Responsibilities of health professionals for specific ethical issues

Responsibilities of Health Professionals for Specific Ethical Issues

Patient's Bill of Rights

Statement on a patient's bill of rights was approved by the House of Delegates in February 6, 1973. The American Hospital association presents a patient's bill of rights with the expectation that observance of these rights will contribute to more effective patient care and greater satisfaction for the patients, and the hospital organization.

The traditional physician- patient relationship takes a new dimension when care is rendered within an organizational structure. Legal precedent has established that the institution itself also has responsibility to the patient. It is in recognition of these factors that these rights are affirmed.

The patient's rights are as follows:

1. The patient has a right to considerate and respect full care
   
2. The patient has a right to obtain from his physician complete current information concerning his diagnosis, treatment and prognosis in terms the patient can be reasonably expected to understand. When it is not medically advisable to give such information to the patient, the information should be made available to an appropriate person on his behalf. He has the right to know by name the physician responsible for coordinating his care.
   
3. The patient has the right to receive from his physician information necessary to give informed consent prior to the start of any procedure and / or treatment. Except in emergencies, such information for informed consent should include but not necessary are limited to the specific procedure and/ or treatment, the medically significant risks involved, and the probable duration of incapacitation. Where medically significant alternatives for care or treatment exist, or when the patient requests information concerning medical alternatives, the patient has the right to such information. The patient also has the right to know the name of the person responsible for the procedures and /or treatment.
   
4. The patient has the right to refuse treatment to the extent permitted by Law and to be informed of the medical consequences of his action.
   
5. The patient has the right to every consideration of his privacy concerning his own medical care program. Case dissociation, consultation, examination, and treatment are confidential and should be conducted discreetly. Those not directly involved in his care must have the permission of the patient to be present.
   
6. The patent has the right to expect that all communications and records pertaining to his care should be treated as confidential,
   
7. The patient has the right to expect that within its capacity a hospital must make reasonable response to the request of a patient for their services. The hospital must provide evaluation, service, and/ or referral as indicated by the urgency of the case. When medically permissible a patient may be transferred to another facility only after he has received complete information and explanation concerning the needs for and alternatives to such a transfer. The institution to which the patient is to be transferred must first have accepted the patent for transfer.
   
8. The patent has a right to obtain information as to any relationship of his hospital to other health care and educational institutions as far as his care is concerned. The patient has the right to obtain information as to the existence of any professional relationships among individuals, by name, who is treating him.
   
9. The patient has the right to be advised if the hospital proposes to engage in or perform human experimentation affecting his care or treatment. The patient has the right to refuse to participate in such research projects.
   
10. The patient has the right to expect reasonable continuity of care. He has the right to know in advance what appointment times and physicians are available and where. The patient has the right to expect that the hospital will provide a mechanism where by he is informed by his physician or a delegate of the physician of the patient's continuing health care requirements following discharge
    
11. The patient has the right to examine and receive an explanation of his bill regardless of the source of payment.
    
12. The patient has the right to know what hospital rules and regulations apply to his conduct as a patient
    

Ethical Issues Related to Patients Rights

1. Right to Truth

The right of patients to know the truth about their condition, prognosis, and treatment is an issue between the physician and the patient. The current trend is toward more frankness on the part of physicians. In the past, the moral obligation to disclose the truth-because the patient has the right to know and adjust to was often overcome by the professional need to protect the patient from potential physical or emotional harm that could be caused by knowledge of a critical or terminal condition. Because of there extended contacts with patients, nurses often find it difficult to accept a physician's decision not to tell a patient the truth about his or her condition. Because of the conflict between physicians' decisions and nurses' personal feelings, it may be advisable for the health care team to meat in order to resolve the problem and to devise a consistent approach to the patient.

2. Right to Refuse Treatment

For reasons that are sometimes known only to themselves patient may refuse treatment even though lack of treatment may result in their death. The question of refusal of treatment may have to be decided in court. Many times, the courts rule that patents cannot be forced to accept treatment. In the case of minor child, however, the courts are likely to rule that parents cannot withhold treatment from a child for any reason. The child is usually made a temporary ward of the court and treatment is allowed to begin.

A patient's decision to die rather than to accept treatment may be difficult for a nurse to understand.

Nurses must recognize a patients' right to individual and allow personal feelings to interfere with patient care. If nurses cannot reconcile their ethical values with those of patients, they should ask to be taken off the case in the interest of the patient.

3. Informed Consent

The issue of informed consent applies to many health care institutions in both legal and ethical ways. Patients have the right to be given accurate and sufficient information about procedures, both major and minor, so that their consent to undergo those procedures is based on realistic expectations.

The responsibility for imparting information about major surgery or complicated medical procedures lies with medical professionals. Nurses should inform their patients; in terms the patients can understand, about even simple nursing procedures before the procedures are started. This includes answering questions that patients may have. Failure to obtain informed, written consent to perform a procedure could involve nurses and other health care professional in legal action or subject to disciplinary action by state regulatory agencies.

Because nurses spend considerable periods of time with patients, they are likely to be most aware of their patients' questions and concerns. Many times, these concerns should be brought to the attention of attending physicians who, because they see the patients' lass frequently, may be unaware of the problems.

4. Human Experimentation

Research and human experimentation are primarily concerns of the scientific and medical professionals. However, if nursing care is required for the subjects involved for such experimental projects, then nurses became involved. In these cases, nurses‘ responsibilities and ethical decisions are related to making sure that informed consent is given for participation in the research experiments and that the safety of their patients is protected. The nurses‘ role, along considered to be that of patient advocate, may, in these situations, place them in direct The nurses‘ role, along considered to be that of patient advocate, may, in these situations, place them in direct conflict with research staffs and sponsoring agencies as well as human subjects research committees.

5. Behavior Control

The issue of informed consent is critical question in any form of behavioral control; the use of drugs or psychosurgery further complicates a highly complex topic.

Controversy persists over the rights of society to decide what is or is not desirable or acceptable behavior. The issue involves both personal and public behavior. Moreover, it also concerns whether individuals have the right to decide for themselves what suitable personal behavior is, or whether others can decide for them based on some other concept of suitable personal behavior.

In this regard, one of the ethical questions that may be confronted by nurses involves informed consent for treatments that are intended to control behavior. Nurses may question whether involves who are candidates for drug therapy or psychotherapy are able and competent to give informed consent, and whether these patients, too, have the right to refuse treatment