Essay on Ethical Decision Making in Healthcare

Healthcare professionals are often faced with an array of ethical dilemmas as a matter of routine. Currently, many legislations, laws, and medical guidelines regulate the healthcare sectors. Most of these guidelines and regulations revolve around patient confidentiality, patient-assisted deaths, informed consent, among other issues (Ulrich et al., 2010). With so many legislations and guidelines, ethical issues can appear out of nowhere even when medical professions have the best intention at heart. Importantly, what may be termed legal might not be considered ethical, and what is ethical might not be permitted. It is critical as a healthcare professional to understand the difference and the relationship between the two. This paper is vital as it addresses common ethical issues prevalent in the healthcare industry.

Physician-Assisted Death

The first ethical issue that health care providers are likely to face in the contemporary world is physician-assisted suicide. In many jurisdictions, including Oregon and California physicians can offer relief to patients who are dying or suffering due to fatal illness (Radbruch et al., 2015). Nevertheless, healthcare leaders need to be prepared to deal with patient assisted dying issues when they arise. Studies also show that about 50 percent of doctors in the United States have engaged in some form of physician-assisted dying (Radbruch et al., 2015).

Moreover, stakeholders include in physician assisted death include patients, physicians, pharmaceutical companies, and insurance companies (Braverman et al., 2017). Every stakeholder, in this case, plays a vital and different role. For instance, pharmaceuticals benefit from this process by providing drugs for those willing to pay for the right to die. Terminally ill patients are also regarded as stakeholders in physician-assisted death. These patients view physician-assisted dying as the only and vital option in their health care choice. The insurance companies are the major stakeholders in physician-assisted death. According to Shankaran et al. (2017), when people become ill, they are often required to update their insurance. This way, they can get a better and costlier plans. If patients get terminally ill and die within a two-year grace period, the insurance companies can gain a significant financial reward. Most insurance companies do not cover this procedure; therefore, patients are forced to cater out of their own pockets.

To be efficient in decision making in patient-assisted death, practitioners should note state laws and consider whether they permit or outlaw the processes (Shankaran et al., 2017). Moreover, before advising a patient regarding this alternative, it would be paramount to evaluate other necessary and available options. The alternative of physician-assisted death is life sustained treatment, but this process would increase the patient’s agony and trigger devastating side effects. Assisted dying would be suitable for chronic advanced medical instances, and in case the patient experiences extreme pain. Physician-assisted deaths leave institutions with dilemmas, and in most instances, they are forced to reason with patients’ rights to autonomy and healthcare providers’ beliefs on what should be done based on their codes.

Malpractice and Negligence

Malpractice and negligence is another ethical issue predominant within the healthcare industry. Health care providers typically run the risk of being prosecuted for medical malpractice and negligence (Van Den Bos et al., 2011). A patient injured by faulty medical equipment or a patient injured during a medical procedure can sue to recover their damages. In addition to this, patients can also sue a healthcare organization when the physicians in that particular organization fail to offer needed medical service or treatment. In delivering medical services, health care professionals must carefully cover all of the bases to avoid the ever-present danger of litigation.

Medical errors occur in the healthcare industry as a matter of routine, and they are the leading cause of death in the United States, according to Van Den Bos et al. (2011). In most cases, patients affected by medical errors never recover, and for others, it may take longer to recover. Malpractice and negligence influence the lives and processes of different people and institutions. First, negligence affects patients receiving care. If the patient, in this case, does not receive adequate care due to negligence, their conditions can deteriorate and can even lead to death. The doctors or physicians are the second stakeholders. In often cases, physicians are prosecuted, and some even lose their operating licenses. Medical institutions also play a huge role, and they are often affected in cases of negligence and malpractice.

Instances of malpractice and negligence are often consequential, and in most cases, it is too late to recover from the damages gained. However, practitioners and medical institutions can implement best practices that deter these instances (Mello et al., 2020). First, there is a need to establish a good patient-physician relationship. To be effective in decision making, medical practitioners should encourage open and honest communication with their patients. Also, and more importantly, healthcare institutions should clearly state institution guidelines. Lastly, shared decision making would be applicable in this case. Physicians and patients should work together to attain outcomes that are suitable for each party.

