BFA515 Ethics and Professionalism | Technological of an Implantable
Questions:
It is now possible to keep a patient alive, which would not have been possible in former times, with modern medical sciences and technological advancements. This has created ethical, moral and legal issues that affect the patient and their families, healthcare providers and societies.
a)Briefly describe the major ethical issues related to end-of-life(EOL) care
Advanced technology is often used that can prolong life or prolong the dying process
There are multiple disciplines involved in the patient’s care
b)Select one ethical EOL issue and discuss the associated dilemmas faced by healthcare providers in a hospital
c)Using a structured ethical decision framework or model, explain how healthcare providers resolve such ethical dilemmas
Answers:
Introduction
Advanced technology has brought change in the pattern which has invovled the contribution in the medical information and also it has given impact on the healthcare of the people. By using technology it also helped the patients to access and helped in recovering in effective manner. The report explains about quality of care and it also include the decisions which are invovled psychologically. As people reach end of the lives the people and family both face many problems. The report consist of many ethical problems which are related with end of life. The technologies are so advanced that it has prolonged the life of a person. It has given enhanement in the medical field and also developed the structure of hospitality in positive way.The hospitals face many problems which are concerned with many ethical dilemma. By enhancement in the technology the precautions are taken easily by the people because the problem is accessed and recovered in easy way.
Advanced technology
The technology has given advancement and betterment in the health of people.It has solved many complex issues which are concerned with the health of people. Also with the enhancement in internet usage the medical professionals are increasing and also it has been called as virtual hospitals. Technology also brought a drastic change in surgery process. There are many surgery approach for diseases which include cancer and heart disease. By use of technology many surgery are less painful with less operation pain on the patient (Russell, 2010).It has also enhanced the outcome in positive way and also made the recovery faster. Screening is done and also detection is made of high probability of disease which have a high rate of complication. The disease are also identifies by screening and minimize the complications and potential harms. The screening is done to eliminate or delay death from diseases. Mammography screening consist of exposure to radiations. It helps to save life by early detection. The tomography scanner take into consideration X-rays and a computer which gives exact pictures of organ inside the body. It also take into consideration the photos of cross section of the body organs. Many a times a person is asked to take a special drink which gives a special X-ray dye. The CT scanner consist of a round which is in centre with the opening where the pictures are taken under the control of CT staff. The main importance is that many parts which are inside the body like lungs are taken into consideration without using surgery (Rafferty, Ball and Aiken,2011).The CT scan takes the radiations that are correct,painless and fast and which leaves no radiations after completion of scan (Ramamurthy and Wilson,2011). There is another scanning method named as positron emission tomography which detects the radioactive substance which are injected into the body. It helps to give information and also differentiate the normal tissue from cancer. The innovation technological of an implantable cardioverter defibrillator is an good experience which brings patients back from the brink of death. It is a device whose size is of pager and it monitors the heart rate and also it take into consideration the batteries which send electric signals to heart which beat too slow or beat too fast. The high technology has improved the quality of life and also it has made easy to detect the diseases. The cost of treatment has taken rise but it has reduced the destruction of body parts. The techonology is so advanced that it has made process easy which include birth control and many other diseases (Bates,2012).The advancement in technology has brought intensification of technology which consist of sharing medical information between practitioners who are related with medical and also medical devices and the newtwork of information affect the healthcare of people (Perkel and Lasch, 2009).Technology includes discussing about the present and past information related with medical ,vital signs,patient alarms. The medical professionals take into consideration the information about the patients and also the system is used at the time of hospital billing departments and also for finding the treatment which is effective (Westerholm and Arnetz,2004). The patient data has helped to improved the decision which arre related to clinical decision making and also to find out the clinical ailments which can be manageable. The technology has brought many changes in surgery in form of less invasive surgery which is considered as an surgicaal aapproach for many diseases which include heart disease. The advanced technology has made the life of people easy to detect the problems which are taking place in the human body (Moyneur, 2010). With the help of technology each and every thing is detected easily and proper steps are taken to recover it in effective way. There are many challeneges which are faced by the healthcare team by the technology has helped to balance the quality of care in effective form (Kaufert and Putsch, 2009). It also improves the access to care and build the workforce of healthcare so that it can be easy for people to overcome their problems in effective manner. Pervasive technology is which do not require or consist the patient to waer the tele devices which has been developed in last past years. The technology has taaken so mmuch enhancement that by sitting at home one can measure the blood pressure of the body and can take corrective steps which gives enhancement in the recover of any disease. It also help the peple to take care of health in effective way which can help in expansion of their life in good manner. Day by day the technology is enhancing and things or complex problems are resolved very easily and in effective form. The advanced technology has major part in exapnsion of eveything without the advanced technology nothing is possible to complete so easily (Erlen, 2009).
