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Indigenous health inequalities
Whether health care should be free
Indigenous health inequalities
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Introduction
When a patient lacks adequate health insurance, their financial circumstance becomes tightly entangled with medical contemplations in the clinical and operational decision making process. Is it ethical to deny those in need of healthcare to care merely based on their ability to afford healthcare? Is it ethical for hospitals and providers to bend billing and reimbursement rules and lower standards in order to provide free care to the indigent population? While at face value, it may seem that the hospital has a “clear-cut” ethical responsibility to offer free, or reduced-cost care for medically necessary procedures, this ethical issue brings about much debate. Hospitals responses to this ethical dilemma impacts the quality of care,
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There is the health of the greater community to consider. Hospitals, contrary to how they are normally perceived, are businesses. Businesses that operate by the beloved quote of “No margin no mission”. While making a profit is not the “true concern” for the hospital and providers, a medical professional or institution cannot provide free care to everyone in the community. A hospital can lose a great amount of money through providing care for those who cannot afford it, which will lead to its bankruptcy. Allowing a hospital to operate in a way that risks its continuing existence not only threatens to put many out of employment, it threatens the health of everyone in the community being served. For these reasons it is unreasonable to think that the hospital is acting unethically when it refuses treatment to those who can 't pay (Welter, …show more content…
My stance is in support of the obligation to provide free care. Hospitals and providers must make extremely difficult decisions and evaluate patients on a case-by-case basis but when a circumstance is beyond the patient’s control and the treatment can dramatically improve a patient’s wellbeing, it is unethical to deny a patient free care (Welter, 2009). Theories of distributive justice, such as utilitarianism and egalitarianism, have emphasized the importance of applying decision-making principals uniformly and consistently (Welner,
For anyone who has ever worked in healthcare, or simply for someone who has watched a popular hit television show such as Grey’s Anatomy, General Hospital, House or ER know that there can be times when a doctor or health care provider is placed in extremely difficult situations. Often times, those situations are something that we watch from the sidelines and hope for the best in the patient’s interest. However, what happens when you place yourself inside the doctors, nurses, or any other of the medical provider’s shoes? What if you were placed in charge of a patient who had an ethically challenging situation? What you would you do then? That is precisely what Lisa Belkin accomplishes in her book “First Do No Harm”. Belkin takes the reader on
Principles of Biomedical Ethics, by Tom Beauchamp and James F. Childress, has for many critics in medical ethics exemplified the worse sins of "principlism." From its first edition, the authors have argued for the importance and usefulness of general principles for justifying ethical judgments about policies and cases in medical ethics. The organization of their book reflects this conviction, dividing discussion of particular ethical problems under the rubrics of the key ethical principles which the authors believe should govern our moral judgments: principles of autonomy, nonmaleficence, beneficence and justice.
Wilson , James G. S., “Rights”, Principles of Health Care Ethics, Second Edition, eds. R.E. Ashcroft, A. Dawson, H. Draper and J.R. McMillan. John Wiley & Sons, Ltd. 2007. pp. 239.
The purpose of the article, “Ethical Dilemmas in the Intensive Care Unit,” is to discuss two important ethical issues that health care workers in the intensive care units face. The first dilemma is treating a nonverbal patient, the second being medical futility. I chose this article because I intend to go into the critical care field once I finish nursing school. I also felt the topic of medical futility was of great important with recent headlines in the news regarding Brittany Maynard. Critical Care health workers are facing a growing patient population; this increase in patients leads to an increase in ethical issues and dilemmas surrounding the critical care field.
Providers must act in the best interest of the patient and their basic obligation is to do no harm and work for the public’s wellbeing. A physician shall always keep in mind the obligation of preserving human life. Providers must communicate full, accurate and unbiased information so patients can make informed decisions about their health care. As a result of their recommendations, providers are responsible for generating costs in health care but do not generate the need for those expenses. Every hospital has both an ethical as well as a legal responsibility to provide care, even if the care may be uncompensated.
I chose to go into nursing because I had taken a sports medicine class in high school I enjoyed, and I thought I would be guaranteed a job graduating that had something to do with medicine. I can remember being so excited to learn how about illnesses and medications, and all the difference procedures done in the hospital. At the time I thought a nurse’s job was to do what the physicians said, and I expected set guidelines that would tell me what I was and wasn’t allowed to do. I had no idea that I was entering onto a career path involving so much complexity, and that the skills I had dreamed of learning were such a small part of nursing in comparison to the emotional, decision making, and critical thinking skills that a nursing career requires. Ethics in nursing was not something that had ever crossed my mind when I chose to take this path, however now ethics is something that I think about every day I am practicing, whether in clinical or theory courses. Ethical theories often come from the idea that because we are human we have the obligation to care about other’s best interests (Kozier et al., 2010), however in nursing ethical practice is not just a personal choice but a professional responsibility.
