Private Clinician Ethics

McCall Ethics Case Study Jerry is Dr. Williams’s office assistant. He has received professional training as both a medical assistant and an LPN. He is handling all the phone calls while the receptionist is at lunch. A patient calls and says he must have a prescription refill for Valium and that the provider, a friend, calls in the medication prior to any flights. This type of request happens often and in slightly different scenarios, but the outcome should remain the same to avoid ethical and legal issues. This paper will review the case study to help resolve the problem at hand, refilling a prescription without provider authorization. Qualified Medical Training Understanding the definitions of a licensed practical nurse, LPN, and a medical assistant, MA is the first step to making a factual conclusion for this case study. Support staff to the provider cannot make decisions about medication refills for patients without a direct order from the provider. This action is outside the scope of practice for an LPN or MA. Licensed Practical Nurse An LPN is a role in support of the nurse or RN, a registered Nurse usually in a skilled nursing setting such as a hospital or long-term care facility. As defined by the National Federation of Licensed Practical Nurses, NFLPN, an LPN “means the performance for compensation of authorized acts of nursing which utilize specialized knowledge and skills and which meet the health needs of people in a variety of settings under the direction

The coordinated care of the patient involves organizing a Child Family and Team (CFT) meeting to facilitate the appropriate delivery of behavioral and healthcare services that meet the needs of the family. During the CFT, the patient, patient’s legal guardians, behavioral health providers, and medical team effectively communicate the appropriate delivery of healthcare and behavioral services. Updates about medical and/or behavioral concerns are faxed to the patient’s primary care physicians. In addition, case managers, clinical care managers, or family support partners make an attempt to accompany the family to the next schedule PCP appointment. This process facilitates both

Because of our somewhat limited understanding of the brain and its processes, it is not known for certain what causes depression; however, there are many theories. Many of these hypotheses are based upon synaptic transmission, the concentration of neurotransmitters (mainly serotonin and norepinephrine), and their transporters in the brain. Neurotransmitters are chemicals that transmit chemical signals from one neuron to the next. In a normal functioning system, neurotransmitters are synthesized in neurons from molecules called monoamines, and their release into the synaptic cleft is based on Ca+2. The neurotransmitters cross the synaptic cleft and will bind to G-protein coupled receptors on the membrane of the neighboring neuron, causing regulation of biological processes that have both short- and long-term effects on the brain. If any of the preceding steps are affected, depression may result.

The discussion on Patrick Dismuke's condition concentrated on his incapability to improve. After reviewing his symptoms and considering possible scenarios resulting from certain kinds of treatment, such as the tube that delivered nutrients into his veins that "broke the barrier between blood and air" and became "a bacteria-laden Trojan horse, opening the door to infection", we attempted to come to a consensus on what would constitute a quality life, as deliberated among the committee. We took into consideration that after every kind of surgery, his status would be temporarily improved but ultimately decline in keeping with his body's proclivity. We acknowledged that the idea of a successful stomach transplant was remote since, as

Analyzing the acute care context is crucial when critiquing the many activities that nurses carry out during their shifts. This analysis ensures that these activities are being performed correctly, while also maintaining that the patient and his or her needs are at the centre of care. In particular, when examining the medication administration process (MAP), nurses must explore many factors, including the practice standards and guidelines that accompany this activity, the positive and negative aspects associated with current as well as best practice, barriers and facilitators associated with best practice, and how one can maintain his or her best practice within this activity. For the purpose of this

There was a lot of literature on health care clinical ethics, considerably less literature on health care organizational and administrative ethics. Many times what is good for health care business may not be ethical, causing an "ethics gap." Ethics gaps can be identified and corrected by careful analysis of an institution's organizational culture. A true case study on how a nurse was able to change a tainted organization into a responsible one by ethics infrastructure changes. Finally, implications for health care were addressed.

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.

