Ethical Aspects of a Health Care Industry Managerial Practice - Essay Example

Ethical Aspects of a Health Care Industry Managerial Practice al Affiliation: Ethical Aspects of a Health Care Industry Managerial Practice Abstract The paper begins with an introduction of the practice of medical ethics across the world. The essay presents a summary of the case study and the ethical dilemma facing the physician. Further, the paper outlines the possible recommendations to addressing the ethical dilemma. The easy concludes with a review of the case and application alternatives for the physician. Introduction Over the years, medical ethics in health care theory and practice has raised concerns in the managerial practice of the industry. Different medical professionals have different interpretations of ethics in practice. This paper intends to analyze case study one ‘End-of-Life Decision-making’ by Elizabeth Menkin. In addition, the essay outlines the physician’s ethical dilemma and best practices in similar situations. Case Summary The case presents the story of Mrs. Doe who suffers from severe dementia. She has lived within the confines of a nursing home for advanced dementia treatment for half a decade. During the previous year, the caregivers have had to spoon-feed her and it takes more time to finish her meals. The patient does not have any recognized family or written wishes concerning her health care conditions. She is unable to walk around or follow simple commands for the last two years. Mrs. Doe has not been able to speak in the recent months. The main diet is reduced to puree of thick liquids due to incidences of coughing and choking. She prefers some soft foods while she dismisses the rest. In the same year, Mrs. Doe has been admitted to hospital wards twice due to pneumonia. However, she has recovered fully without requiring ICU treatment. Mrs. Doe has to use a feeding tube while in the hospital as she is gradually losing weight due to poor feeding habits. However, the patient is still in the ICU under the ventilator with and wrist binding to the frame of the bed. Mrs. Doe’s health deteriorates during one of the weekends. She develops a fever accompanied by strained breathing. The staffs call for emergency response teams and deliver her to the hospital. The physician consults in the emergency room receive her and forward the patient into an intensive care unit. The patient is put under a ventilator and incubated. She breathes better after days of antibiotics and extended suctioning. However, require restraints to prevent her from removing the breathing tube. She also needs sedatives to calm her aggressive nature. The principle does not permit hospital staff to continue restraining her arms and protect the tubes. The other dilemma is whether the nursing home is equipped to induce IV antibiotics. A nursing home may not accept Mrs. Doe in case her stay in hospital surpasses the sevens bed hold. Thus, it will be important to establish the probability of her contracting pneumonia in the future. The ethical dilemmas facing the ICU physician include making informed decisions to suit the interests of the patient. The physician worries if Mrs. Doe is ‘full code’ or the hospital staff has an opportunity to do more. A perfect example of situation where informed decisions are made includes the consideration of resuscitating her if she encounters cardiac arrest. Case Analysis and Recommendations The medical practitioner has to embrace the obligation of compassionate listening. An analysis of past patient outcomes needs consistent recognition of acceptable ethical practices. Medical ethics involve an acknowledgement of prohibitions against participation in various forms of assisted suicide (Keir, Wise & Krebs, 2007). Critics mention that the approach does not lower the distress of medical personnel after participating in such an action. The illustration means that Mrs. Doe’s issues and preference for assisted suicide require collective exploration with respective patients. The appropriate contribution of family members can be sought, where applicable (Seale, 2009). The physician has to listen to the divergent views to acknowledge any issues of sadness, suffering, and hopelessness. All factors that contribute to the validation of the assisted suicide have to be alleviated through existing patient resources. The physician can exploit Mrs. Doe’s strengths to promote sustainability and reliability. The hospital staff has to identify and seek alternatives and opportunities to demonstrate long lasting commitment to the professional practice. The patient and other stakeholders hold such a provision with value. Efforts have to be centered on the advanced dementia treatment of Mrs. Doe based on palliative care (Sugarman & Sulmasy, 2010). The physician can manage her old age as well as severe bio-psycho-social distress. The move aims at lowering the pain and improving Mrs. Doe’s quality of life. On the other hand, medical professionals should use different strategies to minimize medication errors. The first beneficence principle is ensuring accurate entry of the prescription. Transcription errors such as omissions and inaccuracies amount to around 14% of the entire scope of dispensing errors. Agents such as medical physicians have to uphold professionalism and well-informed motives to achieve autonomy. Medical professionals have plenty of opportunities