Today, there are so many legal dilemmas dominating trial for the courts to make a sound legal decision on whose right in a complicated situation. Despite the outcome of the case, the disagreement usually has a profound effect on the healthcare organization, and the industry as a whole. Many cases are arguments centered around if the issue is a legal or moral principle. Regardless what the situation maybe, the final decision is left to the courts to differentiate between the legality issues at hand opposed to justifying a case based on moral rules. According to Pozgar (2012), an ethical dilemma arises in situations where a choice must be made between unpleasant alternative. It can occur whenever a choice involves giving up something good and suffering something bad, no matter what course of action is taken (p. 367). In this paper, I will discuss cases that arose in the healthcare industry that have been tried and brought to justice by the United States court system.
Nearly most of the problems that have arisen at the VA are not only bad scheduling practices that resulted in extremely longer wait times, putting certain veterans before others, but also death to veterans who had to wait for care. Also, there is a lack of ethical culture, but beneficence, justice, nonmaleficence, self-sufficiency as well as confidentiality that was forgotten is this case (McWay, 2014). The beneficence and nonmaleficence are the most important of ethics (McWay, 2014). First, beneficence is to make available good and nonmaleficence means to do no harm whatsoever (McWay, 2014). Also, justice can include the responsibility of fairness, honesty, and in essence treating all patients
The medical Profession recognizes that patients have a number of basic rights. These include but are not limited to the following: the right to reasonable response to his or her requests and need and needs for treatment within the hospital's capacity. The right to considerate, respectful care focused on the patient's individual needs. The right of the patient to make health care decisions, including the right to refuse treatment. The right to formulate advance directives. The right to be provided with information regarding treatment that enables the patient to make treatment decisions that reflect his or her wishes. The right to be provided upon admission to a health care facility with information about the health care provider's policies regarding advance directives, patient rights, and patient complaints. The right to participate in ethical decision making that may arise in the course of treatment. The right to be notified of any medical research or educational projects that may affect the patient's care. The right to privacy and confid...
Why is it so important that healthcare executives adhere to a professional code of ethics?
In this diverse society we are confronted everyday with so many ethical choices in provision of healthcare for individuals. It becomes very difficult to find a guideline that would include a border perspective which might include individual’s beliefs and preference across the world. Due to these controversies, the four principles in biomedical ethic which includes autonomy, beneficence, non-maleficence and justice help us understand and explain which medical practices are ethical and acceptable. These principles are not only used to protect the rights of a patient but also the physician from being violated.
Gedge, E., & Waluchow, W. (2012). Readings in health care ethics (2nd ed.). Toronto, Ontario: Broadview Press.
Steinbock, Bonnie, Alex J. London, and John D. Arras. "Rule-Utilitarianism versus Act-Utilitarianism." Ethical Issues in Modern Medicine. Contemporary Readings in Bioethics. 8th ed. New York: McGraw-Hill, 2013. 12. Print.
Physician-assisted suicide refers to the physician acting indirectly in the death of the patient -- providing the means for death. The ethics of PAS is a continually debated topic. The range of arguments in support and opposition of PAS are vast. Justice, compassion, the moral irrelevance of the difference between killing and letting die, individual liberty are many arguments for PAS. The distinction between killing and letting die, sanctity of life, "do no harm" principle of medicine, and the potential for abuse are some of the arguments in favor of making PAS illegal. However, self-determination, and ultimately respect for autonomy are relied on heavily as principle arguments in the PAS issue.
Resources have always been inadequate for food, economics and healthcare and all scarce resources are rationed in one way or another. Healthcare resources can be in the forms of medicine, machinery, expensive treatment and organ transplantation. For decades, allocation of healthcare resources in an equitable manner has always been the subject of debate, concern and analysis, yet the issue has persistently resisted resolution. Scarcity of resources for healthcare and issue of allocation is permanent and inescapable (Harris, “Deciding between Patients”). Scarcity can be defined in general, in emergency and in crises as well as shortage of certain kind of treatment, medicine or organs. As a result of scarcity of resources, and some people may be left untreated or die when certain patients are prioritized and intention of is that everyone will ultimately be treated (Harris, 2009: 335). Allocation of limited resources is an ethical issue since it is vital to address the question of justice and making fair decisions. Ethical judgments and concerns are part of daily choice in allocation of health resources and also to ensure these resources are allocated in a fair and just way. This paper will explore how QALYs, ageism and responsibility in particular influence the allocation of healthcare resources in general through the lens of justice, equity, social worth, fairness, and deservingness.