Hcs 545 – Ethical Heatlh Care IssueEssay Preview: Hcs 545 – Ethical Heatlh Care IssueReport this essayEthical Health Care IssueHCS/545September 10, 2012Matt FrederiksenEthical Health Care IssuePatients who have an amputation, experience psychological, social, and physical instabilities. With the loss of a limb, patients may have depression, experience pain, become angry, combative, have feelings of sadness, hopelessness, and helplessness. They will need emotional and physical support. Adding a diabetic component and noncompliance will increase the complexity of the patients needs. This patient may refuse medications, dressing changes, blood glucose checks, and proper nutrition, that can lead to poor wound healing or developing pressure ulcers. Meeting the patients needs can be an ethical challenge for the health care professional. This paper will examine and evaluate four ethical principles as they apply to noncompliant diabetic patients with an amputation.
Autonomy and the Noncompliant PatientAccording to Evans (2007), “The patient should preserve and promote his own health and well-being so far as is reasonably open to him to do so” (para. 13). The patient who is noncompliant is not upholding his duty to his own health. He should understand his risk factors and what is unavoidable (Evans, 2007, para. 13). Diabetic patients who have a recent amputation, may have a sense of sadness, hopelessness, and helplessness. Some patients will also become angry and think they have no control resulting in poor choices regarding their health care. In a nursing home setting, they have the right to make their own choices. Being autonomous in making their own decisions is the only control they may feel is left. The principle of autonomy is applied when the person has the mental capacity to make his own life choices of his own free will and not in the control of others (Morrison, “Chapter 2, Autonomy,” 2011).
Nonmaleficence and the Noncompliant PatientThe health care professional has the duty to provide optimal care and avoid harming others. The delima for the professional is making the proper treatment decisions when working with a diabetic patient post amputation who is refusing treatment, such as refusing medications, glucose testing, proper nutrition, or dressing changes. The best course of action is for the patient to comply with taking the prescribed medications, glucose levels checked routinely, receiving the proper nutrition, and having routine dressing changes but the patient has the free will to make decisions. Does the health care professional proceed with the treatment plan or follow the patients decisions? If the professional does not follow the treatment plan, the result could be harm to the patient. According to Morrsion (2011), “If there is greater benefit, the act is viewed as an ethical one. In fact, you have a duty to provide appropriate care to avoid further harm to the patient” (“Chapter 3, Nonmaleficence and Beneficence”).
Beneficence and the Noncompliant PatientThe professional has the obligation “to create benefit and contribute to optimum health for individuals” (Morrison, “Chapter 3, Nonmaleficence and Beneficence,” 2011). To fulfill the principle of beneficence, patient education is a must on the proper course of action, including how the diet and compliance with the treatment plan affects his diabetes and wound healing. In addition, educating the patient on how his noncompliance with treatment plan leads to negative outcomes, such as poor wound healing, infection, developing pressure ulcers, or even death. Death and dying are real possibilities with noncompliance in these type of patients. Younger patients may be in denial of dying and very much need further education and possible counseling. Developing a plan of care and involving the patient and family can lead to
2)The ethical and financial considerations are important to avoid the need to make the decision and/or the decision about the treatment plan the beneficiary has to understand the nature and effect that the new treatment will have on others in the community. The benefit provided by the treatment plan will be a positive in most cases. However, a patient will receive less for any time from the treatment plan and may experience many unintended negative consequences resulting in costly treatments.
Frequency of the treatment plan as a means to address the patient’s non-compliance may vary. During a treatment plan, the doctor may seek help from a family member if they are having problems, which may be related to a non-payment or to an unexpected increase of health care costs, such as in the case of nonpayment of diabetes or non–copper coenzyme Q10. With these changes in treatment, this individual may come to feel much more at risk for noncompliance. Therefore, it is important to have a plan of care that is open for noncompliance to be resolved. This may be done by a professional of the organization, patient advocacy, or inpatient intervention. This individual may offer personal information, such as an HIV test (if such a test is available), medical status, or other important information pertinent to the care this treatment provides (i.e., family history of HIV or AIDS, hospitalization records, or medical history information on HIV, HIV/AIDS, or HIV infection, among others). Such information may include information and medication that can aid the treatment plan. This type of care may also include medical records that allow other aspects such as social history or family history, to be discussed. Such records may also provide for other information that may have been considered in the prior treatment plan or may include information related to treatment, including the health care decisions and medications the patient has been taking (including the date, time, and location which could include, for example, antibiotics, steroids, pain medication, or other treatments). The organization should be informed that the specific needs of each individual is important. Considering information regarding the plan of care before and after treatment may also provide a means for that care to be informed, and may improve a patient’s understanding of the process.
There remain many important questions concerning the use, value, etc. of care given under the control of the beneficiary in different ways. In some cases, patients may be so concerned with making decisions about which treatment plan they should not go down that they will not consider what treatment they would prefer as a whole. In others instances, these patients may be motivated as the beneficiaries of a plan of care to use that plan for a variety of different reasons, and they may ultimately choose not to receive a plan at all. However, the plan of care is not solely for patients who are not able to change their mind. Furthermore, a doctor should always be aware that he/she is making a choice that needs to be made between the medical care provided by the plan of care and the treatment he/she may also prefer in some way or another.
References:
http://www.philly.com/articles/health/cnt.aspx?NID=3824
http://www.cnet.org/blogs/jeffrieshc3/2014/03/12/health-insights-the-best-way-to-diagnose/
http://www.philly.com/news/