Health policy, law and ethics Essay

For the purpose of this assignment I will look at the legal and ethical aspects involved in the following scenario and this will be discussed. I will take into consideration both the deontological and consequentialism theory. Laws relevant to this scenario will be looked at. Scenario To maintain confidentiality the name of the patient has been changed. The patient D is 60 years old male who had kidney cancer he had been admitted to the hospital for further treatment. On the following investigation the patient had been diagnosed with the last stages of cancer which meant it had spread into the surrounding tissue. Prognoses were poor, palliative was to be offered. The family had requested that the patient should not be informed therefore, D was not aware about his current condition. The patient could not understand why medical staff only made him comfortable and were not taking a different approach to his treatment. Consequently, he lost faith in the staff and his will to live and refused everything that was given to him. The nurses made a decision to inform him of his terminal illness, believing this to be in his best interest. He understood the situation and expressed a wish to die at home. Legal aspects The situation that the nurses faced in this scenario was uncomfortable for both the patient and the healthcare professionals. The nurses had a dilemma of legal and ethical aspects on one hand, and patient’s legal rights on other hand. In any discussion of ethical issues in medicine, legal aspects may arise. Both of them set standards of conduct, where law often shows a â€Å"kind of minimal ethical societal consensus† (Emanuel et.al. 1999, p2). The study of law expresses a process of legal thinking and applying legal doctrine to the real-life situation in the healthcare setting (Flight and Meacham 2011). A deontology comes from the Greek term â€Å"deon†, meaning â€Å"duty† (Jones and Beck 1996). White and Baldwin (2004) state, deontological is fundamental in medicine as it means â€Å"do no harm† and â€Å"act in the patients’ best interest† (p.54). Using deontology approach in this case, healthcare providers were following the rule â€Å"Act in the patients’ best interest†. The problem that occurred in this situation is that it was difficult for the healthcare professionals as from a legal point of view the  patient had a right to know the truth if he wish. The NHS Constitution (2013) states, that a patient has the right â€Å"to be involved in discussions and decisions about his the health and care, including end of life care, and they be given information to enable the patient to do this† (p.9). Healthcare professionals were acting according to the Hippocratic Oath and following a set of rules, which are established as a framework of the NHS. One of the rules states, that nurses must â€Å"safeguard and promote interests of individual patients and client† (Tingle and Cribb 2007, p.16). Medical professionals must always act in the best interest of the patient. However, difficulty may be experienced in certain situations as the borderline between legal issues and ethics is narrow. The important professional concept of nursing is accountability for their actions to deliver appropriate care for their patients. This accountability is applicable in the legal context and important professionally, it is based on knowledge and un derstanding. Therefore, legally it is closely related to negligence and duty of care (Young 1995). In this scenario the nurses felt that they were acting as an advocate for the patient by following the rules. Montgomery (1995), state that accountability, responsibility and duty of care are closely linked. Irrespective of professional standing responsibilities, healthcare staff are still accountable, with regard to duty of care within the expectation of their job (Fletcher and Buka 1999). In this case, the patient’s anxiety could have been alleviated if he had been fully informed of the severity of his medical condition. This would then enable him to understand and accept this news, and would not lead the further complications in his psychological condition. Kravitz and Melnikow (2001) suggest that patient’s participation in the decision making process about their care is necessary. Analysing this situation I felt that patient D had a lack of autonomy. A patient should be fully informed about the diagnosis, and consent should be obtained for the treatment proposed; otherwise the autonomous being would be disregarded (Fletcher et al 1995). The importance of patient autonomy came from Nuremberg Trials codes of ethics, which was established in 1948 and stated that â€Å"The voluntary consent of the human subject is absolutely essential† (Washington 1949 p.181). The autonomy of D was disregarded by his family as they believed it would not be beneficial for him to know the truth. However, D had the capacity to make autonomous  decisions, such as whether or not he wanted to receive information about his current condition. Ethical aspects The issue that medical staff came across was to respect patient’s autonomy that had been breached in the described situation. Pearson et al (2005) states that patients are individuals, they have the right to be involved in making the decision process about themselves and their future. This belief refers to patient autonomy which is defined as freedom of making decisions within their limits of competency. Being unaware of his medical condition patient D had been deprived of his autonomy. Hendrick (2004) described autonomy as the ability to think about their lives and act accordingly to a chosen set of rules. Respecting autonomy means treating a person as an individual, involving