Professional - Ethical and Legal issues in Healthcare

Question: Describe about the Professional, Ethical and Legal issues in Healthcare. Answer: Introduction The problem of Ethical dilemma is often faced by the nurses, irrespective of the role and the location of the practice of nursing. Any kind of decision, which is concerned with ethics, will have an immense impact on the nurses, patients and the families of the patients. Due to the nature of importance of ethics, the issues pertaining to ethics has become a fundamental rule and it is associated with all the nursing practices. In the view of Aiken (2004), ethics is a discipline, which deals with the appropriateness and wrongness of a particular action. Ahead of that, it also involves the doing of good acts and excluding any kind of harm. However, in nursing practices taking ethical decisions could be prejudiced and differs from one nurse to the other. For making a best ethical decision, it needs a perception, but somewhat, the control and internalization of the knowledge of ethical toolkit, that are influenced through the beliefs, values and experiences of the nurses. This consecutively forms a logical progression by identifying the ethical dilemma along with the capability of providing a systematic method in the form of a solution (Beauchamp and Childress, 2009). In contrast, Hendrick (2000) accepted the terms morally and ethically and described it in an approach that relates to the nursing practice. According to him, moral and ethics can be viewed merely between what is correct and incorrect, right or wrong in the action of humans and the outcomes of what we do. He also recommended applying these approaches academically and theoretically. The common ethical issues that are faced include universal human rights, abortion, death, environment, healing and quality of life. Being healthcare professionals, we frequently encounter ethical dilemma because of conflicting interests like personal beliefs, social consent or professional beliefs that are not in consensus (Hayes, 2004). In order to practice nursing ethically, the professionals of nursing must be perceptive to identify the doubtful ethical issues in their occupation on a daily basis. Abortion has constantly been a contentious subject leading to an argument in a larger extent over the years, particularly the thought aligned with abortion is ongoing between the perspectives of pro-life and pro-choice. Pro-choice are the individuals who consider that the females possess the right regarding the termination of pregnancy or to keep the baby on the grounds of their health conditions. In contrast, pro-life criticize the act of abortion and recommends it to be criminalized by law. This is due to the reason that, all the human beings should possess the rights to live, despite whether they are having any kind of disability or not. The perspective of the supporters of pro-life is that from the conception time, i.e. when a fetus acquires the form of a human being and hence it has a right to live. The importance and trust of the professionals of healthcare concerning the issue on abortion care are being challenged every day. The supporters who do not agree with the idea of abortion observe it as a type of unethical and immoral activity. If the cause against the act of abortion is significant, then, how do the individuals justify in similar conditions using ethics and morals to put forward the social acceptance of putting to death, particularly, the death sentence employed in a number of countries, even in Singapore which is a although a developed country (Johnstone, 2013). In this article, I desire to argue that the act of abortion should not be observed sim plistically as a killing act, instead to understand the ideas that encourage the thought of abortion. This article will commence by highlighting the ethical theories. In addition, a discussion regarding the act of abortion will be carried out from the viewpoint of legal, ethical as well as professional context. Subsequently, an argument between the right of the fetus and maternity rights will be revealed. This is pursued by the argument between individual value and belief as contrasted to the duty of the healthcare professionals. Lastly, it will also provide the methods to reduce the abortion risk and its prevention. In the concluding section, a demonstration of the level regarding the supportiveness of the act of abortion will be emphasized. Ethics Theories Due to the advancements in the technology, the ethical issues have turned to be more complex and offer additional substitutes. This has resulted in the rise of various controversial questions. For instance, do the pregnant women possess complete independence over their healthcare situations concerning their body? Where does life start? Does the fetus possess any right? Ethically, the reply to these complicated questions and the actions depend on the instinctive morals of a person. The issues like beneficence and non-maleficence, autonomy, justice along with the quality of life come into this particular category. An individual theory of ethics is instinctive. The proposition is that the ethical principles and terms can be observed in the expedience of humans and their instinctive acts. Utilitarianism, which was