Discuss about theLaw and Ethics for Patient and the Healthcare.
Medical law refers to the legislations that have been put in place the guide the relationship between the patient and the healthcare providers (Herring, 2015). It has regulated the process of health intervention and stipulates the boundaries within which each of the parties are expected to work. A violation of any of the requirement can be the basis of the commencement of a civil or criminal proceedings. The laws also clearly explain the right of the patients which must be upheld at all times. These legal requirements attract a penalty for perpetrators who violate them.
Ethics are the values that are set by a professional body. Every member of the body is expected to adhere strictly to the requirements and faces risk of being deregistered if they do not comply (Fremgen, 2016). They may or may not be a requirement by the law. They may therefore not necessarily attract a legal proceeding. These are the expectations of a healthcare provider by their peers in a certain situation. The expectations may be different depending on the level of training and the experience they have. Some ethics may however contradict the laws of the land. This is usually a very confusing moment to many who are torn between the conflicting responses.
Generally, it is undeniable that these regulations set a better basis for patient healthcare provider interaction. They emphasize on upholding human dignity and human rights in the line of duty. Healthcare providers get to know how different situations will be looked at in light of the law. They can therefore make the most appropriate clinical decisions aware of the likely repercussion.
Archie has been born with Encephalomyopathic mitochondrial DNA depletion syndrome. This is a disease that has no cure. It’s rare and has a very high mortality rate according to research. A patient is advised to be taken to a palliative care to manage their pain before the end of life. Archie’s parents are advised by Mandy to enroll her to a clinical trial research but they opt to take her home. Later she becomes ill and is brought to the hospital and admitted in the neonatal intensive care unit and is under observance. The doctor advices her parents to withdraw treatment but they still feel that they should continue fighting after they talked to Mandy. The hospital management is concerned of the available bed spaces and want the doctor to convince her to withdraw treatment.
This case scenario sparks up some legal and ethical issues that need to be scrutinized. Archie is a minor and the parents can consent or refuse treatment on her behalf. The parents after advice from Mandy and the doctor on the available options, they area allowed to make their own decision immediately after her birth. Later when she gets ill, the doctor is in a dilemma. He has the responsibility to ensure autonomy in decision making. He can only advise Archie’s parents but cannot coarse them to take a particular step, though he feels would be the best for her. The management is on the doctor’s neck in an attempt to create beds for other patients. all these steps would be taken with the best of intentions but may spark some legal controversy. The end of life care and procedure is also put in the spotlight (Silvers, Rhodes & Battin, 2015). These are ethical issues and dilemma and their relation to the existing laws.
Autonomy has brought out as an important aspect of patient care. It is one of the bioethical principles that have been adopted in healthcare. According to Clement (2018), a patient should be well informed of their condition and be accorded all the necessary information necessary for them to make a decision. Archie’s parents have been informed of her condition. They have been advised to take her to a palliative clinic by the doctor, Mandy informs them of a research that she would be well suited to enroll. Although all these professionals feel that their advice would be the best for Archie, they can only provide the information and let the parents make the decision. According to Beauchamp (2016), the principle of autonomy in ethics requires that, before one consents to anything, they should be well informed and not subjected to coercion. Even though, the doctor advised them to withdraw treatment, he can only honor their decision whatsoever. Only that which they have consented to.
Withdrawal of treatment option, in end of life care, attracts both legal and ethical concerns (Dent, Harden & Hunt, 2017). According to the laws of Australia, withdrawal of treatment is one of the advanced care directives. It is stated by the patient before they are incapacitated to make decisions or by an individual given the powers of attorney to make such a request (Carter, et.al, 2016). In the case of Archie, her parents have the legal mandate to make a decision on her behalf. She does not have the consensual age hence the law confers the responsibility of decision making to her guardians. However, a doctor can make case before the Family Court to seek an intervention of the court on a decision made by the parents if they feel concerned about it. In the recent years the court has exercised its authority by conferring the power to decide on the withdrawal of treatment to the parents. The decision to continue with treatment should be honored as the law requires.