him in discussion about his planned treatment, allowing him make his own decision. This is an essential part of any document of patients’ rights. O’Connell et al (2010) states that there are some ethical principles in nursing which include two important elements such as beneficence and non -maleficence. Both of them have significant implications for nurses. Hendrick (2000) supporting this view states that, in healthcare settings beneficence appears to be a straight forward term, and means to do â€Å"good†. In this situation there had arisen a massive ethical dilemma, and to choose the right approach to do â€Å"good† was not very easy for nurses. From one side, we had the patient who was not suitable for any medical treatment, as he was terminally ill but still had the right for palliative care, hence staff had to comply with all ethical principles. One of them was beneficence, as it seemed beneficial in the beginning not to tell the patient the truth about his condition, according to his family wishes. The family believed that patient D’s unawareness of reality would help him cope with his progressive illness. However, nurses whose responsibility it was to protect the patient from psychological stress and follow another ethical principle, which is non-malefice nce. Beauchamp and Childress (2009) state that, the principle of non-maleficence dictates an obligation not to harm. Both beneficence and non-maleficence were described in the Hippocratic Oath as â€Å"I will use those dietary regimens which will benefit my patients according to my greatest ability and judgement, and I  will do no harm or injustice to them† (Greek medicine 2010). The patient D’s reaction to the atmosphere surrounding him determined the medical staff to change the original approach to his care and give him the correct information about his prognosis. Respect should be shown to the patient; a simple obligation to give him a realistic picture of his condition. The patient had a right to know the truth, as he was approaching the end of his life. He might need to discuss some questions with his family and carers in order to arrange his affairs (Nicoll 1997). Basford and Slevin (1999) state, the principles of autonomy and justice as, are vital in healthcare practice and are dominant in many arguments within medical and nursing ethics. Consequently, there is a conflict bet ween the patient’s right to know and the carers’ duty of care. Honesty is an important part of any relationship. Jeffrey (2006) suggests that â€Å"communication would become meaningless if there was no overriding moral obligation to be truthful† (p. 64). Conclusion In any ethical dilemma healthcare staff should follow the government polices according to the Code of Conduct. As they are responsible for peoples’ health and have an honour to represent the National Healthcare Service, therefore, they cannot take any situation emotionally and personally. The healthcare professionals’ attitude to clinical judgement seemed to have increased during the last decade. Considering this, healthcare staff were taking into account new views of recognition of patient rights, to make an autonomous choice. The patient D had an opportunity for choice and made a decision to die at home. The argument in this situation was that all medical professionals should be telling the truth whether or not the patient’s family agreed. In this case I believe the medical staff were acting professionally and the patient received the attention he required in time, and there were no regrets afterwards. References: Basford and Slevin (1999) Theory and practice of Nursing Cheltenham: UK Beauchamp and Childress (2009) Principles of biomedical ethics (6th edition) New York: US Emanuel L, von Gunten C and Ferris F (1999). The Education for Physicians on End-of-life Care (EPEC) curriculum: US Fletcher N, Hold J, Brazier M and Harris J (1995) Ethics, Law and nursing Manchester: UK Flight M and Meacham M (2011) Law, Liability, and Ethics for Medical Office Professionals Delmar (5th edition): US Greek Medicine (2010) Hippocratic Oath: translated by North M Online at: https://www.nlm.nih.gov/hmd/greek/greek_oath.html [Accessed on: 21/03/14] Hendrick J (2000) Law and ethics in nursing and healthcare Cheltenham: UK Hendrick J (2004) Ethics and Law Cheltenham: UK Jones R and Beck S (1996) Decision making in nursing Delmar: US Kour N and Rauff A (1992) Informed patient consent-historical perspective and a clinician’s view Singapore Med 33(1): 44–6 Kravitz R and Melnikow J (2001) Engaging patients in medical decision making. British Medical Journal 323: 584-585. Nicoll L (1997) Perspectives on Nursing Theory New York: US O’Connell S, Bare B, Hinkle J, and Cheeveret K (2010) Textbook of Medical-surgical Nursing (12th edition) Philadelphia: US Pearson A, Vaughan B, Vaughan B, FitzG erald M and Washington D (1949) â€Å"Trials of War Criminals before the Nuremberg Military Tribunals under Control Council Law 10 (2): 181-182 Online at: http://history.nih.gov/research/downloads/nuremberg.pdf [Accessed on 11/03/2014] The NHS Constitution (2013) Online at: http://www.nhs.uk/choiceintheNHS/Rightsandpledges/NHSConstitution/Documents/2013/the-nhs-constitution-for-england-2013.pdf [accessed on 10/03/2014] Tingle J and Cribb A (2007) Nursing law and Ethics (3rd edition) Oxford: UK White S and Baldwin T (2004) Legal and Ethical aspects of Anaesthesia critical care and perioperative medicine. Cambridge: UK Bibliography: George J. Annas Edward R and Michael A. Grodin (1992) The Nazi Doctors and the Nuremberg Code: Human Rights in Human . Oxford: US Morrison E (2010) Ethics in Health Administration: A Practical Approach for Decision Makers (2nd edition) London: UK