established by Jeremy Bentham, argues that the essential principle of utility involves the maximization of pleasure and minimization of pain (Ferm 1950,p. 269). It is an illust ration of a significant ethical theory, since it declares that an act, which is morally good, is the one that assists the greater number of individuals. In contrast, Deontology, which is a kind of non-consequences theory, considers the actions that are required to be based correctly on the system and laws concerning the duties and obligations. In the opinion of Kant (1997), absolute adherences are required by deontology to these acts and obligations ethically from duty. The act of abortion was a social, legal and political issue prior to Roe v. Wade decision by the Supreme Court of the United States in the Year 1973. Rights of the Foetus Versus maternal rights In women, pregnancy is a process which is continuing. For identifying a point beyond which the act of abortion should not be permitted is difficult. This is due to the reason that there is an unclear destination from the stage of conception to the birth stage. The identification of the ethical status of the foetus is based on the developmental stages, such as viability, appearance and sensitivity to pain. Therefore, before committing the act of abortion it is essential to know what the act of abortion is. Mainly, it is the termination and expulsion of pregnancy prior to birth. It may take place unexpectedly, in that case it is called miscarriage, or it can be an abortion which is induced. Around 42 million cases of abortion take place worldwide in a year. Around 12 % of abortion takes place at or subsequent to 13weeks of gestation, 1.35 % being performed ahead of 21weeks of conception (Napolitano Thilaganathan, 2010). In spite of the substantiation of abortion in a number of countri es, the response to whether the act of abortion is ethically allowed remains doubtful. The professionals of health care frequently have to face the issues regarding the involvement or withdrawal from the procedure of abortion and such decisions can be complex as well as difficult. From the viewpoint of the expecting women, they have the right to choose what can happen with their body. In the view of Johnstone (2004), the decision regarding abortion should be strong-minded and it should be valued as her independence. In addition, they should be permissible to make a decision what is going to take place with their bodies. No one, together with professionals of healthcare should go against their decisions. The Fetus is regarded as a potential life that depends on the body of the pregnant female for its survival. Following 24weeks of gestation, the life of then fetus is believed to be viable. The rights of the fetus should be the main concern except the ongoing of pregnancy would result in instant destruction and intimidates the physical condition of the expecting mother. According to the Ministry of Health (2004), abortion is allowed if the continuation of the period of pregnancy is intimidating the physical condition of the expecting women and can result in permanent damage to the pregnant women either mentally or physically. However, the fetus grows particularly further than the 24weeks of gestation, the rights of the fetus surpass the rights of the mother. Personal value and belief versus healthcare professional duty In the cases of abortion, the nurses frequently act in response in ways that demonstrate the difficulty of the issue. The values in the area of nursing include realizing what is vital for the profession as well as the nurses personally, in addition to what is essential for the expecting mother. Abortion is an area in which several nurses are struggling with the conflicts of their professional duty and individual worth (Marek, 2003). Since, it is not easy to encourage a woman in the process of decision making regarding the termination of pregnancy (Murphy et al. 2000, p.2235). The individual belief of the individuals affects their decisions, but proficiently speaking, the professionals of healthcare must avoid such type of behavior. In reply to the necessity for information and care that addresses contraception and sexual health (Murphy et al. 2000, p.2235). A number of nurses are in favor in assisting the procedure of abortion. Few nurses may not help in the abortions but may possibl y provide care to the patient subsequent to the process. Several other nurses would help in abortion in the first tri-mester of the pregnancy but may not agree in later stages. There is no obligation for the nurses in supporting a position in which they oppose. However, the nurses are compelled to reveal this information before they start working in the hospitals or clinics that perform abortions. Regardless of everything, the nurses should give respect to the patients decision that looks for care. Being healthcare professionals, we must inform the patient systematically regarding the decisions of healthcare. In Singapore, compulsory counseling is needed prior to the procedure for every patient who wants to terminate their pregnancy. For females who are less than 14 years of age, there is no medical privacy for protecting them from being reported to the police as well as to parents, as it is an offence for any male to