to create comfortable environments for their patients. Caregivers find it easy to express their thoughts, feelings, conflict, and despair. Mrs. Doe’s can address issues surrounding considerations of patient handling through collective negotiations (Butts & Rich, 2012). Lack of information among the nursing home staff is a major reason that patients appear mismanaged. The case presents crucial aspects where physicians remain morally blameworthy. The concept of restraining the patient is an accurate move to ensure quick recovery. At the same time, the medication of the patient protects her from attacking the hospital staff. Therefore, the hospital is not morally obligated to inform the nursing home even though the approach would elicit extreme complications. Such errors have the possibility of encountering reduction (Fry, Veatch & Taylor, 2010). In this case, reduction is achieved through consistencies in the use of reliable methods for verifying patient identity while making entries of the prescriptions into the computer (Hébert, 2014). The beneficence principle facilitates the prevention of medication errors resulting from sound-alike and look-alike terminologies. The physician has to confirm that such prescriptions are correct and complete. Respect for human life rapidly extends to patients, workplace colleagues, team members, and families. The main principles and provisions include autonomy and self- determination, avoiding harm through non maleficence, veracity by truth- telling, and fidelity by keeping promises. Physicians are expected to treat people fairly and understand the context of an overarching commitment to human life. People face challenge of upholding such principles in confrontation of various realities of the professional practice. Identification of conflicting ethical principles includes recognition of the relevance of beliefs to agency law. Medical professionals are in good positions to see the difference between the pain medication case and deliberate murder. The decision on whether to respect Mrs. Doe’s autonomy in a case of pain medication involves keeping her wrists tied. However, traditional goals and values of the medical profession militate on the probable outcomes of the situation. In general, the international medical framework for professional conduct and standards control all medical personnel (Cooper, 2008). The hospital staffs can double the medication to adhere to non- malfeasance principle of declining serving the patient’s best interest. The alternative involves explaining the reasons as to why tying her was necessary. Respect for autonomy also demands that individuals decline the caregiver requests. In this case, the physician can explain to the nursing home that the inserting of a feeding tube would prove extremely dangerous. Similar occurrences emanate from the autonomous agencies requiring that physicians to develop true beliefs on courses of actions. The plans organize their appreciation of ethical dilemma and professionalism (Butts & Rich, 2012). Respect to autonomy will not require physicians to comply fully with any of the nursing home’s ill-informed choices. Irrespective of the patient’s autonomy, Mrs. Doe’s good case serves her best interests. The principles of nursing patients involve insertion of feeding tubes. It does not serve as a way of ending it through autonomous motivation. A comparison can be made to the alleviation of her wrists to the bed frame medication. The nursing home may consider such advanced dementia treatment as unnecessary. Conclusion Medical professionals encounter devastating effects of life-threatening and debilitating illnesses. The irrational emotions reign over the need to be humane and compassionate in responding to others’ suffering. The physician can make a desirable ethical decision through preserving life and restrain Mrs. Doe from removing the tubes.The physicians confront the exhaustion and despair of both caregivers and patients. For Mrs. Doe, it is difficult to develop a balance between facilitating dignified death and preserving the value of life. The physician in this case can endure medical professionalism through sufficient recognition of medical ethics. The variables to consider include personal feelings of helplessness, fear, discouragement, and sadness. Best practices are realized through influencing interpersonal feelings to make ethical decision making in clinical processes. References Butts, J. B., Rich, K. (2012). Nursing Ethics: Across the Curriculum and Into Practice. New York: Jones & Bartlett Publishers Cooper, C. (2008). Extraordinary circumstances. Hoboken, NJ: John Wiley & Sons Inc. Fry, S., Veatch, R, Taylor, C. (2010). Case Studies in Nursing Ethics. New York: Jones & Bartlett Learning. Hébert, P. C. (2014). Doing Right: A Practical Guide to Ethics for Medical Trainees and Physicians. San Fransisco: OUP Canada. Inghelbrecht E., Bilsen J., Mortier F., Deliens L. (2010). The Role Of Nurses In Physician-Assisted Deaths In Belgium: Canadian Medical Association Or Its Licensors. JUNE 15, 182(9) Keir, L., Wise, B., Krebs, C. (2007). Medical Assisting: Administrative and Clinical Competencies. New York: Cengage Learning. Seale C. (2009). End-of-life decisions in the UK involving medical practitioners. Palliat Med; 23:198-204. Sugarman, J., Sulmasy, D. P. (2010). Methods in Medical Ethics. New York: Georgetown University Press, Read More