Reflective Journal
Ethical Issues in medicine
Medicine is an area of specialization that directly affects human lives. Whenever an individual is sick or feels ill, the first realistic step to take is seek medical attention. Everybody expects medical procedures to be flawless and give the best most desired results, however, this is usually not the case. Medical procedures involves the participation of both the doctor and the patient, it requires full participation and involvement of the two in order to achieve the best results. Therefore, for there to be success in any medical practice, the doctor must do his or her part and so does he patient. Many cases have been reported where the patient failed to follow medical procedure to the end, some also ignored instruction and decisions made by the doctors in order to help save a life.
Therefore, this article is a reflective journal of some ethical issues in the field of medicine that I encountered while working as a doctor in a hospital. The journal is a reflection on different ethical problems that occurred sometimes back and were recorded in medical journals, newspapers and some made the news headlines across the country.
28th October – Maternal Decision Making, Ethics, and the Law
I read an article about ethical issue facing maternal decision making in various medical facilities across the country published in November 2005. The main issue that I noted in the article is that mothers do not have the moral obligation or the right to make decisions that concerns them and the unborn child that they are expecting. The article reports that there are proposed legal policies and actions by politician and the government to protect the unborn baby as a separate entity from the mother (ACOG, 2005). The provision thus means that the mother do not have the ethical rights to make decisions that directly affects her and the baby.
In my opinion, this is a cruel proposition since it is not possible to treat the expectant mother as different from the fetus since it is she who carries the child in her womb. The law denies the mother her rights to bodily integrity and the rights to make decisions that affect the both of them. I feel that such a law alienates women and does not recognize the fact that they perform the hard job of conceiving and caring for the unborn child for nine months (ACOG, 2005). The law should recognize that the mother and the unborn child should be treating as one entity because it takes one party to nurture the other.
In this article is a section that states that medical practitioners decided to get a warrant forcing a woman to undergo a caesarian section to have her child born at twenty-six week of her gestation period? This decision was made irrespective of the fact that the woman was in a position to make informed decision about the medical procedure. I think that medical practitioners and the law have lost the respect for expecting women (ACOG, 2005). They also use their positions to force women into taking medical interventions against their wish. Would I have acted in different way if I were the gynecologist attending to the case? Yes, it is important for doctors of all kinds and especially gynecologists to uphold ethical laws and give women the right to make decision concerning their health and that of the fetus. Women should not be treated with less regard compared to the children they are carrying in their wombs since they too are an important part of the fetal development process.
In my opinions, doctors should understand that knowledge and prediction of results in obstetrics could be subjected to limitation and mail fail at times (ACOG, 2005). Ethically, women should be given the chance to make decision on the medical interventions suggested to them by the obstetricians. Situations that force women to take up medical interventions without having the chance to decide and give their opinions are unethical and should be avoided in any medical facility. Politician, medical professionals and other human rights activists must work hard to ensure that women are accorded the right to be heard (ACOG, 2005). When I think of the problems that women go through from conception to delivery, I feel that medics should treat expecting women with more attention just as they do with the unborn baby. Do they want to insinuate that it is better for an expectant woman to dies but have the baby saved?
29th October
I watched in the news and also read from a magazine how a woman was prosecuted and charged with first degree murder for refusing to go through an immediate caesarian section due to issues related to the fetal wellbeing, and she later had a still birth of a male child and a live baby girl who tested positive for cocaine (Pozgar, 8). I tend to think that this woman was mistreated with a lot of contempt. The scenario is a clear indication that the doctors were only concerned with the well being of the children while completely ignoring the health of the mother, so has children suddenly become more important than their mothers, has a fruit ever been regarded highly than the tree from which it comes?
The same piece of information carried a segment in which a 23 year old woman was taken to prison for using cocaine during her pregnancy, while another 22 years old woman was prosecuted immediately after delivering her child who tested positive for alcohol (Pozgar, 8). The woman was put 12 years behind bars for knowingly feeding her unborn with alcohol through her umbilical cord in her placenta into the babies’ blood stream. I fully understand the root cause for the legal charges against the 22 and the 23-year-old women (ACOG, 2005). It is wrong to expose unborn children to drugs since this can harm them, however did the lawyers and the medical practitioners who dealt with the two cases found out the reasons why these women turn to using drugs while pregnant.
Did the bench and the doctors consider the mental health of the mother if they really wanted to ensure that the fetus was healthy? Why was the punishment awarded to the mother after nine months of struggling with alcohol and the use of cocaine (Pozgar, 8). I hereby state that the doctors and the lawyers failed to get to the root cause of the reason why mothers used drugs while pregnant. Every medical facility must closely monitor their patient while pregnant until the fetus is born, they must be able to carry constant test on the mother to see if they are undergoing some degree of crisis that might harm their health and that of the baby (ACOG, 2005). Some women do not know how to deal with stress in the most effective way. It takes the help of the gynecologist to indentify these problems and refers his patient to the right doctor.
My view in the case where a woman was being forced to accept an operation to help save the fetus because the mother was critically ill is different. I beg to differ since in my medical career, I have come to understand that there are many challenges in life and the faint hearted like the 22 and the 23-year-old (Pozgar, 8). In many cases, pregnancy occur when the coupled had not planned for it, in such situation women are usually left alone after the man responsible for the pregnancy has taken off. The woman just like any patient for that matter has the right to make decisions for as long as she was alive.
As a doctor, I would chose to preserve the lives of both the mother and the child, I cannot behave that I am in no position to help a mentally unstable woman. The women become unstable in the sense that they can easily deteriorate in mental health due to stress and depression. Going through a C-section is a dreaded event in a woman’s life, therefore, before any woman get into the operating room, they must be told and must have made the decision voluntarily (Pozgar, 8). All gynecologist, obstetricians and lawyers must understand the emotional turmoil that women go through during pregnancy and must aim at handling women with utmost care before passing any judgment on them.