An ethical concern also arises. In this case, the doctor is supposed to suggest an intervention in the best interest of the patient they are attending to. The administrations interest of creating more space is very logical. Some patients may be denied treatment on the basis of lack of space. Once the doctor agrees to take care of a patient, they assume the duty of care for them (Thomas, Lobo & Detering, 2017). Their judgement should be in the best interest of the patient. Their proposal should be based on clinical judgments and the facts at hand. The principle of beneficence suggests that the benefits should counteract the risks therewith. The continuing of treatment for a patient should be beneficial to her. The continued therapeutic treatment was termed as futile. The medical intervention implemented brings more stress to her body. To prevent further suffering, it would be advisable to withdraw treatment.
The right to life has been provided for in the constitution (Runciman, Merry & Walton, 2017). Taking it away is prohibited. The issue of withdrawing has never been fully settled. Some are still opposed to the idea of anyone deciding that treatment is no longer a viable option. Mixed feelings have been evoked by this approach. Religious and cultural inclinations have brought about this disparity. This is an ethical issue that depends on a person’s beliefs and morality. Archie has the right to healthcare. The hospital should not deny her this right on the basis of creating more space for other patients. the hospital can only advice. she, through her parents, is the only one with the right to choose what happens to her under those circumstances.
Under the prevailing circumstances, the doctor can only honor the wish of the parents. Despite him having an opinion that the treatment is futile, he is bound by law to do as the patient wishes (Byard & Payne-James, 2015). He also has an obligation to fully inform the parents of the clinical diagnosis without withholding any information that may be necessary to consider before decision making. He has a responsibility to take care of her until their contact is terminated. A breach of the contract is unethical though it may not necessarily be unlawful. In this case, if the doctor feels that he is not going to provide any more care he may opt to be excluded. As per the ethical values, this may be treated as unprofessional. The doctor, in my idea, should maintain the relationship with the patient. He should advise them accordingly and let them make a decision without the coercion of the hospital administration.
If continued treatment is observed to cause more harm than good, the doctor can seek legal intervention from the Family Court (Wilmott et. al, 2014). According to the principle of beneficence, any intervention should have an overall beneficial effect. The court can listen to the case made and rule in the best interest of the patient. If there is no overall adverse effect resulting from treatment, he should honor the wishes of the parents.
The principle of justice should be upheld. She should not be refused treatment under any condition. Her right to treatment cannot be revoked. The right to human dignity suggests that one is accorded the right on the basis of being human. The right to treatment should be accorded as one of the components of human dignity. It’s a way to attain the highest level of dignity and wellness
Conclusion.
The ideals of medical laws and ethics guide the response of medical care providers in different dilemmas (Johnson, et. al, 2017). A balance between what is considered ethical and legal should be identified. It’s possible to confuse the two, especially when they conflict in the manner in which they address a particular issue. Both of them form an important component of medical practice. They are fashioned to ensure protection of human rights and promoting human dignity.
References.
Clement, G. (2018). Care, autonomy, and justice: Feminism and the ethic of care. Routledge.
Beauchamp, T. L. (2016). Principlism in Bioethics. In Bioethical Decision Making and Argumentation (pp. 1-16). Springer, Cham.
Dent, J., Harden, R. M., & Hunt, D. (2017). A practical guide for medical teachers. Elsevier Health Sciences.
Thomas, K., Lobo, B., & Detering, K. (Eds.). (2017). Advance care planning in end of life care. Oxford University Press.
Johnson, S., Kerridge, I., Butow, P. N., & Tattersall, M. H. (2017). Advance Care Planning: is quality end of life care really that simple? Internal medicine journal, 47(4), 390-394.
Carter, R. Z., Detering, K. M., Silvester, W., & Sutton, E. (2016). Advance care planning in Australia: what does the law say?. Australian Health Review, 40(4), 405-414.
Runciman, B., Merry, A., & Walton, M. (2017). Safety and ethics in healthcare: a guide to getting it right. CRC Press.
Willmott, L., White, B., Smith, M. K., & Wilkinson, D. J. (2014). Withholding and withdrawing life-sustaining treatment in a patient’s best interests: Australian judicial deliberations. Medical Journal of Australia, 201(9), 545-547.
Silvers, A., Rhodes, R., & Battin, M. P. (2015). Introduction. In Physician Assisted Suicide (pp. 1-8). Routledge.
Byard, R., & Payne-James, J. (2015). Encyclopedia of forensic and legal medicine. Academic Press.
Herring, J. (2015). Q&A Medical Law. Routledge.
Fremgen, B. F. (2015). Medical law and ethics. Prentice Hall.
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