?Health Care Policy, Law, and Ethics Discussion Wk 9

Health Care Policy, Law, and Ethics Discussion Wk 9 “Procreation and Ethical Dilemmas in Health Care” Please respond to the following: *From the scenario, examine the concept of health care ethics, and ascertain the fundamental way in which such concepts apply to procreation-related issues. Speculate on the major ramifications of using moral principles to make decisions concerning such issues.Scenario AttachesConsider the concept of ethics in health care predicated on ethical theories and moral theories, and explore the connection of such ethics with ethics committee decision making. Rationalize the primary concerns of conception, wrongful birth, and abortion from the perspective of health care professionals who must make these decisions. ***This is a discussion, not a paper. Need 2 strong paragraphs and references. ***
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Week 9 Lecture: Healthcare Ethics and Procreation and Ethical Dilemmas
Slide #
Scene/Interaction
Narration
Slide 1
Intro Slide
Slide 2
Scene 1
Professor Charles enters
classroom and introduces the
topics for today?s lesson and
begins the lecture.
Prof Charles: Hello everyone. Welcome back
to class. Today, we will discuss healthcare
ethics, moral principles, and a variety of issues
of procreation.
Ethics and morals are derivatives of the Greek
and Latin terms for custom. Noting that words
are the tools of thought, it is important to know
some vocabulary in order to lay a foundation for
applying abstract theories and principles of
ethics and make practical use of them.
An ethical dilemma arises in situations where a
choice must be made between unpleasant
alternatives. It can occur whenever a choice
involves giving up good and suffering
something bad no matter what course of action
is taken. In healthcare a caregiver may have to
decide do I choose life knowing that an unborn
child will be born with severe disabilities, or
should I choose abortion and thus prevent pain
for both child and mother?
Should I adhere to my spouse?s wishes not to be
placed on a respirator, or should I choose life
over death, disregarding her wishes and right to
self-determination? Should I encourage the
abortion of my daughter?s unborn child, which
is the result of a gang rape, or do ?no harm? to
the unborn child? Such delimmas rise to
conflicting answers.
Let?s first discuss ethics. What is the definition
of ethics?
Casey: Ethics is that branch of philosophy that
seeks to understand the nature, purposes,
justification, and the founding principles of
moral rules and the systems they comprise.
Donald: I would agree, but would also add that
it focuses on the rightness and wrongness of
actions, as well as goodness and badness of
motives and ends. Ethics is the decisionmaking process determining the ultimate
actions: What should I do, and is it the right
thing to do?
Casey: In addition I would add that it involves
how individuals decide to live, how they exist in
harmony with the environment, and how they
live with each other when so few have so much
and so many have so little.
Prof. Charles: Absolutely? what are the three
different but related ways ethics are used?
Casey: The three different ways ethics are used
are philosophical ethics, which involves inquiry
about ways of life and rules of conduct; the
second is a general pattern or ?way of life? such
as religious ethics and the third is a set of rules
of conduct or ?moral code,? which involves
professional ethics and unethical behavior.
Prof. Charles: What is bioethics?
Donald: Bioethics addresses such difficult
issues as the nature of life, the nature of death,
what sort of life is worth living, what constitutes
murder, how we should treat people who are
especially vulnerable, and the responsibilities
we have to other human beings. It is about
making the right judgments in difficult
situations.
Prof. Charles: Great job Donald! Now let?s
take a closer look at morality and ethical
theories.
Slide 3
Check Your Understanding
Which of the following is not
a principle of healthcare
ethics?
A. Anything goes is
not a principle
B. Demonstrates
doing bad in the
healthcare setting
C. Demonstrates good
or compassion
Correct Feedback:
B. Demonstrates doing
bad in the healthcare
setting
Incorrect Feedback:
C. Demonstrates good
or compassion
Slide 4
Scene 2
Prof Charles: Morality is a code of conduct. It
is a guide that all rational persons put forward
for governing their behavior. Morality describes
a class of rules held by society to govern the
conduct of individual members. A moral
dilemma occurs when moral ideas of right and
wrong conflict.
Ethical theories and principles is an attempt to
determine what moral standards should be
followed so that human behavior and conduct
may be morally right.
The consequential theory of ethics emphasizes
that the morally right action is whatever action
leads to the maximum balance of good over
evil. It is ethics that judge actions by their
consequences.