30th October 2014 Emergency care in America
I read an article about the crisis that many if not all states in the country face in their emergency rooms. This article revealed that many hospitals across the country face acute crisis in their emergency rooms and need to have this matter looked into (Oshea, 2007). The issue in this case was that there were many emergency cases being reported and taken to hospitals. Some of these facilities are allowed by the law to offer emergency care to individuals irrespective of the abilities to pay. I think that it is a good gesture to notice that physicians, nurses and other doctors obey such laws and aim at preserving human lives the best way they can (Oshea, 2007.
However, research has shown that there is an influx into these medical areas that cannot be handled in the few facilities found in the country. While I read the paper, I wondered what I would do if I were in a position to offer assistance. I realized that if I were part of the congress or government who are in charge of medical and hospitalization in the country, I would allocate more funds for healthcare facilities (Oshea, 2007. The money would be used for putting up more emergency rooms and employing more doctors so that there would be enough man power, rooms and equipment that are needed in the sections of the hospital.
I had a feeling that due to poor emergency conditions in the emergency rooms, provision of quality emergency care to patients was also law, therefore, developing my strategies for providing better care would heavily rely on purchasing new instruments for experiments. Each hospital should have a wing that is known as the emergency loans. Not all doctors are trained to handle emergency issues at the hospital, therefore, I would suggest to the director of hospitals that they need to employ specialized staff who deal with such issues in the hospital (Oshea, 2007.
30th October 2014 – Medical Malpractices
I watched a video on the television that talked about medical malpractices. I noticed that many hospitals in the world have their employees being involved in occurrence of medical malpractices at all time (McLellan, 34). The malpractices include misdiagnosing the patient, giving the wrong medicine to the wrong person, leaking patients and employees’ confidential information to the public. Looking at this case, I noticed that some employees do not honor the rights of patients and employees, they lacked the ethical values of keeping some information secret unless otherwise stated by the law.
Misdiagnosing patient is also malpractice that is common in many hospitals. I noticed that both the pharmacist and the doctors are usually not aware of the intended harm when they are diagnosing citizens. They usually give wrong medicines to wrong conditions, they allow people who do not have enough knowledge on any disease to be the one providing medication. They doctor administer medicine that some patients are allergic to (McLellan, 34). I realized that some case of misdiagnosis occurred when the doctors were too busy attending to many patients in the fastest way possible so that they are able to see all the patients. I would ensure that there are enough doctors to handle high numbers of employees in order to help the few doctors serve the many patients.
Another piece of information on the segment contained an issue that revealed that some doctors had poorly operated on a child and left the child paralyzed. Some doctors attributed those to how some doctors handled their equipment (McLellan, 34). Doctors should d all the right things in order to keep their patients alive and free from further medical malpractices. A hospital is where people go to get medical help not to become sicker.
31st October 2014 – Cancer Experiments
On this day in the afternoon, I read an article published in the New York Times how an oncologist had used patients as guinea in his experiment aimed at finding cure for prostate cancer. He sample different people from various places, ages and occupations. The ethical issue in this occupational hazard was that the doctor did not explain to the volunteers that the removal of sperms would lead to infertility (New York Times, 2013). A few years after the experiment, some patients returned to the doctor claiming that they had to go through fertility test because the doctors explained to them that the procedure they under took left them sterile. It is ethical for doctors to explain to patients every medical procedures that are done on their body, the patients have the right to know the long and short term effect of the procedure and how it will impact their lives.
They should be made o know that some processes would fail while other would pass. I am not for the opinion of doctors using human beings as guinea pigs in their experiment. They doctors must have high regards for human rights (New York Times, 2013). These professionals must aim at taking care of every person who volunteers for an experiment in their labs. If I were in charge of medical cases in this country, I would officially declare it illegal to use human beings as test materials in medical experiments.
Ethical issues refer to those problems that people face due to denial of ethical rights, discrimination based on race gender or any other field. Medical practitioners are normally thought of as the best and most practical people in the world however, they too lose site and make their patient suffer ethics in their daily practices. Some ethical issues include medial malpractices, forcing women to agree to medical intervention options without their consents, subjecting women to harsh treatment without finding the motives for their actions. There are many other ethical issue in medicine that people face for example other are used as test subjects in medical experiment without being told the consequences of the decisions.
It is important for medical practitioners to note that medical procedure do go wrong, they have the obligations of telling their patients the experiment or procedures they are about to perform on them and how it will affect their lives. Medical professionals should give patients the chance to make decisions and come to a mutual agreement before carrying out new medical procedures on them. They should know that it is their moral duties to ensure that the rights of patients are maintained at all times.
Works Cited
ACOG, Maternal Decision Making Ethics and the Law
- Retrieved from http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Ethics/Maternal-Decision-Making-Ethics-and-the-Law
- McLellan, Francis, Medical malpractice: law, tactics, and ethics.USA: Temple University Press, p, 34 1994
New York Times, Decades Later, Condemnation for a Skid Row Cancer Study. Retrieved from http://www.nytimes.com/2013/10/18/health/medical-experiments-conducted-on-bowery-alcoholics-in-1950s.html?_r=0
Oshea, John, The crisis in America’s emergency rooms and what can be done. Retrieved from http://www.heritage.org/research/reports/2007/12/the-crisis-in-americas-emergency-rooms-and-what-can-be-done
Pozgar, George, Legal and ethical issues for health professionals. New York, NY: Jones & Bartlett Publishers, p 8, 2012
Stright, Sarah, Maternal newborn nursing, Volume 1. New York, NY: Lippincott Williams & Wilkins, p7 -15 2005