Discuss about the Chronic Stomach Pain of Sam.
Definition of health as outlined by WHO is not just the absence of disease or infirmity, but a state of complete physical, mental and social well-being. In the given case study, a patient named Sam aged 21 years admitted in hospital in an emergency was suffering from chronic stomach pain. Camila health care professional realized that the medical team is handling the patient inhumanly and the patient situation was deteriorating. Her balanced discussion with the other medical staff is an appropriate approach following all the protocols established by the hospital. In this case study, we will discuss this scenario within the realm of law, ethics and principle which have been given by Philosopher in the past like Hippocrates, and other international body like UN and UNESCO and UDHR and Bioethics which is the further extension of Human Right in medical field. Promotion of Human Rights is the core principle of UN charter. To promote this all over the world several guidelines have been issued through various bodies like WHO, UNESCO and implementation with the help of a treaty like the Geneva Convention binding upon member countries and evaluating law and ethics time to time. To deal with bio-ethical issues at a global level effectively and practically, international bio law combines human dignity and human rights. Universal Declaration on Bioethics and Human Rights by UNis a legal document. The Broad meaning of bioethics is biomedical Ethics (Chonko, 2012).
The ethical issue found in the case study is that the inner city hospital is not taking their patients seriously, even after knowing that their situation is getting worse and they decided to place them to the physical restraints rather than giving some time to the patient. The Camilla, no doubt, found that Sam is getting aggressive and make use of the abusive language to her in frustration and aggression. Camilla still shows concern, but after discussing this problem with one of the nurse Julia, she came to know that, they are not treating the Sam seriously because of the lack of staff and time. This is against the ethics of the healthcare profession, not giving attention to the patients just because of their own organizational structure problems (Kaci, 2014).
Coming to the principles of the health care principles, then it includes the principles of the Nonmaleficense, Autonomy, Justice and Beneficence. All these principles are important to follow for the reflective equilibrium in the health care organizations (Ashcroft, Dawson, & Draper, 2007). The inner city also needs to follow these principles in order to handle the situation and to maintain the equilibrium in the organization. Talking about the non-maleficence principle, according to this, the hospital should handle the situation without causing any harm to the Sam. Autonomy is the principle that relates to the rights of the patient to take the treatment or refuse to get treated. Moving further, Justice is the principle of the health care ethics which is discussed in the terms of the public health and safety and health equity (Bhanji, 2003). Moreover, the beneficence refers to the duty of the Inner hospital to give benefits to the Sam by treating him in an accurate and effective way. Therefore, the efficiency of the healthcare professionals can be improved by focusing on the resources as the health care is facing the problems because of the lack of these resources (Gillon, 2006). As above discussed about the principles of the ethics, the inner city should take into consideration all these principles to handle the situation in the organization and for the smooth working of the hospital. Autonomy is based on the human capacity to direct his life, Mill’s Harm Principle support moral right of a patient to refuse medical treatment and doctor cannot perform a medical procedure against patient will. However, all these principles in some way are applicable to the current situation or circumstances.
The ethical perspective in this report is highly dependent on the behavior of the staff of the inner hospital and the patient. The Sam behavior, no doubt, was very aggressive and his behavior may affect the safety of the staff. Camilla was unable to identify the condition of the Sam because of his aggressive behavior. The medical team , hereby, decided to apply the physical restraints which can harm the mental health of the patient and also without the consent of the patient and parents. The ethical idea is that the medical team should calm down the patient and instead of giving him physical restraints , the medical team should give him the injection of sleeping and continue to carry out the further tests. Moreover, instead of physical restraints, Sam should be put under the proper supervision and care in the separate room for the safety of the nurses and the other patients (Schröder-Bäck, Duncan, Sherlaw, Brall, & Czabanowska, 2014).
