Access to healthcare: ethical dilemmas and alternative approaches

Health Care Access Ethical Dilemma

Access to health care services is not equitable in the United States. The 15% of Americans without health insurance coverage find it extremely difficult to access health care services (Trotochaud, 2006). This is an injustice that should be addressed. Patients going to rural health care facilities face myriad challenges that are occasioned by stigmatization. Stigmatization of illnesses that patients grapple with occasions ethical conflicts. In the process, patients' right to privacy and confidentiality are often violated. There are practical guidelines that can be used to minimize ethical conflicts. It is imperative that confidentiality and trust be made paramount under circumstances where healthcare professionals deal with patients with stigmatizing illnesses.

A typical example of confidentiality, overlapping relationships and lack of willingness to seek care can be attested to in a situation where a woman working at a local store finds out that her partner is HIV-positive and also suspects that she has been infected but is hesitant to seek treatment at the nearest primary health care clinic because the primary healthcare physician and the lab technician at the clinic are regular customers at her store. They are also her family friends. The lady fears that by going to the clinic she may be stigmatized and discriminated against because of her health status. She is not even sure whether her diagnosis should be kept a secret from her family. Any health care provider including this primary health care physician and the lab technician should at all times safeguard the guiding principles of their profession (Tummala & Roberts, 2009). While factoring in issues pertaining to concepts of privacy and voluntarism, health care providers should at all times know that they right to self-rule or self-determination squarely lies with them. They have to appreciate that every patient is worthy of respect irrespective of their race, ethnicity, socio-cultural background, or sexuality (Tummala & Roberts, 2009). The healthcare providers have to be seized of the beneficence factor and use their expertise to remedy a patient's medical conditions. The providers must use their powers in an ethically directed manner. They must endeavor to do good and minimize harm. Of great importance to accessing health care in rural setting is the issue of confidentiality. The health care providers in the rural setting should never disclose a patient's personal information in order to safeguard their privacy. This can largely help in stemming stigmatization. It is very difficult to uphold these ethical principles in rural health care settings owing to the overlapping relationships and conflicting roles, clinical competence, and exceptional stresses on caregivers in the rural set up (Tummala & Roberts, 2009). Caregivers in the rural set up are also struggling with the aspects of cultural values vis-a-vis professional standards.

In a rural set up, health care providers often interact with their patients in non-medical roles. In such situations, health care providers find it extremely difficult to uphold the principle of autonomy, ethical use of power, confidentiality and right to treatment. To mitigate this kind of dilemma, a health care provider must learn to separate personal and professional roles (Tummala & Roberts, 2009). A provider can also gracefully dismiss himself from handling a sensitive case. They can also refer their patients to neighboring communities.