Doctor Facilitated Denial Summary

Patient's decision-making is influenced by several factors. Patients may change their decisions, from accepting or refusing treatment depending on the available treatment options. The capacity of the individual to make informed medical decisions can differ as the patient's status changes cognitively, emotionally, and/or physically and as the proposed treatment interventions change. Treatment refusal is a common situation faced by clinicians. Patients do not usually refuse the medical advice if the advice is of good intention. When patients refuse an advice, it indicates some underlying reasons related to the patients or family, factors associated with the physician as well as social and organizational issues.

ii. Unconscious physician bias. Another theme in the reading that related back to class was the unconscious biases of doctors influence their interactions with patients, with consequences for patient outcomes. These unconscious biases affect interaction through the doctor’s communication. Establishing a basic understanding of treatment and diagnosis can foster better patient outcomes. An example of unconscious physician bias was Abraham 's focus on former secretary of the Department of Health and Human Services, Dr. Sullivan, in chapter eight. Dr. Sullivan’s campaign focused on the individual choice in adopting healthy lifestyle choices from diet to exercise. Skipping over racial disparities, the unconscious bias inferred through his words was that he considered the patient to blame whenever they fell ill.

Clinicians have observed that the DNR order set has a negative connotation and implies withholding or halting curative therapies (Venkat, 2014 ). As health care providers focus on the clinical aspect of care a dichotomy is created when the surrogate for the patient injects emotion into the thought process (Buscaino, 2013). They may perceive their choice to either be permission to terminate or agree to the DNR order to do “all that they can”. A study led by Ruth Wittmann-Price and Linda M. Celia, reported that a majority of physicians reported that they were personally likely to consent to AND for a

The effect of the medical model creates a sense of hopelessness and poor outcomes for the individual who has a label. This approach does not give the individual control over their life decisions (Timimi,

The article “The COPD Exacerbation Experience: A Qualitative Descriptive Study” explains the health behavior of a selected population with Chronic obstructive pulmonary disease. The author of the article conducts a research study on individuals suffering from the condition due to the high prevalence of the disease in the United States. The article undertakes a qualitative and descriptive study in a bid to understand all aspects associated with the condition and the reasons for its high prevalence. This essay will focus on analyzing the application of Social Cognitive theory to explain the health behavior of a patient population with the COPD condition. The Social Cognitive Theory focuses on understanding an individual’s behavior, based on their observations. In the health behavior, the theory explains that a patient may learn different aspects of their illness considering the signs and symptoms that they may have.

This assignment will explain the pathophysiology of the disease process chronic obstructive pulmonary disease (COPD). It will examine how this disease affects an individual looking at the biological, psychological and social aspects. It will accomplish this by referring to a patient who was admitted to a medical ward with an exacerbation of COPD. Furthermore with assistance of Gibbs model of reflection (as cited in Bulman & Schutz, 2004) it will demonstrate how an experience altered an attitude. In accordance with the Nursing and Midwifery Council, (NMC) Code of Professional Conduct (NMC, 2005) regarding safeguarding patient information no names or places will be divulged. Therefore throughout the assignment the patient will be referred to

Acknowledging how the patient perceives illness and health, helps in understanding the beliefs and how they relate with preventing

Other barriers in implementation might include the legality of certain medical interventions, associated costs and limited resources for providing the best care possible (Mason, 2013, p.12). As nurses, a barrier in implementing advance directives might also arise when advocated end-of-life wishes are undervalued or poorly recognized by others who do not share the same comfort or high priority in the medical workplace. Finally, the patient, families, and healthcare professionals face barriers in misconceptions regarding advance directives, especially in regards to

In order to state a constitutional claim under the Eighth Amendment for lack of proper medical care, a prisoner must meet a three-fold test. First, the actions or inactions of prison authorities must correspond to a "deliberate indifference" standard. Estelle v. Gamble, 429 U.S. 97 (1976). Secondly, that deliberate indifference must be directed "to [a] serious medical need [ ]". Id. In order to state an Eight Amendment claim for denial of medical care, a plaintiff must demonstrate that the actions of the defendants or their failure to act amounted to deliberate indifference to a serious medical need. Id. at 106. Additionally, there must be some personal involvement on the part of prison officials. West v. Atkins, 815 F.2d 993 (4th Cir. 1987), rev 'd. on other grounds, 487 U.S. 42, 106 S.Ct. 2250 (1988). “Deliberate indifference to a serious medical need requires proof that, objectively, the prisoner plaintiff was suffering from a serious medical need and that, subjectively, the prison staff were aware of the need for medical attention but failed to either provide it or ensure the needed care was available.” Blackwell v. Webb, et al., Civil Action No. RDB-13-1947, at 10.

