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Challenges in applying ethical principle in health care

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Challenges in applying ethical principle in health care

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Mental ill patients are always victims of Paternalism.  Its difficult at times to allow a combative mentally ill individual to use his autonomy when he places himself, staff and other patients at risk.  Especially when reasoning,  cooperation and calmness is no where in the picture.  Patient is all delusional, hallucinating  and being very disruptive.  Based on his presenting behavior and lack of cognitive capabilities to reason, the medical staff has withhold his right to be an autonomous person, until he is more settled, and some what back to reality.  Although some mentally ill  individuals are not capable of making full use of their autonomy and would need a surrogate, but most of them are capable of making sound decisions once they are better.

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Anonymous

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As an A&E nurse relieving in ICU, I had to admit a 4 year old, with a diagnosis of severe pneumonia. He was in severe respiratory distress and only his parents could calm him down, when he was pulling out the IV lines and nasal prongs. On admission, my colleagues told the parents that only the child can be admitted, they would have to go home and leave him, according to the floor matron's orders. Questions then arose as to why in the general ward, there were parents with their children. The child got more hysterical as he could hear and see his parents' distress at having to leave him. I then had to advise the parents to wait whilst I called the matron and doctor to ask that they be allowed to stay since he was the only admission in the ward. It was for the patient's benefit, and the doctor agreed. It worked out well, with one of the parents being allowed to stay. It then raised issues that since they only usually admitted unconscious patients, they, as the nurses had not thought about letting the caregivers stay if they had conscious ones.

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My 6 year old patient has continuous fever and iv paracetamol 4th hourly was ordered.inspite of all cooling measures and iv paracetamol ,the fever was still not subsided.syrup brufen was ordered and it is not available in the hospital.the patient is allergic to voltaren.so i asked the pharmacist to somehow get the brufen as it is his right to get the right treatment.Somehow the pharmacist was able to get the medication

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My 6 year old patient has continuous fever and iv paracetamol 4th hourly was ordered.inspite of all cooling measures and iv paracetamol ,the fever was still not subsided.syrup brufen was ordered and it is not available in the hospital.the patient is allergic to voltaren.so i asked the pharmacist to somehow get the brufen as it is his right to get the right treatment.Somehow the pharmacist was able to get the medication

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Same happened in medical ward l worked husband was HIV positive on ARVS but wife did not

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My own Case was a case of vaccination,i deal directly with applicants(patients)that wants to travel to different countries , and one of the most important reasons for vaccination is to reduce mortality among host countries,an applicants that was meant to have 5 different types of vaccine came to the clinic with a forged vaccination record,i was able to detect and in that case I rejected the record the applicants explained to me that he went to a local health centre paid them, and asked them to write those vaccines In the record for him, I totally disregard the record.when he discovered that I was serious about it he then told me another thing that I should just go ahead and record the vaccine in the report his taking to the embassy even though he has refused to be vaccinated.,this was raised and reported to the embassy. Even though the applicants have a right to health care services this will pose a larger to the people in the country he's traveling to.

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Dear all great so sharing your description of ethical scenarios and some of you have mentioned important topics such as rights and confidentiality. Now start to think about  how you could applied ethical  principles to the scenario . You will read about these in the first few weeks of the module. Beauchamp and   Beauchamp and Childress (2013) reference  would be an important source to look at. Keep on the discussion! 

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Dear all great so sharing your description of ethical scenarios and some of you have mentioned important topics such as rights and confidentiality. Now start to think about  how you could applied ethical  principles to the scenario . You will read about these in the first few weeks of the module. Beauchamp and   Beauchamp and Childress (2013) reference  would be an important source to look at. Keep on the discussion! 

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Recently a member of a Christian denomination was brought.
The patients vitals  and blood levels were abnormal. The patient required blood transfusion. The family kicked against it because of belief.
After a long deliberation and consideration the family was asked to sign a document relieving the hospital of liability.
Patient later recovered but took time.

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As a nurse in a small district hospital there was severe shortage of resources . They was a patient with a big septic wound who required a lot of bandages for dressing and the same bandages can be used to dress more clean wounds which requires less bandages . The dilemma was distribution of resources ,as it was difficult to choose what to do we had to ask all patient if they can afford to buy bandages and most patients with small clean wounds where able to afford and the hospital bandages where given to the patient with septic wound.

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Throughout my nursing career, I've dealt with all sorts of ethical dilemmas and ethical issues. But this case which i am about to present takes presidence.
After I graduated from nursing school I was placed on the Surgical Unit where I cared for a 39 year old patient who was diagnosed with Aids. To add to his diagnosis he had Syphilis and toxoplasmosis. His condition was getting worse.His prognosis was very poor. He was also involved in a romantic relationship with his girlfriend for almost 5 years and refused to communicate this information to her. We the nurses on the unit tried to convince him in telling his girlfriend so that she can be tested and that appropriate care can be rendered to her but he still refused. When she decides to question him as to why he's not getting any better he tells her because of the brain infection he has. Of course, she believes him. It was saddening for me. What added insult to injury he was a health care provider as well. He should not better. He felt no remorse for his actions. He was not only selfish but malicious in his own way. Days later he passed away. As nurses, we know that patients has the right to confidentiality and the right to make they own decisions. At the end we advised her to take routine labs which she did and her serology came up negative. But we still encouraged to continue following up with her routine blood works.

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I have ever been faced with a very difficult situation which was very ethical i was faced with a core mandate to perform a role which was met with ressitance from the family of the patient i was providing care to.
Working at the A&E , an elderly man was rushed in bleeding, he was unconscious, vital signs were assessed and he had low BP with an irregular but fast pulse. blood sample was taken to lab and it was determined that he has low haemoglobin as a result of so much lost of blood. He was in hypotension although parenteral fluids were commenced. The doctor immediately ordered for blood to be transfused. once the blood was received, i prepared to commenced the transfusion, but was asked by the relatives not to do it as their religion do not permit them to have blood transfusion. No amount of persuasion could yield results. So the Doctor was called in to explain the likely consequences of their decision and they were eventually asked to sign a document to approve their decision. They finally came around to agree for the transfusion to take place and my patient was stable after some hours.