Multiple disciplines
There are many disciplines and all the health care disciplines distribute a common and also the primary commmitment which serve the patient and also it makes the working ideal towards the health concerned with all. There are many members who are professional and are concerned with the healthcare system. Everyone has a special responsibility and also have a speciality which plays an important role in concerned with care planning. It gives many benefits to both the patients and also to the health professionals which are there in team (Eysenbach and Till,2011). These consist the outcome of health and also it increases the level of satisfaction and also the job satisfaction is increased of members concerned with the team. It also take into consideration optimum functioning of the team and also make the outcome in effective way. The team members clearly define the role in care planning. It also consist all the levels of staff which include social workers,nurses and aides. It also breakdown the barriers which are concerned with communication between the specalists and also it enhances the cooperation among specialists. The people related with health care can go with an evolution which can enhance the complexity (Lo, 2012). The technology which are related with healthcare is equipped with many mulltiple sensors and is able to collect and transmit the data with a laptop for conducting the further diagnosis.There ae many parameters which gather multiple clinical parameters. The technology is build on wirless networks and the advanced computer technologies (Lyons, 2006).
Case
There was an old lady named Mrs g. She was 76 year old and was brought to the emergency department when it was found that there was a distress in respiratory system. The emergency department doctor analyzed that the patient was responsing to verbal stimuli. Many doctors reviewed and she is admitted to ICU for observation. She is in serious condition and the discussion is made with the family regarding cardiac arrest. Relatives are invovled in discussions which are concerned with end of life issues so that the decision can be made and also the situation should be understand by all the parties. Son was given information about the another condition and by that it was stated that she does not need any measures in relation with cardiac arrest. By talking to her son the decision was made that there was no resuscitation order (Riley,2009). The main importance of resuscitation order is to hold life saving measures when the patients respiratory function stop working. Next day her daughter arrived. She said that she was not in contact with the patient from last 3 years but she want that everything should be done at this stage. Then she has arranged a meeting with the medical staff. In this case a clinical ethical dilemma was accessed. The daughter asked for the care conflict with the patients and also put in difficult position to accept the patient wish or to give satisfaction to the daughter’s request. Then the doctor decided to call to the son and discussed the treatment plan with him on phone. The son said that the team should continue the current supportive treatment. He said to the doctors that her mother dont want any aggressive measures which will discomfort her. He said that he will discuss this to her sister afterwards. In this by analysing the ethical dilemma the first step is of situation which consist of ethical principles that is applied and also which are related with ethical concepts. To take into consideration the decision process one should think the ethical principles which are autonomy,beneficence,normaleficence and justice. All these principles will acess to guide the primary care physicians and nurses which can apply to the care of the patients. The team of healthcare discussed about the patients situation to her family. If the treatment is given to her then also the death is expected. So the better critical care medicine should take into consideration the tension between saving life and making peaceful death possible. The emotional tension was seen between son and daughter. It is also seen that there was disagreement in concern with the healthcare plan. The ethical dilemma which is analyzed in this case is to respect the wishes of patient or not considering the wishes by taking into consideration the demand of daughter (Meterko and Desai, 2010). In this situation the team of healthcare was concerned to provide the medical treatment benefit that patient does not want. Thus the team emphasised in giving comfort and providing support by including oxygen,suctioning and pain relief for respiratory distress. The healthcare providers take into consideration the decision of both son and daughter and solved the issue. The principle of beneficence has given direction to the doctor to act in the interest of patients and also the nurse who is concerned with the health of the patient wants to give care which is considered as best possible interest. Giving her comfort and free of pain is an best example of this principle. In the end of life dilemmas the stress which is concerned with illness or dying can make a tension and also it can create barriers to commmunication. Consultant focuses that the concern of daughter is concerned with the sense of grief and loss and also it is concerned with regret and guilt. Also in this ethical dilemma the healthcare professionals have more focus on patients and also it helps in enhnacement of therapeutic alliance (Clements,2009). At the time of meeting with the son and daughter the consultant stated the value of comfort and its relevancy and importance with the patients who are dying. The statements which are related with end of life are very difficult to elaborate but it gives information to the family members that can provide and can create a concensus around the medical decisions which should be taken into consideration (Mayer and Davis,2007 ).Relating with this case the consideration should also be made by considering the illness and impact on her quality of life.In this case the ethical issues in nursing practice is prolonged with the process of dying and also the measures which are inappropriate is the most worst experiences which are seen. It is seen that the patient treatment is creating a violation of this principle in considering the daughter needs. It is considered that all people should be treated equally and the resources which are available should be used equitably. The principle is not taken into consideration from the beginning but it has also facilitated the principal concerned with ethical to contribute to the situation which is concerned with conflict. When the patient is taken into observation under ICU it is always considered that high technology many give effect to the expectations of what can be achieved at end of life care. The doctors have the right to take into consideration the autonomy which can be responsible to exercise the ethical belief which can handle the request of the incorrect treatment (Delbanco,2009).There are clinical situations that has provoked the ethical structure which creates a challenge to navigate.There are many facts related with clinical factors. Also the patient preferences and the values of family are taken into consideration.By analyzing the case it is seen that there are difficult situations where the measures are considered and implemented to prolong a life of patient. In this study the situation of patient care is related with the moral distress which focuses on prolonging life and also by performing test and treatment concerned with ill patients. The feeling of dissatisfaction arises and also it has given end of life care which consist of usage of technologies and also consist of responsibility for the welfare of patients.The care which is provided is not considered by her age or by social status.Also the patient was admitted in ICU and also the measures can be taken effectively (James, 2013).The goal improves the condition of patient and also minimize the pain .It gives a chance to the professionals to elaborate the possibilities of various actionsand also it can be decided easily that what will benefit the patient and also the care is provided and in satisfying way (ClearCheng,Yang and Chiang,2009).
