Short Answer Questions Ethical Issues

Question 1

One demand on ethical health care going forward could be privacy and security of medical data. This is more so the case given that the deployment of technology in the medical realm has become even more pronounced. This means that going forward, private patient data could be exposed to more sophisticated hacking attempts. In seeking to meet this particular demand, the relevance of embracing the beneficence ethical principle cannot be overstated. This is to say that efforts should be made to ensure that the decisions made in as far as the implementation of technology-based solutions in the healthcare realm is concerned ought to be aligned with the best interests of patients. In those instances whereby risk to privacy is deemed too great, then efforts should be made to either embrace robust security measures, or a decision to abandon implementation made.

The other demand on ethical healthcare that ought to be highlighted in this case is increased cost of accessing competent or quality healthcare. It is important to note that as Makary (2019) points out, “overall healthcare costs — including all private and public spending — are anticipated to rise by an average of 5.5 percent per year over the next decade — growing from $3.5 trillion in 2017 to $6 trillion by 2027” (311). In essence, what this means is that only those who have financial muscle will be able to access quality healthcare. In my opinion, the most relevant ethical principle in this case would be justice. This is more so the case owing to the fact that this particular principle relates to fairness. Thus, there is need for the various stakeholders in the healthcare realm to ensure that strategies are put in place to ensure that health care is equitably as well as justly distributed to all persons regardless of their socio-economic status.

Question 2

The most reasonable response for healthcare providers in this case would be to change the narrative about advance directives being for the elderly only. Instead, healthcare providers should, through commentaries in the relevant media etc., highlight the relevance of advance directives for persons of all ages with or without preexisting medical conditions.

In instances whereby an advance directive does not exist, i.e. as is often the case in medical emergencies, healthcare providers ought to deploy the most appropriate medical interventions with an intention of ensuring that the most urgent clinical needs of the patient are met. Later on, treatment decisions can be adapted and aligned with the preferences of the patient’s surrogate.

Question 3

From an ethics point of view, the ethical principle of beneficence could be used in defense of the celebrity’s decision. This is more so the case given that as this particular principle dictates, there is need to always act in the best interests of the client. In this case, the client’s best interests would be to ensure that she does not lose her livelihood. However, the ethics of such a decision could be refused on the basis of the ethical principle of veracity. This relates to being honest and truthful with the patient. In this case, there would be need for the patient to be made aware of the fact that a decision of this nature could have long-lasting physiological and psychological effects on the child. The decision could also take a physiological toll on this particular celebrity. As Clark (2016) observes, in line with the veracity principle, healthcare practitioners ought to be sincere and forthright with patients even in those instances whereby there is a risk of causing distress to patients.

Being a baby created by technology, as it has been stated above, could have both physiological and psychological effects on the child. From a physiological perspective, such a move could result in serious health defects. On the other hand, from a psychological perspective, the child could later on, i.e. as an adult, face significant challenges with regard to identity formation. For instance, as Clark (2016) observes, “human cloning presents a threat to our concepts of human identity and individuality” (79). Thus, there would be need for limitations to be embraced on this front. The said limitations should be categorical that any manipulation of natural child bearing processes are unlawful.

Question 4

In the present scenario, I would first seek to find out what might be the cause of the bruise from Jesse herself. This, in my opinion, would be part and parcel of my normal clinical interactions with this particular client. The ethical principles that would be in support of this particular course of action are; beneficence and fidelity. In as far as beneficence is concerned, one of the factors that this principle captures is ensuring that various courses of actions are meant to benefit patients. The principle could also be perceived in the light of the need to secure the wellbeing of others by, amongst other things, preventing injury or harm. In seeking to find out what caused the bruise, I would be seeking to prevent further harm if indeed the bruise was as a result of abuse. With regard to fidelity, it should be noted that I would be seeking to remain committed to my professional duties/promises – i.e. in relation to the promotion of the wellbeing of patients.

If Jesse denies abuse and lacks a logical explanation for the said bruises, I could either seek to engage her parents on the same, or contact the relevant authorities. It is important to note that although the maintenance of confidentiality is of great relevance in clinical settings, there are some scenarios whereby involving a third party would be permissible. This, according to Clark (2016) is particularly the case in those instances whereby others appear to be at immediate risk, i.e. as is the case with Jesse.

Question 5

One of the safeguards to use when developing policy on assisted death is a mental health evaluation to evaluate whether a patient has impaired judgment (Pereira, 2011). Patients should be referred to a mental health specialist to establish their mental wellness. Two psychiatrists could come in handy on this front. One of the psychiatrists will provide an evaluation system while the other will ensure that a two-track approach is maintained. Mental health evaluation enables the doctors and family to establish that the patient is making decisions rooted in their rational states. In any case that the patient is found to be mentally ill, then euthanasia is cancelled and the patient is given prescriptions that relate to mental health.

Terminal illness is the second safeguard to use when developing policy on assisted death. A terminal illness may be described as a disease which cannot be cured and is likely to lead to death (Pereira, 2011). Some of the examples of terminal illness include advanced heart disease, advanced cancer, and motor neuron disease. When a patient is evaluated and it is established they have a painful and agonizing terminal illness, then assisted death may be administered to them. Terminal illnesses results in hopelessness and a low quality of life. Patients who have terminal illnesses may have the right to propose euthanasia.

The third safeguard towards assisted death is self-administration. Every individual has the right to their own life. There are different forms of assisted death including voluntary, involuntary, active and passive. The different forms are legalized in different countries in the world. Voluntary euthanasia is when an individual has made the request because of their fragile condition. Self-administration may also be referred as suicide. When a patient has been evaluated and established to be mentally okay, then they may be facilitated in the administration lethal injections.

Question 6

There are various documents under which healthcare is either declared or supported as a fundamental right. The said documents have been highlighted below;

a) International Covenant on Economic, Social and Cultural Rights (1966): In this case, i.e. under Article 12, the need for persons to attain the greatest health standard possible – both mental and physical – is restated.

b) Universal Declaration of Human Rights (1948): Under Article 25, all persons have a claim to a living standard that promotes health and wellbeing.

c) Constitution of the World Health Organization (1946): In this case, health has been identified as a right which all persons should enjoy.

Question 7

The first area in efforts to establish whether a patient’s treatment decision is competent is evaluating their capacity. Capacity refers to the patient’s basis of informed consent. A patient is able to make a medical decision if they can show an understanding of the situation and appreciate the consequences of their decision. The second area is communication of choice (Sulosaari, Suhonen, & Leino?Kilpi, 2011). A patient may be described as competent if they can also communicate their choice. Effective communication of the choice by the patient means that they have the ability to reason and make coherent decisions. The third area is appreciating the benefits, risks and alternatives of a decision. Every decision has its own benefits and risks. A competent patient is never in denial and they accept what comes their way. The fourth area is reasoning. The power of reasoning shows that a patient is mentally healthy and rational.

Question 8

One of the healthcare decisions that seems rationing but is not is provision of substandard protective care to healthcare workers. Rationing healthcare equipment is a good move to ensure that finances and other resources in the health sector are well utilized (Williams, Dickinson, & Robinson, 2012). However, in present COVID 19 pandemic times for instance, providing cheap and low-quality protective care increases the risk for health care workers contracting the illness. It is therefore not a medical rationing decision. Rather, it increases treatment costs for the pandemic.