Ethical Issues in Clinical Practice
WRITTEN RESPONSE #1 (READING SUMMARY) THLEAD 410: ETHICAL ISSUES IN CLINICAL PRACTICE UNIVERSITY OF WASHINGTON TACOMA Part One: Articles Summary In “The four topics: Case analysis in clinical ethics,” Jonsen et al states that a clear standards of operation is needed for clinicians to effectively address ethical issues (Jonsen et al, 2007, p. 164). Clinical systems such as properly referring to the patients’ medical records, patients’ requests or demands, patients’ ability to perform daily activities of living, and the overall circumstances of the patients are relevant in resolving ethical dilemmas (Jonsen et al, 2007, p. 66). Jonsen et al concludes that, decisions regarding ethical dilemmas should be dealt with caution, certainty of the case, and understanding of the ethical issues in question (Jonsen et al, 2007, p. 169). According to Jarvie & Malone, the authors of “Children’s Secondhand Smoke Exposure in Private Homes and Cars: An Ethical Analysis,” the challenges regarding how to protect children from second hand smoking exposure in private homes and cars, and still protect individual rights (Jarvie and Malone, 2008, p. 2140).
The statistics indicates that “22% of children younger than 18 years old and 40% of children younger than 5 years in the United States live with someone who smokes,” (Jarvie and Malone, 2008, p. 2140). It costs about $4. 6 billion per year for medical expenditures among children in the US exposed (Jarvie and Malone, 2008, p. 2141). The courts have ruled in different cases that the harm caused by second hand smoking to children by individuals who smoke in private homes and cars, overrides individual rights of these individuals to do as they want in their homes and cars with regards to this issue (Jarvie and Malone, 2008, p. 142). Jarvie and Malone concluded that, creating laws to restrict smoking around children to prevent second hand smoking exposure in private homes and cars, does not threaten individual autonomy (Jarvie and Malone, 2008, p. 2144). In Rosemarie Tong’s “New perspectives in healthcare ethics,” the healthcare delivery system in the US is examined and the changes from a patient – doctor relationship system, to the entire industry (admin, insurers) involvement in the decision making of delivering care (Tong, 2007, p. 7).
The definition of the different types of ethical theories and their advantages and disadvantages such as the utilitarianism, Deontology, Virtue based, Natural based theories just to name a few (Tong, 2007, p. 7-23). The professional – patient relationship models such as engineer and priestly models and they affect patient – doctor relationship (Tong, 2007, p. 42). Confidentiality and privacy is one of the most important aspects of patient-professional relationship in the healthcare delivery system in creating an atmosphere of trust from patients to their doctors (Tong, 2007, p. 9). Part Two: Discussions and the readings The Dax case video was very confusing to me and left me undecided as to the ethical questions regarding this case. I found myself agreeing with Donald Dax that, with the severity of the injuries sustained, and the unbearable pain he was under, he should have been given the choice to end his life if he so chooses. However, I also agree with the doctors and his mother’s decision not to aid him in taking his life.
I still can’t reconcile the ethical twist between these two. I feel that no one has to go through the magnitude of pain that Donald gone through, with over 60% of his body burned with no significant use of his limbs and eyes, he should at least have the choice whether he wants to live or not. In Jarvie and Malone article, I strongly disagree with parents who argue that their individual rights have been violated by regulations prohibiting smoking in private homes and cars around children.
I believe that the argument does not hold ground as we have seen government interference in similar child danger situations such as child abuse, parents using drugs around their children and many more child abuse cases, and remove the children out of those situations. I do not believe that second hand smoking is any different from and other child abuse cases. The ethical question here for me is, is the children under and physical, mental or health danger? With second hand smoking exposure, I am perfectly fine with laws to regulate it. Part Three: Substantive Questions ) Who decides what’s ethical? 2) Is ethical standards inform by ones religious or non-religious beliefs? Reference Jarvie, J. A. , & Malone, R. E. (2008). Children’s secondhand smoke exposure in private homes and cars: An ethical analysis. American Journal of Public Health, 98(12), 2140-45. Jonsen, A. R. , Siegler, M. , & Winslade, W. (2007). The four topics: Case analysis in clinical ethics. In N. S. Tong, R. (2007). New perspectives in healthcare ethics: An interdisciplinary and crosscultural approach. Upper Saddle River, NJ: Pearson Prentice Hall