The health care provider resolve the ethical dilemma by consulting the healthcare team and also by discussing the main concern with the daughter and son of the patient so that the final decision decision can be made which do not arise any conflicts in future.The open discussion is made which gives encouragement and resolve the issue in effective way.The health care team focused on communicating each and every possible aspect in front of the family so that the conflict does not arises in any case (Diana,2009).
Conclusion
It has been concluded that health is an an important aspect for a living being. If the health is not good the person cannot enjoy its life effectively. So, now a days there are many technologies which has given support and given enhancement in prolonging the life of a person. The technologies are very effective and it has made easy to identify the problem by taking into consideration advanced technology and also it is considered with end of life issues. There are many issues which are faced by hospitals but the hospitals and the team take into consideration the health of the patient. In this report it is clearly analyzed the ethical dilemma which is faced by the health team and by the hospitals.
References
Bates, D.W., 2012. Using information technology to reduce rates of medication errors in hospitals. BMJ: British Medical Journal, 320(7237), p.788.
ClearCheng, S.H., Yang, M.C. and Chiang, T.L., 2009. Patient satisfaction with and recommendation of a hospital: effects of interpersonal and technical aspects of hospital care. International Journal for Quality in Health Care, 15(4), pp.345-355.y, P.D. and McNeil, B.J., 1988. Patient satisfaction as an indicator of quality care. Inquiry, pp.25-36.
Clements, J.M., 2009. Patient perceptions on the use of advance directives and life prolonging technology. American Journal of Hospice and Palliative Medicine®, 26(4), pp.270-276.
Delbanco, T.L.,2009. Patients evaluate their hospital care: a national survey. Health Affairs, 10(4), pp.254-267.
Diana, M.L., 2009. Exploring hospitals' adoption of information technology. Journal of medical systems, 26(4), pp.349-355.
Erlen, J.,2009. Ethical Issues in Health Care.
Eysenbach, G. and Till, J.E., 2011. Ethical issues in qualitative research on internet communities. Bmj, 323(7321), pp.1103-1105.
James, J.T., 2013. A new, evidence-based estimate of patient harms associated with hospital care. Journal of patient safety, 9(3), pp.122-128.
Kaufert, J.M. and Putsch, R.W., 2009. Communication through interpreters in healthcare: ethical dilemmas arising from differences in class, culture, language, and power.
Lo, B., 2012. Resolving ethical dilemmas: a guide for clinicians. Lippincott Williams & Wilkins.
Lyons, J.S., 2006. The complexity of communication in an environment with multiple disciplines and professionals: communimetrics and decision support. Medical Clinics, 90(4), pp.693-701.
Mayer, R.C. and Davis, J.H., 2007. An integrative model of organizational trust: Past, present, and future. Academy of Management review, 32(2), pp.344-354.
Meterko, M. and Desai, K.R., 2010. Patient satisfaction with hospital care: effects of demographic and institutional characteristics. Medical care, 38(3), pp.325-334.
Moyneur, E., 2010. The relationship between technology availability and health care spending. Health Affairs, p.W3.
Perkel, R.L. and Lasch, L.A.,2009. Relationship of advance directives to hospital charges in a Medicare population. Archives of Internal Medicine, 154(5), pp.541-547.
Rafferty, A.M., Ball, J. and Aiken, L.H., 2011. Are teamwork and professional autonomy compatible, and do they result in improved hospital care?. Quality and Safety in Health Care, 10(suppl 2), pp.ii32-ii37.
Ramamurthy, K. and Wilson, A.L., 2011. Organizational context, climate and innovativeness: adoption of imaging technology. Journal of Engineering and Technology Management, 19(3), pp.221-247.
Riley, I.S.,2009. Myocardial infarction: a comparison between home and hospital care for patients. Br Med J, 1(6015), pp.925-929.
Russell, L., 2010. Technology in hospitals: medical advances and their diffusion. Brookings Institution Press.
Westerholm, P. and Arnetz, B., 2004. Living with conflicts-ethical dilemmas and moral distress in the health care system. Social science & medicine, 58(6), pp.1075-1084.
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