Situational ethics is concerned with the
outcome or consequence of an action in which
the ends can justify the means. Why do good
people sometimes do bad things? The answer is
fairly simple: One?s moral character can
sometimes change as circumstances change?
thus the term situational ethics. Remember
ethical decision-making is the process of
determining the right thing to do in the event of
a moral dilemma.
Slide 5
Scene 3
Discussion between Prof Charles
and students.
Prof. Charles: Principles of healthcare ethics
are universal rules of conduct, derived from
ethical theories that provide a practical basis for
identifying what kinds of actions, intentions,
and motives are valued. Ethical principles assist
caregivers in making choices based on moral
principles that have been identified as standards
considered worthwhile in addressing healthrelated dilemmas.
Prof Charles: Beneficence describes the
principle of doing good, demonstrating
kindness, showing compassion, and helping
others. Doing good requires knowledge of the
beliefs, culture, values, and preferences of the
patient —what one person may believe to be
good for a patient may, in reality, be harmful.
For example, a caregiver may decide that a
patient should be told frankly, ?There is nothing
else that I can do for you.? This could be
injurious to the patient if the patient really
wants encouragement and information about
care options from the caregiver.
Compassion here requires the caregiver to tell
the patient, ?I am not aware of new treatments
for your illness; however, I have some ideas
about how I can treat your symptoms and make
you comfortable. In addition, I will keep you
informed as to any significant research that may
be helpful in treating your disease processes.?
Nonmaleficence is an ethical principle that
requires caregivers to avoid patient harm.
Nonmaleficence is not concerned with
improving others? well-being, but rather with
avoiding the infliction of harm.
Justice is the obligation to be fair in the
distribution of benefits and risks. Justice
demands that persons in similar circumstance be
treated similarly.
The principle of autonomy involves recognizing
the right of a person to make one?s own
decisions. Autonomy means recognizing an
individual?s right to make his or her decisions
about what is best for him or herself.
Casey: So, Professor Charles?can you tell us
about virtues and values?
Prof. Charles: Absolutely! Virtue ethics
focuses on the internal character of a person
rather than on specific actions that he or she
performs. Properly understood, virtues serve as
indispensable guides to our actions; however,
they are not ends in themselves. The
relationship between means and ends and
principles (virtues) and practice (values) is often
difficult to grasp. A moral value is the relative
worth placed on some virtuous behavior. A
value is a code of conduct. Values are used to
judge the goodness or badness of some action.
Values are the motivating power of a person?s
actions and necessary to survival, both
psychologically and physically.
Donald: Just to be clear, religious ethics serve
as a moral purpose by providing codes of
conduct for appropriate behavior through
revelations from a divine source. These codes of
conduct are enforced through fear of pain and
suffering in the next life and/or reward in the
next life for adhering to religious codes and
beliefs?
Prof. Charles: Yes, the prospect of divine
justice helps us to tolerate the injustices in this
life where goodness is no guarantee of peace, or
happiness, wellness, or prosperity.
Casey: I am still not quite clear how religious
beliefs of a patient affect the actions of a
caregiver in the hospital.
Prof. Charles: The caregiver can learn of a
patient?s religion through information gathered
upon admission. Caregivers often find it
difficult to discuss spiritual issues for fear of
offending a patient. Caregivers can share with
the patient those religious and spiritual
resources available in the hospital and
community.
Slide 6
Check Your Understanding
Professional ethics are a ——————– established by a
the membership of a speicif
profession
A. Code of conduct
B. Loose belief system
Correct Feedback:
A. Code of conduct. Most
professions have a code of
ethics to describe what is
right or wrong.
Incorrect Feedback:
B. Loose belief system does
not provide guidance of what
is right or wrong for members
faced with ethical dilemmas
in their work.
Slide 7
Check Your Understanding
Healthcare ethics committees
membership should be comprised
of multidisciplinary groups such
as ——————————-A. Bank tellers
B. Community leaders.
C. Nurses aides.
D. Real estate agents
Correct Feedback:
.Correct answer: Membership
should be leaders in the
community, an ethicist,
educators, legal advisors,
physicians, ministers, etc.
Incorrect Feedback:
A. Bank tellers
C. Incorrect. Please try again.
D. Incorrect. Please try again.
Remember, to be successful
the committee should select
its members to include a wide
range of leaders from the
community.
Slide 8
Scene 4
Discussion of procreation and
ethical dilemmas
Prof. Charles: Now let?s discuss procreation
and ethical dilemmas.
We will discuss the various issues of
procreation with primary focus on abortions.