have sexual contact with a female who is less than 14 years of ag e (statutory rape). The Health Promotion Board (HPB) counseling centre counsels the females who are below 16years of age. The patients who are mentally disabled require certification by a psychiatrist that continuation of the pregnancy can result in harming the mother prior to the medical procedures. It is compulsory to wait for 48 hours after the procedure of counseling is conducted ahead of the procedure of abortion. The patients who choose to terminate their pregnancy are needed to sign a declaration of level of education, marital status and number of kids. All the patients must receive complete information and understand the information as well as consent willingly. This entire procedure is strictly confidential and nobody is provided with the information, including the parents of the patient. The professionals of health care frequently have to face the issues regarding the involvement or withdrawal from the procedure of abortion and such decisions can be complex as well as difficult. From the viewpoint of the expecting women, they have the right to choose what can happen with their body. Every pati ent who will undergo the termination of pregnancy is required to have post abortion counseling and need to come back following a week for follow up of any sort of complications. Additionally, political aspect is one of the issues that deals with political candidates, who are not in favor of abortion will pass the legislation and go on confronting the strategy in bringing up the consideration to their viewpoint. The legal aspects of Roe V.Wade (1973) has given a work of abortion law, codifying, regulating and limiting whether, when and under what conditions the women may opt for an abortion (Learman et al., 2005). Prevention and ways of lowering the abortion risk In the year 1986, the government of Singapore encouraged those who manage to have more kids that lead to a reduction in the rate of abortion. The identification of the ethical status of the foetus is based on the developmental stages, such as viability, appearance and sensitivity to pain. Therefore, before committing the act of abortion it is essential to know what the act of abortion is. Mainly, it is the termination and expulsion of pregnancy prior to birth. It may take place unexpectedly, in that case it is called miscarriage, or it can be an abortion which is induced. Around 42 million cases of abortion take place worldwide in a year. Around 12 % of abortion takes place at or subsequent to 13weeks of gestation, 1.35 % being performed ahead of 21weeks of conception (Napolitano Thilaganathan, 2010). In spite of the substantiation of abortion in a number of countries, the response to whether the act of abortion is ethically allowed remains doubtful. The professionals of health care frequently have to face the issues regarding the involvement or withdrawal from the procedure of abortion and such decisions can be complex as well as difficult. From the viewpoint of the expecting women, they have the right to choose what can happen with their body. In the view of Johnstone (2004), the decision regarding abortion should be strong-minded and it should be valued as her independence. In addition, they should be permissible to make a decision what is going to take place with their bodies. No one, together with professionals of healthcare should go against their decisions. It could be used to know their menstrual cycle, planning of pregnancy or avoiding pregnancy. In addition, vasectomy is also applicable to be performed on males along with tubal ligation for females which only can be performed in a clinic or hospital with the consent of the patient. All the types and methods of contraception have a probability to get failed. Additionally, by using simple language whil e communicating with the patient would be better in providing education regarding family planning as well as raise the awareness pertaining to abortion to patients and their families. Conclusion: The act of abortion has been a controversial issue over several years. It involves several ethical issue as well as laws. In the situations that affect the decision of the individual, for instance cases of rape, have an effect on the expecting mothers health, some individuals think that it is all right, but a number of them consider that the fetus must be viable. Hence, the nurses provide education to the pregnant women and their families regarding the process, risks and complications. An improved access and utilization of the contraceptive services as well as emergency contraception could result in the reduction of the cases of unintentional pregnancy and a decline in national rate of abortion. It should underline the significance of the programs of family planning through public support in such a way to reduce the prevalence of unplanned pregnancy as well as abortion. In addition to that, there is also a need to provide education to the pregnant women and their family members regar ding the procedure as well as concerns after the completion of the procedure. In all the situations, healthcare professional are responsible to review the potential benefits as well as harms prior to the execution of any sort of intervention. Health care professionals