Jury of her peers Essay

After the first reading 1. What do the women think happened at the farm? The women thought Mrs. Wright might have murdered her own husband. After the second reading 2. What is the climax of the story (When in the story does the narrative take a turn)? The story’s climax is when there are more evidences compiled at the end (the dead bird, broken cage, abuse, marital oppression) this turns the story to Minnie Foster as a victim and not as a criminal. 3. How well does this story fit the model of the stages of narrative? The story shows all the stages of narrative in correct order (intro, rising action, climax, falling action) except that the conclusion is left for the readers to think. 4. What other things do you notice? The women were not allowed to be jurors but in this story, they outsmarted their husbands/men in collecting evidences that would point to who the victim and who the murderer was. The strongest evidences would be the abuse and loneliness experienced by Mrs. Wright and the irony of how the bird and Mr. Wright were killed in the same way. 5. What questions do you still have? Â  Will the women tell their husbands/men what they saw? Will the women stand up at the trial for the evidences?

The Importance of Immanuel Kant's Works Research Paper

The Importance of Immanuel Kant's Works - Research Paper Example Kant has influenced many other great thinkers of modern times. It was because of the wholeness of Kant’s work that many people from different professional backgrounds identify with him. Kant wrote extensively on political philosophy, moral philosophy, perception, and categories of the faculty of understanding. In this paper we will attempt to outline the main ideas of Kant and then an analysis of his ideas will be followed. We will also discuss the strengths of Kant’s ideas briefly at the end of the paper. Kant wrote extensively on philosophy as he covered different branches of philosophy. He wrote on Metaphysics, ethics, politics, and aesthetics. He was particularly interested in creating a bridge between the rationalist and empiricist philosophies. The major work of Kant is The Critique of Pure Reason. This book holds great value in the field of philosophy as it made important contributions to Metaphysics. In this great book Kant has attempted to solve the problems th at were not previously answered by Metaphysics and philosophy. Kant is known all over the world for these two books and they are also a compulsory read in any philosophy curriculum. In the other works of Immanuel Kant, his works on ethics, aesthetics, and political philosophy are included. Kant wrote Ground Work of the Metaphysics of Morals in which he outlined his moral philosophy. In other books like Critique of Practical Reason and Metaphysics of Morals, Kant has explained his view on ethics and morality. He believed that morals and ethical standards cannot be relative in nature and they should be absolute. He also stressed more on actions and behaviors than the consequences of actions and behaviors. The Categorical Imperative of Kant is a widely discussed and accepted ethical theory. The views o Kant on ethics will be discussed in detail later. Kant also wrote on aesthetics in detail in his books Observations on the Feeling of the Beautiful and Sublime and Critique of Judgment. On aesthetics Kant was of the opinion that our judgment of beauty is not cognitive in nature (Kant, 1). This means that we do not reason and then come to a conclusion about beauty rather it is aesthetical in nature. Such were Kant’s ideas about aesthetics. In the field of politics too Kant contributed heavily as he wrote Perpetual Peace: A Philosophical Sketch. The focus of Kant’s political philosophy is on law and on mixed form of government. He is not in favor of democracy as many of his contemporaries but at the same time he is also not in favor of extremely autocratic government. Kant’s political views were mainly aimed at finding ways to end ways and bring long term peace in the world. He was not in favor of wars at all and attempted to give a political philosophy that will end all kinds of war and bring about perpetual peace. Kant's Philosophy The philosophy of Immanuel Kant is complex and covers a wide range of topics. Kant has written on ethics, politics , and on reason and experience. In this section we will talk about each of these three areas in great detail. It is important to understand the social settings as well as the philosophical thought prevalent in the days of Kant in order to understand fully what he is trying to say. Kant was living at a time when enlightenment movement was in its full flow. Philosophers and thinkers had started to celebrate the power of reason and logic in the field of metaphysics and philosophy.  