Today the Army is an organization that closely manages every penny spent to avoid what it considers wasteful spending on inefficient practices. Across the board, within the scope of Army activities exist many practices that are wasteful and take money from other areas of necessity. Medical treatment by way of medical appointments is one such process that has had to undergo a shift in practice as medical appointment failures have risen during intense budget constraints. As an Army major command (MACOM), the medical command has worked to convey that all sites where medical facilities exist are all echoing the same message across the board to change the mentality towards missing appointments. With the MEDCOM looking to adjust it own practices across its own enterprise, the command is also looking to spread the message to supported MACOM with the intent of spreading an understanding that Corps leaders must update policy and implement control measures including strategic messaging that stops wasting over $ 4 million in missed appointments while simultaneously prioritizing mission accomplishment and continuity of care.

Cases such as this are eventually resolved in court, but it does not close the gap in how to ethically handle future problems, or improve the current problems in death laws. This is where an ethics committee becomes the strongest asset to not only solve disputes, but do so in an ethical manner when policies provide little guidance and the public misunderstands the limitations of medical intervention.

The right to refuse has many components to it: there are family implications, religious implications, and social implications. Every patient has the right to consent for treatment, care, or blood products. The decision to consent or not is theirs to make unless otherwise implicated. In every action in health care there are many perspectives to a topic and can bring many ethical conflicts each seen differently by another individual.

Jesus went with his apostles to the northern section of Israel, the gentile cities of Tyre and Sidon. While there, a Canaanite woman from that region approached them crying: “Have mercy on me, O Lord, Son of David; my daughter is severely possessed by a demon.” Even though Jesus heard her he did not say a word to her. St. John Chrysostom in his Commentary on the Gospel of Matthew tells us that He did not answer her because He knew the great gift that He would give her. His silence wasn’t to ignore her, but so that she would persevere and through persistence build humility which would “reveal the treasure laid up in her”—that of knowing her relationship with God.

Ethical standards for all healthcare professions include principles of informed consent, veracity, and beneficence to provide best care (Kornblau & Burkhart, 2012). However, the definition of best practice can still differ among patients depending on their diagnosis, age, personality, and personal culture. Best practice gets further complicated when the patient is a child. The law concerning medical decisions for children states that children are unable to make their own decisions soundly (Goldstein, 1977). A parent must stand in as the decision-maker giving consent to treatments. Parents have the right to establish and dictate the course of healthcare without interference by the state. Parents can choose to accept or decline treatments,

Doreen, I found your discussion response to be very interesting. Nurses are the members of the care team that are most accessible to the patient, therefore they deal with ethical issues on a daily basis when providing patient care. According to Silva, Marvins, Bobre, Frazao, & Rosa (2014) ethics, is a fundamental aspect of the nursing practice, and nurse should understand both their competencies and limitations when delivering care (p. 241). I experienced the exact example you gave for an ethical situation. We had a patient on the unit who has not only a DNR on her chart, but also a copy of her living will which clearly stated no ventilator. She had a relatively minor procedure with complications, which is why she ended up in ICU.

Our history has plenty of examples of ethical violations in clinical research. It wasn’t until 1906 that the Pure Food and Drug Act was passed and started the road to protecting human participants in research. Before then, there were no regulations regarding the ethical usage of humans in research. There are several cases of what you could call unethical medical research studies in our history. From 1932-1972, the Tuskegee Syphilis Study (which was sponsored by the U.S. Department of Health), studied the effects of untreated syphilis in 400 African American men by withholding treatment. The subjects were not even told that they were in an experiment and most of the subjects believed that they were getting treated for “bad blood”. During World War 2, concentration camp prisoners were conducted upon by the German scientists for research. On December 9, 1946, 23 scientists and administrators were put on trial for allowing these crimes against humanity and war crimes. The

After extensive training, practice, and exploitation of their skills, medical students become interns who go on to become residents, who finally evolve into attending physicians. After this grueling journey of education and advancement of knowledge, it is quite common for some physicians to feel comfortable in their line of work; moreover, doctors of this caliber often submerge themselves into routine scenarios and procedures where the question of medical ethics remains close to non-existent. However, when questions of this nature do arise, it is imperative that doctors are aware of their severity and are adept at being able to confront them with a high level of appropriateness. Physicians often ask, “What is the right methodology to solve this dilemma?” Thus, when these specific questions develop, it is quite fascinating to reveal the factors that determine the choices and decisions a physician would make regarding these scenarios. From logical, emotional, and even physician credibility, there are a plethora of situations in which physicians must question their plan of action for their patients and determine the best course forward to ensure patient health and wellness.