Ethical and legal issues in the field of healthcare
Introduction
Healthcare workers should understand the legal and ethical implications for health care and should also adhere to the ethical standards and code of conduct. Besides, healthcare workers should be sensitive to the issue that arises in the field healthcare and should understand that the primary duty is to provide quality healthcare and protect the patients from harm. In the legal system, laws should be enacted to regulate the human behavior, prevent harm and protect the individuals' rights. Professionals should also adhere to the healthcare ethics that comprise moral principles and the need to examine human character, distinguish between the right and wrong and adhere to moral duty and obligation. However, healthcare professionals face ethical and legal issues as they try to offer quality care to the patients. Despite the legal and ethical policies, they often meet ethical dilemmas especially when they are required to make two right choices. Legal and ethical issues are pervasive in the healthcare settings and to address these issues, healthcare managers should help the clinicians deal with the moral distress by practicing professional code of ethics and, solve legal and ethical issues by developing and implementing effective and innovative interventions.
Healthcare professionals face ethical dilemmas due to various factors such as individual values and beliefs, religion, culture and other factors that affect the ethical views and the ethical decision of patients and healthcare providers. For the healthcare providers to recognize and solve the ethical issues that may arise from family involvement and policies and laws, they should understand and adhere to the code of ethics (Hurst et al, 2005). Ethics encompass human behavior, values or moral principles and distinguishing between right and wrong. In ethics, people should have a common belief which entails the concepts of doing good and avoiding harm. However, the concepts of common beliefs become complicated in the healthcare field, and they tend to negotiate on principles and personal standards. In the field of healthcare, both patients and healthcare providers hold different beliefs which lead to disagreement. The disagreement does not arise due to lack of ethical standards, but it arises due to ethical dilemma that occurs due to cultural diversity, religion, and other factors (Hurst et al, 2005. To avoid these complexities and conflict, healthcare providers are expected to understand the ethical and legal requirements in providing patients care, in the advance directives, in dealing with the patient mental status, when working with families and when billing. The following are legal and ethical issues that healthcare professional encounters in the field of healthcare;
Informed consent to treatment
Informed consent is the permission given to the healthcare professionals by patients to initiate treatment. The Code of Ethics states that patients have the right to receive sufficient and understandable information about their medical condition so that they can make informed decisions regarding their treatment (Nijhawan, 2013). Informed consent applies in both ethical and legal system, and it is perceived as a vital step in the process of providing quality care. However, there are various ethical issues that arise in the field of healthcare due to the ethics of informed concept. In other words, even though the purpose of the informed consent is to allow the patients understand the medical condition and agree on the treatment, the agreement is hindered by communication barriers, cultural, language and religious barriers. Ethical and legal issues in the informed consent arise due to
- Language barrier
At times, patients do not fully understand the treatment agreed to receive. Some of them sign a consent without having a complete understanding of the risks and benefits associated with the type of treatment or surgical procedures (Nijhawan, 2013). Healthcare providers are required to meet the legal and ethical responsibility by obtaining an evidence for the informed consents. However, lack of communication and the shared decision between the patients and the healthcare provider, failure to consider the health literacy of the patient and failure to consider cultural issues may result to misunderstanding. Due to the misunderstanding, healthcare provider experience ethical and legal dilemma in trying the make choices between doing good and respecting the patient's wishes.
- Religious Influence
Patients should have the right to accept or to contest the medical treatment being offered. However, some patients are influenced by religious beliefs in making a decision based on treatment. The beliefs interfere with the rule of behaviors that are set by the health care system, and they may end up fulfilling the patient's wishes (Nijhawan, 2013). The health care providers should ensure that the patients fully understand the treatment and their religious rules to make an adequate decision.
- False expectations
Based on the treatment, there is always a patient-physician discrepancy where patients rely on higher expectations from the treatment. This occurs since patients do not understand the risk as well as the benefit of the treatment. Other patients fear the treatment as they believe they are treated as ‘experimental model' (Nijhawan, 2013). Patients use negative perception on the treatment and it becomes difficult to explain to the patients about the treatment.
Patient privacy and confidentiality
Healthcare professionals face an ethical dilemma in deciding whether to break confidentiality or not. In the field of healthcare, patients give the healthcare provider his or her private information either through written or verbal means. The healthcare provider should keep the information confidential as a way of promoting trust, respect, privacy, and autonomy (Olsen, Cutcliffe & O'Brien, 2008). However, the healthcare provider may decide to disclose the information but the problem arises when deciding the situation in which the information should be disclosed. According to HIPPA privacy rule, healthcare providers should protect the patient's past, present and future health information and health status and provide quality care. The circumstance under which the information should be disclosed is limited since they can only disclose to personal representatives when they request access to and when the information is needed for investigation or enforcement action (Olsen, Cutcliffe & O'Brien, 2008). Accidental disclosure to the privacy may lead to huge fines and other consequences.
