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Tuesday, July 27, 2010

Ethics and Morality in the Heath Care Service

Definition of Terms

1 The Class’ Understanding of Ethics and Morality

2 A Difference: Ethics being more legal and Morality, personal.

3 Health Services needs to be carried out with a good integration of a legal and personal character.

General Knowledge of the Oaths and Pledges Health Professionals take
 Significant Issues like Dedication to duty, unique mode of operation, institution goals and objectives, Knowledge of rights and responsibilities.

2 Hippocratic Oath
 Florence Nightingale Pledge
 Ripples’ Pledge or Oath

General Issues and actions that witnessed in the health care service delivery system

1 Abortions, Strikes, The falling in love of a client and service provider, Harassment and Euthanasia,

A look at three major issues in health care service delivery

1 Confidentiality in tensions between the Public and individuals’ good E.g. an HIV patient womanizer do you disclose it to the community?

Caring for client whose identity can be a fortune to you when broke

2 Strike actions of health professional and its consequences

3 Health service – Profit or People oriented

Conclusion: all actions should be judged by

1 General Legal, Professional and Societal requirements.

Short Notes on the Topics

Ethics: a system of moral principles: the ethics of a culture or the rules of conduct recognized in respect to a particular class of human actions or a particular group, culture, etc.: medical ethics; Christian ethics.

Morality: pertaining to, or concerned with the principles or rules of right conduct or the distinction between right and wrong; ethical: moral attitudes or founded on the fundamental principles of right conduct rather than on legalities, enactment, or custom: moral obligations.

The difference
The difference between ethics and morals can seem somewhat arbitrary to many, but there is a basic, albeit subtle, difference. Morals define personal character, while ethics stress a social system in which those morals are applied. In other words, ethics point to standards or codes of behavior expected by the group to which the individual belongs. This could be national ethics, social ethics, company ethics, professional ethics, or even family ethics. So while a person’s moral code is usually unchanging, the ethics he or she practices can be other-dependent. Ethics refers to professional conduct. Morals refer to personal conduct.

One’s Moral outlook towards HIV might be different from what his/her profession as a health worker expects from her.

Oaths and Pledges
Statements and Utterances that are binding and demand a level of rights and responsibility on the part of those taking it and for whom it is being taking

The Nightingale Pledge was composed by Lystra Gretter, an instructor of nursing at the old Harper Hospital in Detroit, Michigan.
I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician, in his work, and devote myself to the welfare of those committed to my care.

Hippocratic Oath, By the Greek Hippocratus father of Medicine
Considered in part: “I solemnly pledge myself to consecrate my life to the service of humanity; … I will practice my profession with conscience and dignity. The health of my patient will be my first consideration; …. I will not permit consideration of religion, nationality, race, party politics or social standing to intervene between my duty and the patient; I will maintain the utmost respect for human life from the time of conception; even under threat; I will not use my medical knowledge contrary to the laws of humanity. I make these promises solemnly, freely and upon my honour”.

Health service – Profit or People oriented
The ethical implications of the growing commercialization of health care have become a matter of heated controversy. Those favoring the trend toward health care for profit claim that an increased role for entrepreneurs and competition in the delivery of health care will result in a more efficient and effective health care system. For others, the pursuit of profit is antithetical to the values central to medicine.

For the Notion of People Oriented
They argue that a society has a moral obligation to meet the basic needs of all of its members rich or poor alike should have access to the health care he or she needs. The rise of for-profit health care only increases the growing problem of access to care.

In view of the benefits health care institutions derive from society, it is unfair for them to refuse to help society serve those who can't afford care or are too costly to treat. All hospitals benefit from government subsidized programs, medical research and medical education paid for by taxpayers' money. In fairness, hospitals have an obligation to serve society's needy.
In a system of for-profit health care, the opportunities for patient manipulation and exploitation are endless. Society must not allow the motive of economic gain to enter so directly into the practice of medicine, placing the well-being of patients in serious jeopardy, and undermining the trust so essential to the physician-patient relationship.
The commercialization of medicine will lead to the abandonment of certain virtues and ideals that are necessary to a moral community. The ideal of service to humankind, caring, compassion, charity, a sense of community, and altruism have been perpetuated by physicians whose primary concern has been the alleviation of human suffering and the restoration of health.

For the Notion of Profit Oriented
For-profits have greater and quicker access to capital at lower costs than do non-profits. At a time when massive investments of capital are needed to keep up with the state of the art in medicine, non-profits are experiencing increasing difficulty in attracting funding.
They maintain that all persons have a basic right to freedom and thus a right to use their property in ways they freely choose. They argue that owners of for-profits have no special obligation to provide free services to the poor. While public funds may indeed subsidize research and medical education, it is patients and doctors who benefit from this education and research, not the owners of hospitals. If there is any obligation to serve the community in return for such subsidies, it is with patients and doctors that it lies.
Health care is like food, clothing and shelter. Just as these "basic needs" are sold on the market and distributed according to ability to pay, so too should health care. If some cannot afford to pay for such basic needs, it is up to the government or voluntary agencies to see that they secure it.

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