The Epic Of Gilgamesh Essay Example | Topics and Well Written Essays - 1000 words

The Epic Of Gilgamesh - Essay Example Right from his birth, his adventures under the influence of Enkidu to his last days the readers find that there is always a divine connection in his actions and speeches. The relationship between Gilgamesh and gods can be compared with the relationship of Abraham and God in the Book of Genesis. In both the stories God has a sinifcant role to play in the development of the character. Epic of Gilgamesh goes on to prove that desire of God and destiny of man often comes in conflict. The clash between mortality and desired immortality heightens the tragedy of the epic poem. The prologue of the epic â€Å"Whoever you may be, governor, prince or anyone else, whom the gods may choose to exercise kingship† (George, xxxvi) comments that god has impartial view of mankind. In the poem Gilgamesh is portrayed with lot of glamor. The lines which denote his lordly appearnce and stature are: â€Å"Supreme over the kings, lordly in appearance/ he is the hero, born of Uruk, the goring wild bull†. (Kovacs, Tablet I) His appreciation is evident when it is said â€Å"Gilgamesh is awesome to perfection† His bravery and courage is reflected in the following lines: His physical greatness is complemented by his leadership abilities and his camaraderie with his fellow subjects; â€Å"He walks out in the front, the leader/ And walks at the rear, trusted by his companions/ Mighty net, protector of his people†. (Kovacs, Tablet I) The story of Epic of Gilgamesh is clasified into epsiodes namely a) the meeting of Gilgamesh and his friend Enkidu, b) encouter with fickle and voluptuos goddess Shamhat, c) journey through the Cedar forest, d) death of Enkidu and e) search for immortality. The journey through the Cedar forest has high importance because Gilgamesh and Enkidu duo kills the monster Humbaba and also defeat the Bull of Heaven. Ishtar, the goddess of sex and warfare supervises their combats. Companion’s death urges him towards quest for life of eternity. Utnapishtim offers him a chance to

Risk Management Research Paper Example | Topics and Well Written Essays - 1500 words

Risk Management - Research Paper Example Identification and Description of Risk Management Issue Medical malpractice is a major risk management issue affecting most teaching hospitals. Medical professionals can define medical malpractice as the inaccurate administration of healthcare services to a patient. In most cases, this always result to harm in patients as the mistakes made by the medical professionals at times can lead to devastating effects like death or disabilities to the patient. In teaching hospitals, most professionals are still students who are undergoing training on various grounds by using the patients who register at the hospital for medical purposes as their tests subjects. The effects of Medical malpractice by a practicing practitioner who is not yet qualified can at times be disturbing because they range from wrong dose calculations, wrong dose prescriptions to wrong injections that the doctor did not prescribe (Baker, 2010). Discussion of Steps That Have Been Set In Place to Address the Issue To address the issue of Medical malpractice in major teaching hospitals, various steps are incorporated. ... Secondly, the hospitals have employed enough physicians who monitor patients before they undergo medical procedures to avoid Medical malpractice that may lead to excessive pain, emotional distress, or death to a patient. In addition, the physicians explain the rehabilitation process of patient to make them mentally prepared and avoid the emotional distress that are caused by the medical procedure he has undergone. Thirdly, medical professionals are required to conduct a thorough research on the patient’s history to avoid Medical malpractice from the medical professionals’ side that might lead to the unexpected death of a patient. Lastly, ‘failure mode effect analysis’ has been introduced in most teaching hospitals to avoid Medical malpractice that leads to delayed treatment of patients visiting the center for medical purposes, therefore, improving the quality of healthcare services administered to patients (Joint Commission on Accreditation Health., 2011). Discussion of How an Organization Has Determined a Path to Remedy the Problem Organizations have taken various paths to remedy the problem of Medical malpractice by laying emphasis on the patient’s consent before passing patients through various medical procedures that are risky, but are also essential in the diagnosis of a patient’s ailment. The consent allows the medical professionals to touch and administer required medication to a patient, and frees him or her from the discomfort or consequences caused by the treatment administered to patients by will (Joint Commission on Accreditation Health., 2011). The organization has also laid emphasis on the informed consent to make the client aware of the various stages that he or she will undergo while