The alternative perspective is the clinical perspective as the medical team of the inner city hospital need to hire more skilled and experienced staff in order to handle these kind of the situations in the health care organizations. To treat Sam, the hospital should follow a patient-centered approach and improve the patient’s well-being, functionality, and quality of life. Sam was suffering from chronic pain and due to a history of drug abuse which leads to anxiety, depression, or somatization disorders. Physical restrains step decided by the hospital will make his condition worse rather than this, hospital should adopt pain management plan and train medical personnel related to this so that they may handle Sam like patient effectively (Campbell, Potash, & Botash, 2010). In the management and treatment of pain with the help of education and individual clinical experience and competency CRNA (Certified Registered Nurse Anaesthetist) can be utilized in a variety of therapeutic, physiological, pharmacological, and psychological modalities.
The hospital needs to respect and protect Sam’s Human Dignity and Human Rights, to avoid discrimination and breach of confidentiality and to take consent and maintain physical integrity to protect people from misuse in the biomedical field. The hospital is bound by the 1948 UN declaration of the UDHR which states that all people are “free and equal in dignity and rights”. The hospital is also bound by the 1964 Helsinki Declaration, which clearly underlines the basic principle with respect to Dignity and Human Rights outlined first time for the welfare and interest of any individual that should have priority over the sole interest of science or society (Moka-Mubelo, 2016).
As per UDHR dignity is inherent to all human beings, as all human beings are born with free equal rights. This international humanitarian law equally applies to the field of Biomedicine as explained below:
Respect for the dignity of the person: This principle came from the Universal Declaration of Human Rights by United Nations in the year 1948 in which state that the basis for freedom, justice and peace is founded on the recognition of the inherent dignity and equality of human beings (Targum, 2001).
Professional responsibility and accountability: This principle includes professional responsibility and accountability, personal and professional integrity, and advocacy. It also refers to professional boundaries, insurance and conscientious objection.
Quality of practice: This includes safety, competence, kindness, compassion, caring and protection from harm.The health professionals must be competent, safety-conscious and who act with kindness and compassion, provide safe, high-quality care. Moreover, the health care environment should be safe for themselves, their patients and their colleagues (AANA, 2017).
Trust and confidentiality: This includes trust, confidentiality and honesty.The health care professional exercise professional judgment and responsibility in circumstances where a patient’s confidential information must be shared.
Collaboration with others: This principle focuses on collaboration, team-working, communication and documentation. It is clear that the relationships with colleagues are based on mutual respect and trust. However, health care professional understands that effective and consistent documentation is an integral part of their practice (Gabr, 2015).
In this unit I have learnt the following health care ethics as shown in the diagram below. In this unit I have understood the theories which explain about decision makers who provide appropriate resolution within the realm of medical ethics. In this theory, people should stick to their obligations and duties during decision making procedure. These theories explain how a decision maker takes the decision and give correct resolution according to the guidelines in ethical dilemma. These theories are divided into four categories (Summers, 2011).
Accoding to the theory of Dentology, a person should always keep his promises and follows the law. People who follow this theory will produce consistent decisions as they are based on the individual’s set duties.Along with many positive attributes, it also contains flaws. There is no logical or rational basis for deciding an individual’s duties.For example, a businessperson thinks to be his duty to be on time in every meeting, one day he is getting late, over speed will break the law and not to do this will not be able to full fill his duty. This is a question that to full fill duty, whether one should break the law or to keep the law one forgets about duty (Gamlund, 2012).