According to Glanz, Rimer, and Viswanath (2008) the Health Belief Model attempts to explain why people do or do not engage in specific health behaviors such as taking action to prevent, screen for, or to control illness conditions through concepts including susceptibility, seriousness, benefits and barriers to a behavior, cues to action, and self-efficacy. Perceived susceptibility is defined as a person’s beliefs about the likelihood of getting a disease or condition. Perceived severity is defined as a person’s feelings about the seriousness of contracting an illness or of leaving it untreated. Perceived benefits are described as influencing whether a person’s perceived susceptibility will lead to behavior change. Perceived Barriers are described as

Leventhal’s model of self-regulation is based on the idea that each person forms a cognitive representation of their illness, which allows them to make sense of their symptoms. This illness perception and the patient’s emotional response then guide behaviour towards managing the illness (Leventhal et al., 1984). An illness perception is made up of five major components. These are illness identity, potential cause, timeline, its consequences and how it may be controlled. Often patients with similar diseases can hold very different perceptions of their illness (Petrie and Weinman, 2012). Clinical severity of the condition does not necessarily predict how a patient will cope. This essay will outline strengths and weaknesses of whether the model can be used to explain health outcomes and coping strategies, implement successful interventions and predict or even improve adherence to treatment. Finally, the importance of constructs not included in the model, such as social support, will be discussed. The essay will evaluate the model using examples of illnesses such as stroke, cancer, diabetes and asthma.

Our society finds it difficult to talk about dying and euphemisms are the norm. It is typical for both doctors and patients to be hesitant to initiate a discussion on dying. Focus instead is often more often placed on interventions and actions for managing symptoms. This avoidance can leave patients and their families unprepared for the inevitable death. (Schapira, 2010) It also often results in requests for therapies which may be excessive, costly and even painful in the hopes for a cure. One study demonstrates that when patients are aware that they are terminally ill, the majority are able to reach a state of peacefulness and also exhibit lower levels of distress. (Ray, Block, Friedlander, Zhang, Maciejewski & Prigerson, 2006) It is also important that family members are willing to discuss end-of-life options with their loved ones. According to elderly patients, they are most often the ones who initiate these conversations with their

Conner and Norman, 1995 describe the health belief model as ‘the oldest and most widely used model in health psychology’. It originated in the 50’s and was developed further by Hochbaum, Rosenstock and Kegals throughout the 1980’s for health education programmes and to predict different health behaviours and responses to treatments. The four terms that are the basis for the HBM are perceived susceptibility, perceived barriers, perceived severity and perceived benefits. The behaviour of the individual depends on their belief that they are susceptible to a health problem, how serious they deem it to be, whether they think that treatment will benefit them and if there are barriers that may get in the way.

Health belief model was one of the first and most widely recognized theories of health behavior. (Butts & Rich, 2011). This theory was formulated in an attempt to predict health behaviors by focusing on the attitude and beliefs of individuals. It is aimed to determine the likelihood of an individual to participate in health-promotion and disease prevention programs. (Kozier & Erb, 2011). This theory postulated that if a patient is well- motivated, there is a possibility that he will participate in these activities. Motivation can be derived by the individual's perceptions towards his condition. According to Becker (1974), individual perceptions include patient's perceived susceptibility, perceived seriousness of the disease and perceived threat.

Lying in medicine seems to be a requirement for doctors because they think that truthful information can hurt patients (Bok 222). According to doctors, while they are telling the truth, patients may have a heart attack or their psychological mechanism might be alleged. Furthermore, death comes more quickly. However, these are so rare and considering these universal is an overgeneralization. In addition, doctors consider their patient as a child and see them like a blind, suffering and passive toy (M.Smith and M.Weil 22); hence, doctors think that they can make choices for their patients without telling the truth to patients. However, this opinion just shows doctors’ paternalistic view (Bok 227).