Doctor and Patient Confidentiality

The third ethical issue has to do with patient confidentiality. Health care professionals are legally responsible for protecting patients and hospital data. It is important to note that healthcare professionals are usually held accountable when a breach of electronic data happens. Moreover, the Health Insurance Portability and Accountability Act (HIPAA) highlights guidelines on when and how hospitals can release patient information (Murray et al., 2011). The HIPAA and other related laws state the type of information hospital ought to release to third parties and the information that needs to be kept private. A slight misrepresentation, in this case, can lead to unwarranted instances. In most cases, medical executives find themselves entangled in court cases and legal suits regarding the loss or theft of social security numbers and exposure of personal health information.

Although the HIPAA is straightforward in terms of its requirements, there remain some grey areas. For instance, withholding information regarding a patient’s conditions could be termed unethical as it could harm a patient or other people (Murray et al., 2011). The vice versa can also be harmful. A medical professional could be persecuted or fired for posting information regarding his or her cases on social media. There are two major stakeholders in patient confidentiality: patients and medical institutions (Maiorana et al., 2012). It is patients’ information that gets leaked or shared, and it is either a healthcare provider or the hospital that transmits this information. Hospital and patient data are critical in outstanding medical care; therefore, there is always a need to gather patients’ data. But to be effective in this case, healthcare professionals should create policies and confidentiality agreements. They should provide their patient with documents that specify the information that can and those that cannot be shared. Health care institutions should also provide regular training to their staff.

Health care professionals are often bombarded with numerous ethical issues. At times these issues affect their medical processes and can lead to unwanted medical outcomes. For instance, physician-assisted death is legal in some states, but not all U.S. states. A miscalculation, in this case, can lead to lawsuits and even termination of the medical institution. Another ethical issue that dominates the healthcare sector is malpractice and neglect. Matters related to malpractice and negligence are often consequential, and at times it can trigger death. Patient confidentiality is the final ethical issue in the paper. Health Insurance Portability and Accountability Act provide instances when and how health care providers can share medical information. Policies and confidentiality agreements should be established to be successful in keeping medical information away from the grasp of unauthorized hands.

References

Braverman, D., Marcus, B., Wakim, P., Mercurio, M., & Kopf, G. (2017). Health care professionals’ attitudes about physician-assisted death: an analysis of their justifications and the roles of terminology and patient competency. Journal of Pain and Symptom Management, 54(4), 538-545.e3. https://doi.org/10.1016/j.jpainsymman.2017.07.024

Maiorana, A., Steward, W., Koester, K., Pearson, C., Shade, S., Chakravarty, D., & Myers, J. (2012). Trust, confidentiality, and the acceptability of sharing HIV-related patient data: lessons learned from a mixed methods study about Health Information Exchanges. Implementation Science, 7(1). https://doi.org/10.1186/1748-5908-7-34

Mello, M., Frakes, M., Blumenkranz, E., & Studdert, D. (2020). Malpractice liability and health care quality. JAMA, 323(4), 352. https://doi.org/10.1001/jama.2019.21411

Murray, T., Calhoun, M., & Philipsen, N. (2011). Privacy, confidentiality, HIPAA, and HITECH: implications for the health care practitioner. The Journal for Nurse Practitioners, 7(9), 747-752. https://doi.org/10.1016/j.nurpra.2011.07.005

Radbruch, L., Leget, C., Bahr, P., Müller-Busch, C., Ellershaw, J., de Conno, F., & Vanden Berghe, P. (2015). Euthanasia and physician-assisted suicide: A white paper from the European Association for Palliative Care. Palliative Medicine, 30(2), 104-116. https://doi.org/10.1177/0269216315616524

Shankaran, V., LaFrance, R., & Ramsey, S. (2017). Drug price inflation and the cost of assisted death for terminally ill patients—death with indignity. JAMA Oncology, 3(1), 15. https://doi.org/10.1001/jamaoncol.2016.3842

Ulrich, C., Taylor, C., Soeken, K., O’Donnell, P., Farrar, A., Danis, M., & Grady, C. (2010). Everyday ethics: ethical issues and stress in nursing practice. Journal of Advanced Nursing, 66(11), 2510-2519. https://doi.org/10.1111/j.1365-2648.2010.05425.x

Van Den Bos, J., Rustagi, K., Gray, T., Halford, M., Ziemkiewicz, E., & Shreve, J. (2011). The $17.1 billion problem: the annual cost of measurable medical errors. Health Affairs, 30(4), 596-603. https://doi.org/10.1377/hlthaff.2011.0084