Clinical Issues: Clinical Ethical Dilemmas

The community clinic has been a great experience to test our abilities and skills for the future as doctors of physical therapy. This opportunity helps students to get to know the strengths and weaknesses in real situations with patients. The community clinic is truly helpful and gives us, students, the chance of experiencing what our future jobs as physical therapy doctors will be like. The combination of practice, observation and feedback from classmates, professors and third year mentors gives a considerable amount of useful knowledge.

The desires of a patient are essential in an ethical medical situation. The physician and court system generally respects the autonomy of patients to make their own decisions. In cases of incompetence or minors, these choices are usually granted to surrogate decision makers or the legal system itself. In the case of Cruzan v. Director, Missouri Department of Health (Menikoff, 2001), one can see where Nancy Cruzan, a patient in a persistent vegetative state (PVS), was not granted the right to have medical treatment removed. This landmark case presented the discussion of a right to die on a national forum. The reason for such debate is because of the ruling given Supreme Court of the United States in 1990. I contend that the Supreme Court of the United States (SCOTUS) was wrong in reaffirming the state of Missouri that there was not sufficient

A physician has the responsibility to determine the legitimacy of all work injuries and to report its finding accurately. If a physician prepares a report with the intent to use it in support of a fraudulent claim and knowingly submitted for payment under an insurance contract, the physician may be subject to fines or imprisonment and risks the possibility of having his or her medical license revoked. Presenting a claim for an item or services based on a code known to result in greater payment or submit a claim for services not medically needed is a violation of the false claim act.

When it comes to the Guatemalan syphilis experiment and the Tuskegee experiment both were two unique experiments. Recently, the United States apologized last year for the experiment, done in Tuskegee which was meant to test the drug penicillin. However, Two years before that, Health and Human Services Secretary Kathleen Sebelius made an apology for the experiment conducted in Guatemala. With that said, the researcher rejects the case that a utilitarian could make the case that the Guatemalan syphilis study was more ethically defensible than the Tuskegee study, because the Guatemalan study had greater potential to lead to useful medical knowledge that could save many lives, while the Tuskegee study did not have any such potential (Bonnie Steinbock, 2005). I believe that neither experiment was for medical knowledge or served and medicinal purpose and that

Last week I had the opportunity to talk to Mr. R who was brought in to the hospital due to a workplace injury. The referral was put through by the attending physician indicating that there was concerns of substance use. I started the conversation by introducing my role as a hospital social worker and tried to build report by asking Mr. R how he was managing at the hospital. Being transparent is important and explaining the reason for the visit helps in creating trust for the therapeutic intervention. I probed Mr. R about his alcohol use and if he identified that as being an issue for him. Mr. R indicated that he has been using alcohol for over a long period and reports this as a part of his daily social life, which makes it hard for abstinence.

Healthcare encompasses ethical issues related to business in addition to ethics concerning patient care. Physicians, hospitals, clinics, and other healthcare entities are subject to the potential for fraud and abuse. There are complex regulations and laws associated with Medicare and Medicaid, The Health Insurance Portability and Accountability Act (HIPAA), and The Patient Protection and Affordable Care Act (ACA) and are in place to prevent and/or address the unethical issues of fraud and abuse (Krause, 2013).

Do health care workers have the right to conscientiously object to providing care if it varies from their own personal moral and ethical belief system?

It is indeed stressful to be faced in a predicament where someone’s life is at stake; whether be on the ED’s or the ICU’s side. Therefore, as a leader representing the ICU, my approach would probably be to assess the situation, identify the problem, and collaborate with the ED leadership to resolve the current and potential issues that resulted from the disagreements. Meanwhile, I will emphasize to the ICU staff the importance of having an awareness of their behavior, especially if they are verbalizing their frustrations towards the other department since critical situations in the health care settings entails rationally solving the problem while setting aside our departmental differences to achieve our common goal of giving a superior care

Describing the problem or the main issue in this case would be using patient data for research purposes for better future outcomes and quality improvement for the society as a whole even if it is without having consent from the patient. This problem illustrates a key ethical dilemma which is allowing research for the betterment of society without their consent while maintaining respect and privacy for the patients who are contributing to this research. Is it ethical to violate individual rights for the good of society at large? Clinical research involving people has been permitted without consent for over 10 years in the US using the Exception and Waiver regulations (Lecouturier, 2008). Some of the knowledge gained by this research can include improvements and quality of cancer treatments, better understanding of health hazards, reliable evaluations of new preventative measures and treatments, and

Perhaps the toughest feedback I have ever received came from a well-respected physician who was unsatisfied with his electronic medical records that I prepared for him as a medical scribe. In the middle of a demanding shift, I was confronted about my documentation in which I did not document in a way that was focused on ensuring ‘Level 5’ charting. In other words, the physician gave me feedback on my charting methods and asked me to change the way in which I documented his interactions so that the hospital would receive the most compensation. This request proposed an ethical dilemma for myself as I had observed every interaction between the physician and his patients and knew that my documentation was a genuine attempt to accurately record

When caring for patients, nurse practitioners must incorporate ethical knowledge in practice. Ethics addresses morals, advocates doing the right thing, and encourages providers to act appropriately (Epstein & Turner, 2015). Not only do ethical issues arise from bedside dilemmas, but ethical issues can also stem from problems at the organizational level. The code of ethics can help guide the levels of direct and non-direct patient care for the NP (Epstein & Turner, 2015). Legal considerations that are important to the NP and clinical practice are the following: a) negligence, b) breach of duty, c) informed consent and refusal, d) battery, e) confidentiality, and f) patient autonomy.

Morality plays a huge role in the health care field. This principle of right and wrong conduct is noteworthy to specialists while assessing the benefits and troubles of medical procedures. One may find the progress of helpful advances hard to endure. For example, using a piece of vitro arrangement to pick babies for an impeccable inherited human cloning. If we screen an incipient organism for a tissue sort, we can then allow certain physical qualities for the newborn child. We can pick their eye shading, kind of learning, physicality, and capacity that could propose our babies regardless, consummate in a perfect world society. Inherited

Ethics refers to the accepted code of conduct by an individual while performing his/her duties. It is a set of principles that can result to critically changing actions and choices that had been made previously. Ethics can be referred to as a branch of philosophy that assist in dealing with the decision making dynamics on what is wrong or right (Wöhlke, Wiesemann, Schicktanz, & Carmi, 2012).

First and foremost, individuals are responsible for the way in which they chose to live their lives. It is imperative to take care of your body as you only get one in a lifetime. Healthy eating habits are a choice for most people around the world. In some circumstances where people are starving and have no choice is the exception to the rule. Obese individuals, when told by a medical professional should in fact change their habits and lead a healthier lifestyle. Individual responsibility should be a top priority as it relates to personal health. The lack of attention-to-detail may result in a lifetime of hardships and pain do to crippling diseases.

There is one issue that I could think of that is challenging regarding to patient care throughout my preceptorship this week was one of the patient in my unit refuse to come out of her room to receive treatment and allowing the lab technician to draw her blood. The patient already refuses to go to the cafeteria in the morning to have her breakfast because she said she was having a back pain. When the nurse asks us to have her go to the treatment room for her assessment, she refuses to come out from her room again. Until the lab technician arrived in the unit for lab work, I have gone to her room and ask her to come to the treatment room again for the lab work, she did not respond. I cannot tell whether she was breathing this time because she