According to Bioethics, patient should not suffer by any means. This is the first duty of any health care provider. As seen from the given case study, Camilla with her compassion and love was able to understand her patient better and discussed the issue with the other medical staff present at that time. At the same time, she knew about the underlying dangers, however, following the highest medical ethics and established protocols she was able to provide the best care to Sam. Therefore, working towards the goal of improving patient outcome, I will recommend all health care providers to follow the following professional practices:
I will like to end by suggesting that every health care provider handling patients directly or indirectly are bound by Bioethics. We more often come across persons like Julia, who is completely unaware of these guidelines. With continuous Trainings, Monitoring the Evaluation, we can ensure that dignities of patients are maintained in each case. According to bioethics patient should not suffer by any means. This is the first duty of medical personnel reforms. Essence of the law is love, law without love is empty and love without law is directions so we have to follow ethics and protocol to perform our duty. Here law and Ethics were given by many Philosopher in the past and every professional love to perform his duty perfectly fine and on time. Camila in this case study with love and compassionate heart was worried about her patient Sam, and she discussed this matter with other medical staff and health professional who were present at that time she followed all the ethics protocol, which has been established by the hospital by providing the best care to Sam along with respecting other health professional boundaries under which they were working. I would like to suggest that every health professional who is handling patient directly or indirectly are bound to Bioethics but they are not aware so proper guideline and training regarding patient rights and Ethics and hospital protocol must be given time to time so that the dignity of the patient should be maintained in every case.The basic purpose of this law is with the principle of justice, human relationship should be governed.
References
AANA. (2017). Chronic Pain Management Guidelines . Retrieved from https://www.aana.com/resources2/professionalpractice/Pages/Chronic-Pain-Management-Guidelines.aspx
Andorno, R. (2009). Human dignity and human rights as a common ground for a global bioethics. PMC journal, 34(3), 223-40. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19386998
Ashcroft, R., Dawson, A., & Draper, H. (2007, June). Principles of Health Care Ethics, Second Edition. Retrieved from https://onlinelibrary.wiley.com/book/10.1002/9780470510544
Bhanji, S. (2003). Health Care Ethics. Journal of Clinical Research Bioethics, 4(1), 1-2. Retrieved from https://www.omicsonline.org/health-care-ethics-2155-9627.1000142.pdf
Campbell, A., Potash, J., & Botash, A. (2010). Case Study: Legal, Ethical, and Clinical Perspectives on the Health Care Professional’s Response to Child Sexual Abuse. Retrieved from https://www.upstate.edu/bioinbrief/articles/2010/2010-04-case-study-child-abuse.php
Chonko, L. (2012). Ethical Theories. Retrieved from https://www.dsef.org/wp-content/uploads/2012/07/EthicalTheories.pdf
Gabr, M. (2015). Health ethics, equity and human dignity. Retrieved from https://www.humiliationstudies.org/documents/GabrHealthEthics.pdf
Gamlund, E. (2012). Ethical theory. University of Bergen. Retrieved from https://www.uio.no/studier/emner/matnat/ifi/MNSES9100/v14/lectures/mnses-ethical-theory-gamlund.pdf
Gillon, R. (2006). Medical ethics: four principles plus attention to scope. Retrieved from https://www.ht.lu.se/media/utbildning/dokument/kurser/FPRB01/20132/gillon.pdf
Kaci, Y. (2014). Universal declaration of human rights. Retrieved from https://www.un.org/en/udhrbook/pdf/udhr_booklet_en_web.pdf
Moka-Mubelo, W. (2016). Human Rights and Human Dignity. pp. 89-125. Retrieved from https://rd.springer.com/chapter/10.1007%2F978-3-319-49496-8_4
Schröder-Bäck, P., Duncan, P., Sherlaw, W., Brall, C., & Czabanowska, K. (2014). Teaching seven principles for public health ethics: towards a curriculum for a short course on ethics in public health programmes. Retrieved from https://bmcmedethics.biomedcentral.com/articles/10.1186/1472-6939-15-73
Summers, J. (2011). Principles of healthcare ethics. Retrieved from https://samples.jbpub.com/9781449665357/Chapter2.pdf
Targum, S. (2001). Treating Psychotic Symptoms in Elderly Patients. PMC journal, 3(4), 156–163. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181181/
University, S. J. (2017). How the Four Principles of Health Care Ethics Improve Patient Care. Retrieved from https://online.sju.edu/graduate/masters-health-administration/resources/articles/four-principles-of-health-care-ethics-improve-patient-care
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