Ethical Issues in Healthcare PDF

COLLEGE OF RADIOLOGIC TECHNOLOGY PROFESSIONAL ETHICS, JURISPRUDENCE, AND CULTURAL SENSITIVITY SUMMER S.Y. 2023 – 2024 Natasha Louise Y. Fernandez ETHICAL ISSUES IN HEALTHCARE...

COLLEGE OF RADIOLOGIC TECHNOLOGY PROFESSIONAL ETHICS, JURISPRUDENCE, AND CULTURAL SENSITIVITY SUMMER S.Y. 2023 – 2024 Natasha Louise Y. Fernandez ETHICAL ISSUES IN HEALTHCARE Access to health services means "the timely use of INDIVI- EXAMPLE: PATIENT PRIVACY AND CONFIDENTIALITY personal health services to achieve the best health DUAL The protection of private patient information is outcomes." It requires 3 distinct steps: AND one of the most important ethical and legal ○ Gaining entry into the health care SOCIETAL issues in the field of healthcare. Conversations system (usually through insurance RIGHTS between a physician and a patient are strictly coverage) confidential, as is information about an ○ Accessing a location where needed individual’s medical condition. Specific health care services are provided provisions of the Health Insurance Portability (geographic availability) and Accountability Act, or HIPAA, define exactly ○ Finding a health care provider whom what information can be released and to whom. the patient trusts and can In the field of mental health, the conflict between communicate with (personal the needs and legal rights of patients and the relationship) need for protection of society present major Access to health care impacts one's overall physical, dilemmas for health care professionals. social, and mental health status and quality of life. Barriers Public health statutes may conflict with these to health services include: concerns since they require the reporting of ○ High cost of care o Inadequate or no certain diseases and events for epidemiological insurance coverage purposes or for the specific protection of the ○ Lack of availability of services public. ○ Lack of culturally competent care CULTU- A health system must decrease geographic inequalities HUMAN EXAMPLE: TUSKEGEE STUDY OF UNTREATED RAL and must be culturally relevant to the population it serves. EXPERIM SYPHILIS IN NEGRO MEN CONSIDE- ENTATION African men with syphilis participated in a study which RATIONS In our growing multicultural society, health professionals AND purported to learn more about the treatment of syphilis for need to recognize that applying only traditional RESEARC African Americans. Little did they know that the study westernized medical practices may no longer be H aimed to document the regression of syphilis without appropriate for many patients and families. Health treatment. professionals must have an awareness of and sensitivity to the different cultural practices and spiritual beliefs that EXAMPLE:DRUG TESTING shape a family’s life. This should incorporate beliefs and All new drugs are tested on human volunteers. There is, of traditions. course, no way subjects can be fully apprised of the risks ○ Language barriers. in advance, as that is what the tests purport to determine. ○ Unfamiliarity with the concept of This situation is generally considered acceptable, provided palliative care/hospice settings. volunteers give “informed” consent. ○ Distrust of health care services/clinicians. END-OF These are often complex moral, ethical, or legal dilemmas, ○ Personal experiences/past trauma. -LIFE or combination of these, regarding a patient’s vital ○ Religious differences. ISSUES physiologic functions, medical-surgical prognosis, quality ○ Belief in alternative medicines. of life, and personal values and beliefs. These should ○ Fear of the unknown. include the following: ○ Resuscitation status TECHNO- Health care resources are defined as all materials, ○ Withholding and withdrawing medical LOGY personnel, facilities, funds, and anything else that can be therapies AND used for providing health care services. Health care has ○ Palliative care SCARCE long been a limited resource for which there has been an ○ Coma, vegetative state, and brain RESOUR- unlimited demand; everyone needs health care. death CES Services should be organized and distributed in RESUSCIT Each patient has a “code status” documented accordance with health needs and the ability to benefit. A- officially in the medical record by the attending TION physician. Health care services are inherently scarce: money for STATUS ○ FULL CODE – all appropriate efforts services is not unlimited, facilities for delivering services will be made to revive a patient after are finite, and health care professionals are limited in time, cardiopulmonary arrest geography and skills and capacities, and so on. ○ Do not resuscitate (DNR) – the EXAMPLE: In a third world nation, you only get predetermined decision to decline the care you can afford. cardiopulmonary resuscitation, including defibrillation and ACCESS Every individual should have equitable access to pharmacologic cardioversion in case TO health services. However, inappropriate financial of respiratory arrest QUALITY barriers to health care do exist. As a result, ○ Do not intubate (DNI) - the HEALTH economic disparities between the rich and the predetermined decision to decline CARE poor have a major impact on the health status of intubation for the purpose of the population.  COLLEGE OF RADIOLOGIC TECHNOLOGY PROFESSIONAL ETHICS, JURISPRUDENCE, AND CULTURAL SENSITIVITY SUMMER S.Y. 2023 – 2024 Natasha Louise Y. Fernandez subsequent mechanical ventilation in case of respiratory arrest WITHHOL- Withholding support – not initiating a treatment DING AND because it is not beneficial to the patient WITHDRA Withdrawing support – the discontinuation of a WING treatment MEDICAL Forgoing treatment – the combination of both THERAPIE supports, in which disease progression is S allowed to take its course. An order of “comfort measures only” (CMO) is written by the physician which means patients with this status receives medications for pain control or sedation or to otherwise eliminate distress. PALLIATIV The goal of palliative care is to “prevent and E CARE relieve suffering, and to support the best possible quality of life for patients and their families, regardless of their stage of condition or the need for other therapies. Key components are spirituality, family involvement, and non-tradiational therapies. COMA, These conditions involve unconsciousness and VEGETA- absent self-awareness but are distinct in terms TIVE of neurologic function STAGE, ○ Coma – a state of unconsciousness, AND without arousal or awareness BRAIN characterized by a lack of eye opening DEATH and sleep/wake cycles with intact brain stem reflex responses; however no meaningful interaction with the environment occurs ○ Vegetative stage– transient state of wakefulness without awareness, characterized by cyclic sleep patterns, spontaneous eye opening and movement, and normal body temperature yet lack of purposeful responsiveness o ○ Brain dead – the absence of brain stem reflexes or cerebral motor responses in addition to apnea and is irreversible.