Ethical Principles Health Care Poor

Ethical Principles Health Care Poor

Healthcare, in the minds of most people is a universal human right, an aspect of life and health and an aspect of justice, and yet the experience of poverty and disenfranchisement in the United States often dictates limited access to adequate health care. Cost prohibitive care as well as the rejection of those stricken by poverty creates essential gaps in access and delivery of health care to those who need it most. This is especially true of equitable on going preventative treatment that could in turn offer a reduction in the amount of life saving and costly care that is given in duress, without the ability of the individual to pay for such care. Those in poverty tend to avoid care until they have reached the point where their condition is intolerable. Though the ethical standards of many (if not most) are inclusive of the idea that health care is an aspect of social justice they are unable or unwilling to demonstrate this in their daily lives, by acting in such a way as to promote those who are disadvantaged at a more basic level. Large corporate and even non-profit hospitals bear the signage on the wall that indicates they will not refuse to care for someone based on their inability to pay, and yet the doors of services are still frequently closed to them and the institutions are unscrupulous about debt collection, even going so far as to take from these individuals everything they have ever worked for in their lives.

In the United States this is not always the poorest people, but often the working poor who live well below 200% of the federal poverty level but do not qualify for public assistance. Many of these people are also young, as standard employee-based health insurance programs rapidly disappear across the nation. ("Young and Uninsured," July/August 2008, pp. 4-5) Many assume that nursing is a profession that draws individuals with beneficent motives and for the most part this is true, as most front line health care workers consider non-maleficence to be their top priority (Wray, Walker & Benedict, May 2008, p. 779) and in so doing many even seek out resolutions for access and the need for preventative care as essential problems faced by those in poverty that must be addressed. Wray, Walker & Benedict stress the need to in their intensive research work, to address the ethics of access for vulnerable groups through an examination of how student nurses viewed such access and vulnerable groups who seek it. The qualitative study found that as was expected a great many of the student nurses interviewed were responsive to equality and justice in access to care for vulnerable groups and yet the study also found a few of the interviewed group who had a stereotypical views of vulnerable groups, that the researchers deemed would likely compromise their ability to safely do nursing work. The group expressed both hope, for those who expressed the desire to work within the confines of beneficence care and seek to help all those who enter the stream of care, rather than just those who can pay for it, have good health insurance, and who "work for a living." (May 2008, p. 779) it is actually surprtising that there are as many people in th world as there are who believe that the poor are those who do not work, given the current state of the economy and that fact that the majority of people who seek health care but are unable to pay for it are members of the working poor, class, a group that works full or greater than full time but has no or little opportunity to achieve economic independence.

Part of non-maleficence is seeking to offer intervention and preventative care to those who need it so they may not have to face costly life saving care. Nurses and other front line health care workers feel fidelity with those they serve and seek to demonstrate this through active participation in the development of ethical standards that are inclusive of the disadvantaged, acting within their political arena to make changes, on an institutional or local level, some even acting in a more global way to advocate for change on a national level. (Wold, Brown, Chastain, Griffis & Wingate, October/December 2008, pp. 171-178) Wold et. al. stress there are cases, that should be seen as templates to change, where groups of student nurses and nurses have banded together to help create a healthier community through the attempt to solve a specific health related problem, in the case of this review to assist in a rural southern community who had a significant lack of dental care for the poor. These types of social change constitute a living example of how nurses at all levels can and often do advocate for change within the confines of their profession.