should be encouraged to provide valid services to guarantee accessibility, affordability and quality of care for the women,. Being a nurse, the care goals for every patient should be determined by giving proficient care, even if it is in opposition to the personal belief. The ethical principles, personal values and belief, laws, and code of conduct, should be kept in mind while analyzing all the situations individually and an association between patients, their families and the healthcare providers for establishing the ethical action. References: Abortion In Singapore https://sg.theasianparent.com/abortion_in_singapore/ Bandman, E. Bandman, B. (2002). Nursing Ethics Through the Life Span. (4th ed.). Upper Saddle River, Beauchamp,T.L and children , J.F. (2009) Principles of Biomedical Ethics, 6th edn. Oxford: ocford university Press Bulletin of the World Health Organization, year 2000 Butts, J., 2008.Ethics in professional nursing practice. Jones and Bartlett Publishers. code of practice for midwives - Health Professionals Portal Dadlez, E. M., Andrews, W. L. (2010). Post-abortion syndrome: Creating an affliction. Bioethics. 24(9), 445-452, DOI: 10.1111/j.1467-8519.2009.01739.x. Ethical, Social, and Legal Issues C, https://www.coursewareobjects.com/objects/evolve/E2/book_pages/murray/pdfs/Murray_036-050_Ch03.qxd.pdf F.(n.d). A History of Philosophical System (p.269). Finer, Lawrence B. and Lori F. Frohwirth, Lindsay A. Dauphinee, Susheela Singh and Ann F. Moore."Reasons U.S. Women Have Abortions: Quantitative and Qualitiative Perspectives."Perspectives on Sexual and Reproductive Health, Guttmacher.org, September 2005. Guidelines on Termination Of Pregnancy _Singapore https://www.moh.gov.sg/content/dam/moh_web/HPP/all_healthcare_professionals/(2)_Guidelines%20on%20Termination%20of%20Pregnancy.pdf Hayes,C.(2004). Ethics in end of life care. Journal of Hospice Palliative Nursing,6 (1):36-45 Hendrick J.Law and ethics in nursing and health care.Cheltenham: Stanley Thornes, 2000. https://www.familyplanning.org.nz/advice/contraception/contraception-methods https://www.healthprofessionals.gov.sg/content/dam/hprof/snb/docs/publications/Code%20of%20Practice%20for%20Midwives%20(Aug%202001).pdf https://www.moh.gov.sg/content/dam/moh_web/Publications/Reports/1998/National%20Medical%20Ethics.pdf Johnson BR, Ndhlovu S, Farr SL, Chipato T. Reducing unplanned pregnancy and abortion in Zimbabwe through postabortion contraception. Studies in Family Planning 2002, 33 (2): 195-202. Johnson, D. (2013) The Jolly Hangman, the Jailed Journalist, and the Decline of Singapores Death Penalty,Asian Criminology, 8:41-59 Jones RK, Darroch JE and Henshaw SK, Patterns in socioeconomic characteristics of women obtaining abortions in 20002001, Perspectives on Sexual and Reproductive Health, 2002, 34(5):226235; Henshaw SK and Kost K, Abortion patients in 19941995: characteristics and contraceptive use, Family Planning Perspectives, 1996, 28(4):140147 158; and Henshaw SK and Silverman J, The characteristics and prior contraceptive use of U.S. abortion patients, Family Planning Perspectives, 1988, 20(4):158159 162168. Learman, L. A., Drey, E. A., Gates, E. A., Kang, M., Washington, A. E., Kuppermann, M. (2005). Abortion attitudes of pregnant women in prenatal care. American Journal of Obstetrics and Gynecology. 192(6), 1939-1947, DOI: 10.1016/j.ajog.2005.02.042 Lipp,A.(2008). Challenges in Abortion care for practice nurses. Practise Nursing,19(7):326-9 Making abortions safe: a matter of good public health policy and practice Marek, M. J. (2003). Nurses' attitudes toward pregnancy termination in the labor and delivery setting. JOGNN. 33(4), 472-479 Marshall, J., Raynor, M. (2001). Conscientious objection 1: Legal and ethical issues. British Journal of Midwifery. 10(6), 389-392 Marston C, Cleland J. Relationships between contraception and abortion: a review of the evidence. International Family Planning Perspectives 2003, 29 (1): 6-13 Napolitano,R., Thilaganathan,B. (2010). Late termination of pregnancy and foetal reduction for foetal anomly. Best Practice research: Clinical Obstetrics Gynaecology,24(4):529-37 NATIONAL MEDICAL ETHICS COMMITTEE OMalley, C. Legal and Ethical Issues Concerning Pro-Life Choices. 2013 , https://ftp.kumc.edu/xmlui/bitstream/handle/2271/1173/STTJUNW-2013-OMalley.pdf?sequence=1 Singh S, Sedgh G. The relationship of abortion to trends in contraception and fertility in Brazil, Colombia, and Mexico. International Family Planning Perspectives 1997, 23 (1): 4-14. TERMINATION OF PREGNANCY ACT (CHAPTER 324) https://statutes.agc.gov.sg/aol/search/display/view.w3p;page=0;query=DocId%3A%2212e6e975-dbc5-4964-9128-4d2f4ca6d89c%22%20Status%3Ainforce%20Depth%3A0;rec=0 Theological Bioethics: Participation, Justice, and Change https://books.google.com.sg/books?id=7TBZz54xdMkCpg=PA287lpg=PA287dq=kissling+2004+citation+prolifesource=blots=5JpunNNtJbsig=tuvr8q26wp6BEe-pTk2YF0lsyUAhl=ensa=Xved=0ahUKEwia2e6s5IbMAhXJLpQKHT_QDiMQ6AEILjAD#v=onepageq=kissling%202004%20citation%20prolifef=false White, Angela. "Cost of Giving Birth at the Hospital or at Home." Blisstree.com, 21 September 2008. "Why It Matters: Teen Pregnancy and Education."The National Campaign to Prevent Teen Pregnancy, retrieved 19 May 2009. www.who.int/bulletin/archives/78(5)580.pdf