obtaining informed consent before undertaking medical procedures and respecting the choices of the patients regarding medical care and services even if they refuse the care (Henry, 2005).

Patients require adequate knowledge and disclosure to make informed decisions or judgments. Kalra, Massey, and Mulla (2005) reiterate that failure to disclose or provide comprehensive information on diagnosis, medical procedures and medical errors impairs the trust between patients and doctors, impacts the ability of the patients to make the right decisions, and causes unnecessary litigations or legal suits. On the other hand, when healthcare providers disclose all information relating to diagnosis, medical errors, and medical procedures, they create an opportunity for caregivers and patients to contribute to the overall improvement in patient-doctor fidelity and trust. In as much as there is widespread espouse for the disclosure of medical procedures, diagnoses and medical errors in various literature, Banja (2008) denotes that most studies fail to indicate the kind of information that physicians should provide to the affected patients, their families, and their caregivers. Nonetheless, the duty of the physician does not just end at the disclosure of information. They must disclose this information in an accurate, inclusive and objective manner, as well as, in a way that the patient can discern. The ethical principle of veracity reiterates and fosters the trust and fidelity between patients and doctors by ensuring that physicians provide truthful information regarding the expected outcomes of treatment procedures, associated risks and benefits, and the unexpected medical error before he or she can embark on delivering care (Banja, 2008).

Discussion-how Ethics and Law Impact Health Care Delivery Services

The concept of safeguarding patients and medical practice from unexpected medical error or malpractices can be an incredibly intricate and daunting task. Nonetheless, without ethical precepts and legislation that play an oversight role when it comes to medical procedures, the conduct of healthcare providers and the provision of care, medical errors would not only increase in health facilities but would also go unpunished. Based on this understanding, ethical guidelines and laws have various practical implications when it comes to healthcare delivery in medical institutions.

For instance, physicians usually find themselves in situations whereby promoting good and doing what is best for the patients requires them to cause harm. A good example is when a doctor has to administer an injection as part of typhoid treatment. In this scenario, the patient will experience harm when the doctor uses a syringe to inject him. In the event that there is no other treatment option that the doctor can use such as tablets or syrups, then he or she is permitted to proceed with the treatment under the assumption that the benefit the patient will obtain from the procedure will supersede the harm caused by the injection. Thus, it is the moral obligation of physicians and other healthcare providers to maximize benefits and minimize harm while according services or treatment to patients. However, in situations whereby the healthcare practitioners are found to have inflicted harm on patients due to negligence, they are liable to litigation.

Physicians ought to know that their duty of care does not provide them with the unlimited power of making decisions for their patients. They need not only to respect the privacy of patients and maintain patient-doctor confidentiality but also revere the capacity of patients and the families or caregivers to make their own decisions. Informed consent cannot be given when physicians do not follow these moral rules relating to the right to self-determination and autonomy. Thus, irrespective of the level of the patient’s injury or illness, healthcare providers must first obtain informed consent as reliable evidence that the patient understands the benefits and risks of the medical procedure.

One of the most challenging aspects of the delivery of medical care is the disclosure of medical errors. Thus, it is no surprise that most healthcare facilities are not disposed to handling the disclosure of medical errors. The fact is the occurrence of medical errors involving multiple patients can be a nightmare to health facilities since the process of resolving the issue is not only time consuming but also requires immense resources. In this regard, healthcare facilities must have institutional guidelines or policies on the disclosure of unexpected outcomes from the delivery of treatment since they are still obligated to follow ethical the ethical principle of disclosure and prerogative to knowledge. In situations whereby medical errors occur as a result of negligence, ethics, and laws in the medical profession require the healthcare providers to disclose the error, acknowledge the effect of the mistake, apologize for the error and employ amicable solutions.

Conclusion

This article has explored and outlined the ethical, moral and legal issues that impact the delivery of healthcare services. There is a consensus that healthcare providers are obligated to adhere to ethical principles such as nonmaleficence and beneficence, justice, right to self-determination and autonomy, right to knowledge and disclosure, and veracity. Violation of these ethical tenets in the medical profession and delivery of healthcare services, in general, can result in litigation. Nonetheless, there are situations whereby certain violations of these principles are permitted such as when the benefits obtained outweigh the harm inflicted on the patients. Such circumstances include whereby a treatment procedure causes harm to a patient in the form of pain, but it has to be administered to facilitate the healing process. Despite these allowances, physicians must always strive not to cause harm to patients or commit negligent medical errors as they would result in a violation of ethics and laws in healthcare delivery.

 

 

 

 

 

 

References

Banja, J. D. (2008). Problematic medical errors and their implications for disclosure. HEC Forum,20(3), 201-213. doi:10.1007/s10730-008-9072-7

Gelling, L. (1999). Ethical principles in healthcare research. Nursing Standard,13(36), 39-42. doi:10.7748/ns1999.05.13.36.39.c2607

Henry, L. L. (2005). Disclosure of medical errors: ethical considerations for the development of a facility policy and organizational culture change. Policy, Politics, & Nursing Practice,6(2), 127-134. doi:10.1177/1527154404272611

Kalra, J., Massey, K. L., & Mulla, A. (2005). Disclosure of medical error: policies and practice. Journal of the Royal Society of Medicine,98(7), 307-309. doi:10.1177/014107680509800704

Muller, D., & Ornstein, K. (2007). Perceptions of and attitudes towards medical errors among medical trainees. Medical Education,41(7), 645-652. doi:10.1111/j.1365-2923.2007.02784.x

Sullivan, M. (2001). Ethical Principles in Pain Management. Pain Medicine,1(3), 274-279. doi:10.1046/j.1526-4637.2000.00031.x

Wheat, K. (2009). Applying ethical principles in healthcare practice. British Journal of Nursing,18(17), 1062-1063. doi:10.12968/bjon.2009.18.17.44162