Contemporary Issues in Information Systems Research Paper

Contemporary Issues in Information Systems - Research Paper Example Additionally, at the present there are numerous CASE tools which can be used by software development teams. These tools offer rigid policy and standards about implementation and design of the systems (Lamb, 2012; VisualCase, 2012). In addition, a number of the advantages offered by CASE and other similar techniques are that, by making the client element of the software development process (for instance by analyzing the marketplace and focus groups); a product is further possible to convene real-world requirements and features. In view of the fact that software development process heavily relies on redesign and testing, hence the price of servicing an application over its lifetime can be reduced considerably. In this scenario, a carefully established technique to development offers assurance for the code and design reuse, minimizing expenditures and improving value. Ultimately, quality software products are likely to develop a company’s image, offering a competitive edge in the market (Rouse, 2005). This report presents a detailed analysis of two major market leaders of CASE tools. Basically, this report presents an analysis of two major applications IBM Rational Software and Oracle Designer. These tools contain wonderful features and provide an excellent support throughout the software development process. This report will present the comparison of these two applications and specification of major features for more enhanced performance management of the application development. In this scenario, this research will assess these two products on the basis of different features and quality parameters. Analysis This report presents a detailed analysis of two leading CASE tool applications by comparing their features and attributes. In this scenario, I will compare and contrast IBM Rational Software and Oracle Designer on the basis of Repository (it demonstrates how the selected tools is using repository), Forward engineering features, Reverse Engineering feat ures and Modeling tool features. I will assess both applications of above stated characteristics to suggest a most excellent application. Repository IBM Rational The IBM Rational Case tools offer information that is able to improve quality of software development groups to function more efficiently and productively. Additionally, IBM Rational Rose permits development teams to uphold, capture and take benefit of software knowledge by means of a repository available to people through a web and Eclipse interfaces as well as to programming through a RESTful web based interface (IBM, 2012). In this scenario, Eclipse plug-in integrated in Rational Developer for System development connects the software developer to local as well as remote RAA repositories. In fact, it as well scans software application source files from local and remote workplace IDE software development projects into a local RAA system repository (IBM, 2012). In addition, the capability to scan symbols in some kind of fil e scanned by the Rational Asset Analyzer representation scanner, including the results into the Rational Asset Analyzer repository and comprising the data and information in the inquiry and analysis services. Moreover, it integrates information from a wide

Job Security in Relation to Japan and India Assignment - 1

Job Security in Relation to Japan and India - Assignment Example The loyalty and commitment from the employees are widely dependent on the job security offered by the organizations of the country. To cope with the situations and a more stable relationship between the employees and the employer Japanese companies are constantly changing their pattern of employment which is needed to be implemented by the Government of India and the organization at India for a more stable and strong relationship building for building an employee base with high commitment and loyalty instead of being rigid to the rules of the Government. Flexibility at work plays a vital role in building trust amongst the employees and satisfies with job security for the employees (Zechariah, â€Å"Comparative Industrial Relations in Japan and India†). With the initialization of industrialization in Japan, the Japanese Industrial Relations System is a perfect blending of continuity and change in the characteristics of the employees. The first industrial enterprise of Japan was founded by the Japan government in the year 1890. This was first handled by powerful industrial families of the country but later with the transition from the agrarian society to the industrial nation demands relationship between the employees and the employers with the changing business model. With the influence of the western culture into the workplace, the organization are influenced to change their work structure. Various reforms came into play with the introduction of lifetime employment as a form of linkage between the employer and the employees to build the strong relationship. With the development of industrial relations, the workers are needed to possess’ special skills to retain their jobs in the competitive environment. The emergence of the lifetime employment and remuneration pattern was designed keeping in mind the future trend in the industry. The regular employees are who enjoys lifetime employment schemes and are paid according to the length of their services in the system.