End-of-life Decisions
Healthcare professionals face ethical dilemma in deciding the right treatment for a life-threatening illness. Healthcare providers are expected to practice end-of-life practices to sustain life. Patients also have the right to exercise control on the medical intervention (Rosenfeld, Wenger & Kagawa‐Singer, 2000). At this situation, healthcare providers face ethical dilemma due to the lack of decision-making capacity, agreement with the patients' treatment choices and providing full care support to the end-of-life. For example, a nurse may face an ethical dilemma in trying to sustain the life of a patient who has dementia. Since end-to-life decision requires effective communication with the patient, factors such as cognitive impairment and responsive behaviors may hinder the process of improving end-of-life (Rosenfeld, Wenger & Kagawa‐Singer, 2000). Healthcare provider may face an ethical dilemma in deciding between the risk and benefits associated with the treatment.
Conflict of interest
According to the ethical codes, healthcare professionals are expected to minimize the conflicts of interest to avoid causing harm to the patients. Instead of focusing on common goals and meeting the patients' interest, the healthcare providers hold both primary and secondary goals which bring conflict (Nijhawan, 2013). Some workers focus on personal gain such as developing a medical device to receive a reward from the company that has invented the device. Failure to handle the conflict of interest may result in fines, loss of investment and negative reputation.
Conflicting professional obligations
At times, healthcare professionals go beyond the area of competence and overrule the treatment professional. Even though they are allowed to treat other problems in which they have no training, they may face ethical and legal issues when they violate the code of ethics and taking the inappropriate action (Nijhawan, 2013). Professional has a legal and ethical obligation but they develop duty conflict when they ignore law and duty and focus on personal beliefs.
How to address ethical and legal issues as a healthcare manager.
As a healthcare manager, I will address these issue by creating an ‘ethical mechanism'. The latter comprises ethics committee who understands the policies and have ethics training in assisting the healthcare workers, patients and families. As a manager, I will promote ethical practices by creating education and open discussion where health care works would discuss important issues regarding the clinical ethics and understand the ethics policy. Ethics must be learned and for that reason, I will create the educational program to train workers on how to apply theoretical principles in executing tasks (Childress et al, 2002). By engaging in the educational program and understanding the ethical policy, workers in the healthcare field will distinguish between right and wrong and adhere to ethical obligation. Through education program and discussion, workers will speak up and raise ethical questions where they will solve complicated issues by applying different experiences and values. As a healthcare manager, I will also support the code of ethics by setting behavior consistent with the job description and providing performance reviews. Since the issue of informed consent is a major cause of moral distress among the healthcare professional, I will encourage the improvement of informed consent process by hiring professionals who would explain to the patients about the treatment, the role of informed consent form and test the misunderstand to see whether the patients understand the risks and benefits of the treatment (Childress et al, 2002). Since most frequent issues encountered in the field of healthcare care are related with informed consent, confidentiality, end-of-life decisions, unethical practices and the conflict of interest, I will encourage the workers to focus on the core ethical principles while performing the professional task. These principles include valuing the relational autonomy, do good and avoid harm, value the patient's life, exercise justice and solidarity (Childress et al, 2002). As a manager in the field of healthcare, I will also ensure that the healthcare providers have the necessary knowledge and skills to address ethical issues. They should be competent and familiar with the code of ethics for them to practice ethics. Finally, I will create a culture of ethical practice and create a system change.
Conclusion
The development of the medical field has modernized the area of medical practice where healthcare professionals are using technology to diagnose illnesses and offer quality treatment. The rapid developments have also improved the medical management where professionals provide effective medication with minimal side effects. These development have insisted the need to adhere to duties and obligations and focus on patients' interest. Healthcare professionals are encouraged to value the issue of autonomy, beneficence, confidentiality, and justice in offering quality care. Healthcare providers are expected to adhere to the principles of ethics in all situations and focus on common goals. Ethical dilemmas are inevitable since some situations are complex and need one to make a decision from two choices. In some cases, professional are unable to, make decisions based on disclosing privacy, maintaining confidently and adhering fully to the ethical codes. To address these issues, the healthcare managers should understand the legal and ethical principles and help the healthcare providers enhance their professional skills, build their competence and understand ethical and legal issues and how to address them.
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