Ethics fall within the purview of morality and as humans people must have personal perspectives on what is right and wrong. In different professions, ethics are the foundation for best practice. Values are critical to ethics codes in a given field. The healthcare system operates similarly under a set of ethical codes that guides the relationship between health service providers and users. Litigations are becoming common because of the increased knowledge by consumers of healthcare services. Those in the healthcare team have to balance their obligations to the government, hospital managements, and patients. The decisions they make often extend beyond a patient’s clinical condition. My five-point ethical statement will be:
A). Always communicate the truth to patient and family. B). Uphold patient’s wish or decision after providing complete information. C). I have to do my best to avoid any mental, physical, or physiological harm to patients. D). I have to give the same care to everyone without discrimination. E). I have to ensure the best medicines, devices, and the most reliable information is granted to patients for their health outcome.
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The pillars of medical or healthcare ethics, autonomy, beneficence, non-maleficence formed the supporting frame of my ethical statement. Patients are different because of the backgrounds. It becomes necessary for a practitioner to set boundaries that are morally sound as well as ethically acceptable. Consent is a very significant element in medical ethics. And one holds it that as much as it is the health practitioner's obligation to treat a patient; the life is the patient's. They have the right to determine the final course of their life. However, this is after the necessary and full information is disclosed. Hebert (1995), states that no procedure should be undertaken "unless the patient has consented to it" (p.84). This statement is rightly put, and where the patient is incapable family members should do so. The bottom line, tell the truth and get consent.
Ethical Story
As a member of the medical staff, some clinical and hospital encounters place someone in an ethical dilemma. These situations are usually tough to navigate through them. Chally and Loric (1998) wrote that ethical dilemma is "a moral problem involving two or more mutually exclusive, morally correct actions" (p.17). The fact that these situations are morally right reinforces the challenge in decision-making. Sometimes, even the best minds find it difficult.
My story is about a family in which the husband and father had a late colon cancer diagnosis. The cancer in his colon has metastasized and has affected several organs impairing normal function.Upon admission, he began refusing medication. He opted for alternative medicine that is not provided by the medical facility. While undertaking rounds, I discovered that he had hidden his drugs somewhere in a drawer. When I engage him in a conversation, I found out why he does not want the medication. He wants to die, and suicide was an option. He had refused chemotherapy but was convinced to accept radiotherapy. Still, he found radiation as something forced upon him. He confided in me about the choices he had to make while receiving treatment.
He asked me not to tell his family and anyone else visiting him. During my conversation with him, he asked if he can be assisted to die. This choice was due to the prognosis of his condition. I was compassionate and reassuring but felt torn between keeping what he asked me to do and bringing my ethical codes into perspective. This information is crucial to the hospital management, the oncologist, physician, and his family. The decision that I will make will have far reaching implications. And whether I was prepared for the outcome was very significant.
I went against his wish and told the hospital management. They brought in a psychotherapist after informing him that he will need someone to talk to in the absence of other activities that hemay be prepared to try while under treatment. While the psychotherapy was ongoing, he was placed in an environment that kept him from committing suicide. After a few months, he was discharged from the hospital, taken home by family and friends. The news I got was that he passed away peacefully without committing suicide.
The background of the moral or ethical statement is from such experiences. These five points are now the focal areas that one will begin to follow. As at when this incidence took place, the truth was communicated to the family about the wishes of their father and husband. Also, I had to do my best to avoid causing harm to either the family or the patient. My primary concern was the patient and his understanding of dying. I had to stick to the best, and available information for the patient, part of it was that he does not have to die by assisted dying or suicide. It was a tough decision to make, but he had to for the sake of his family.
The lectures have broadened my perspective on ethics and the application in a healthcare system. As one engages each day with patients, the ethical practice needs to guide one's conduct. Patients should also have their wishes met as part of the treatment process.
References
Chally, D. S.,&Loric, L. (1998). Ethics in the trenches: decision-making in practice. Am J Nurs , Volume 98, Issue 6 , pp.17-20.
Hebert, P. C. (1995). Doing right: A practical guide to ethics for medical trainees and physicians.Oxford University Press.