Discussed to a lesser extent are issues relating
to sterilization, artificial insemination, and
wrongful birth, wrongful life, and wrongful
conception. While discussing these ethical
issues you should apply the ethical theories,
principles, and values discussed previously.
Can anyone explain the case, Roe versus Wade
(1973)?
Casey: I think I can. In this Supreme Court
case the court held that the Texas penal
abortion law was unconstitutional stating: ?State
criminal abortion statutes?.that except from
criminality only a lifesaving procedure on
behalf of the mother, without regard to the stage
of her pregnancy and other interests involved is
violating the Due Process Clause of the
Fourteenth Amendment.?
Prof. Charles: Very good Casey! That is an
excellent explanation. There will most likely be
a continuing stream of court decisions, as well
as political and legislative battles, well into this
century. Given the emotional, religious, and
ethical concerns, as well as those of women?s
rights groups, it is certain that the controversies
and ethical dilemmas surrounding abortion will
continue for many years to come.
Donald: Prof. Charles?.what about state
abortion statutes?
Prof. Charles: Donald that is a great question?
The effect of the Roe v. Wade decision was to
invalidate all or part of almost every state
abortion statute in force then. Since then many
state abortion laws have been enacted to restrict
the performance of abortions as much as
possible.
Casey: Do elective sterilizations on competent
individuals cause problems similar to abortions?
Prof. Charles: No, Casey?. As long as proper
consent has been obtained from the patient and
the procedure is performed properly. If
negligence is involved then a civil malpractice
may occur.
Donald: I think that the discussion on
procreation and ethics has really clarified some
questions for me. Now, a little more
clarification on the legal issues of wrongful
birth, life, and conception would really help.
Prof. Charles: Well, that is a great lead-in to
this next topic.
Slide 9
Scene 5
Discussion on the integrity and
confidentiality of the patient
record.
Prof. Charles: There is substantial legal debate
regarding the impact of an improperly
performed sterilization. Wrongful life suits
usually are deemed frivolous since the courts
are unwilling to permit financial recovery for
the ?injury? of being born into the world.
Prof. Charles: Wrongful birth cases result from
improper sterilization cases where an unwanted
child was born. Also, the parent can sue the
physician who failed to determine the extent of
harm of rubella infection during gestation
resulting in birth defects.
Casey: I would say the birth defects of the child
in such a case does result in injuries and added
expense of child rearing and anguish by the
parents. After all, it was the result of negligence
by the physician.
Prof. Charles: Exactly?It is so important to
remember that such negligence is the proximate
cause of the injuries and expenses of child
rearing.
Donald: Professor, in our discussion wrongful
conception has not really been addressed.
Prof. Charles: To touch upon this subject again
let?s discuss the case, Lovelace Medical Center
versus Mendez. A physician employee at
Lovelace Medical Center performed a negligent
sterilization and failed to tell the wife of the
unsuccessful operation resulting in a child nine
months later. The parents sued the Medical
Center for wrongful conception. The court
awarded the couple reasonable expenses to raise
the child to majority.
.
Casey: But unwanted pregnancy is not always
the result of negligence on the part of the
physician.
Prof. Charles: Exactly. The physician can
always practice informed consent and notify the
parents the sterilization attempt was
unsuccessful.
Slide 10
Scene 6
Prof Charles: We are just about out of time.
Let?s go over what we learned in this lesson.
Summary
Picture of Casey and Donald as
they speak.
Abortion is defined as the premature
termination of a pregnancy, either spontaneous
or induced. Individuals have a right to refuse to
participate in abortions for reasons of
conscience or religious or moral conviction.
Physicians feel the effects of the abortion
controversy. There are cases in which
physicians have filed successful litigation
regarding physical and mental health injuries
suffered as a result of the controversy.
Ethics is the branch of philosophy that seeks to
understand the nature, purposes, justification,
and founding principles of moral rules and the
system they comprise. Morality is a code of
conduct. It is a guide to behavior that all
rational persons would put forward for
governing the behavior of all moral agents.
Ethics signify a general pattern or way of life,
such as religious ethics; a set of rules of conduct
or ?moral code,? which involves professional
ethics; or philosophical ethics, which involves
inquiry about ways of life and rules of conduct.
Political corruption, antisocial behavior,
declining civility, and rampant unethical
conduct have heightened discussions over the
nation?s moral decline and decaying value
systems.
Before we adjourn, are there any questions?
Donald: I have no questions; I think that the
information was clearly presented, Professor.
Casey: No questions for me?
Professor Charles: Well, if there are no further
questions, I will say good evening and I will see
you next time.

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