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Healthcare has emerged as a renowned sector-focused on maintaining and reviving the physical, emotional, and mental health of an individual or a community. Ethical consideration has a pivotal role in the healthcare sector. Ethics determine the code of conduct to be adopted by a professional. The healthcare sector is severely affected by the morality and service motive of individuals working in this sector. Service-motive implies a greater inclination towards ethics to determine decisions and the course of action to be adopted. The report encompasses the role of ethics in deciding the best suitable plan and action in serving patients. Healthcare dilemmas, values, rules, and regulations exhort need to align one's practices with the ethically accepted means. The focus is on determining the right and wrong means along with its consequences on treatment and the patient. Ethical issues can be understood as a means (decisions which are taken by professionals) of conflict with the morally accepted standards, these decisions vary in severity of consequences and might include legal damage to the practitioner/professional (Cohen et al., 2014).
Ethical consideration in the decision-making process
The decision-making process by healthcare professionals is backed up by ethics and values governing their code of conduct. The key aspects of ethical decision-making include autonomy that focuses on the right of the patient to choose for their healthcare program and course of action, justice towards the service motive and benefit of the society, beneficence suggests deciding for the benefit of the patient, and no malfeasance ensures the safety of the patient from any harm (Durojaiye et al., 2018). Transparency, trust, respect, and humility are some assisting ethical values to decide for the healthcare course of action. The impact of ethical consideration by professionals includes time consumption and satisfaction of the patient. Some of the problems can be articulated as right and wrong but many decisions are subject to complexities and dilemmas.it has been observed that the key aspects such as autonomy and beneficence counter each other. The ultimate arbiter in such cases is the caretaker who is in charge of the case (Cohen et al., 2014). The criteria to decide were distinguished based on normative and feasibility approach and predominance of normative criteria was revealed by studies. Value-added to healthcare plans by ethical decisions surpassed the feasibility criteria that included the interest of shareholders and investors. Out of 10 studies conducted, 8 were in favor of normative criteria of decision-making. 'Horizontal equity' is prescribed for patients with the same healthcare plan whereas 'vertical equity' is advocated for patients with varying needs by WHO. Interventions are considered for severe healthcare needs than mild ones (Légaré et al., 2014). Ethical consideration has been preferred based on the performability of the health care plan and satisfaction of the patient. Dealing with dilemmas and complexities exerts pressure on professionals to decide between two equally good alternatives or to choose the hard way to achieve efficacy/efficiency. Decisions based on normative criteria tend to suit healthcare due to ethical considerations and the service motive of the profession (Tanios et al., 2013).
The most critical decision taken by healthcare professionals is regarding euthanasia. To decide whether or not to opt for euthanasia/ hastening of death of a patient. When a person suffers from unbearable pain and demands to end his/her life voluntarily is one of the toughest decisions for the doctor in charge. Voluntary suicide is legal in some countries as taking a life is considered the gravest sin universally. But evaluating the factors like unbearable pain and no hope for revival makes euthanasia preferable over torturous agony that the patient suffers from. This option suits terminal illness in which death is an inevitable part of the disease. From an ethical point of view, ending one's life is condemned as the greatest sin and rejecting the gift of nature. A case from the Centre for Practical Bioethics is considered here to explain the dilemma concerning such decisions. An elderly man of 83 years old was suffering from severe medical issues. The man couldn't take the pain and be frustrated from the persisting treatment. The Man underwent a cardiac resynchronization therapy defibrillator implantation and made the man completely dependent on the instrument. The shocks he experienced were painful enough to demand euthanasia. The advocacies enveloped the worn-out physical health of the man. To deactivate the defibrillator was fully supported by his cardiologist concerning the autonomy of the patient. It is torturous and hostile to let the man suffer the shock. The aged man was vulnerable and lacked the strength to bear shocks. But turning off the pacemaker was subject to the death of the man within few minutes. The majority of cardiologists have faced similar dilemmas (Pesut et al., 2018). After a thorough and meticulous discussion by ethics consultation, the patient's autonomy was respected and the elderly man's wish for voluntary/assisted death was fulfilled. The man bid adieu to his family and friends peacefully. The supporting discussion was that voluntary death is a better alternative to the unbearable miseries. Such examples emphasize the need for ethical considerations in healthcare professions.
Chosen contemporary issue
Consumer experience in the healthcare sector is a vital issue about the sustainability of the hospital or care centers. In-person as well as digital experience of the patient helps to determine the smooth flow of healthcare plan and management (Munthe et al., 2021). The perception of patients regarding the management and structure of the healthcare center is attached to the ethical consideration. There is a noticeable gap between delivering quality services rendered by healthcare units and centers and normative and ethically approved services. Patients' satisfaction is of the utmost importance as it is the core objective of the sector. Rendering quality services in the health department is not merely a responsibility but justice to one's profession. Loopholes in care plans, mismanagement between departments, long waiting hours and complexities in qualitative techniques adopted leaves patient underserved and compromise quality (Tanios et al., 2013). For instance, the difference in the results of the medical condition of the patient obtained from different physicians lacks a holistic view and leaves the patient ambiguous. This issue needs to be addressed as lack of satisfaction experienced by the patient is a key impediment in the success of the healthcare unit or course of action. It has been observed that the focus has been on industrial development rather than customer satisfaction in the majority of the healthcare centers and hospitals. This approach has been disruptive to both the industry and patients. Ethical consideration has been ignored while focusing on the profit maximization approach in the healthcare sector. In 2018, public satisfaction was consistently declining with the services provided by NHS, it reported to only 53 percent. The main segment that was unsatisfied by the services was the young generation ranging from 18-64 (Cooper 2018). The study discerned that the key aspects of dissatisfaction among the general public were scarce staff, lack of funding, and inefficient allocation of the fund. The study also considers the political influence on customer satisfaction (Al-Abri and Al-Balushi, 2014). However, the issue is intact and it needs stringent measures to be undertaken by the governing council. Customer satisfaction is vital as it signifies the valuation of humanity and morality by the healthcare sector (Cooper 2018).
Analysis of issue application to ethical consideration and management by professionals
Customer experience is facilitated by addressing patient's needs, streamlining the action plans, and eliminating futile processes to meet the health needs of the patient. It has been observed by the way articles and journals that ethics and values have been replaced by the interests and comfort level of the professionals. Limited professionals stick to their principles and prefer holistic treatment of the patient. The concentration over profit maximization has pushed the service motive back in the line (Pesut et al., 2018). The depleting ethical consideration is a grave issue as depicted by 2018's statistics. Ethics and values such as autonomy, efficacy, beneficence privacy, transparency, and respect are been put at stake while carrying out jobs. Professionals need to realize that assisting to make people healthy and free from diseases and illnesses requires determination towards their roles and inculcation of values and ethics. It has been observed that ineffective management has led to dissatisfaction among customers (Al-Abri and Al-Balushi, 2014). Time-consuming scheduling, unnecessary processes, and stringent professionalism lead to a lack of quality service to the patient's need. People are reluctant to visit hospitals due to a lack of confidence in the services and past experiences. Some very limited professionals justify their roles in providing holistic healthcare course of action and plan to the patient. It must be noted that with advancements in technology, the focus has been shifted to ROI from reviving health and wellbeing of the mental, emotional, and physical state of an individual. The absence of a relationship between the caretaker and the patient creates an invisible veil between the two parties. The patient's experience is a viable factor to determine the sustainability of the healthcare unit/center (Munthe et al., 2021). If a person is satisfied, it creates potential for more engagement by the way of recommendations. To connect with the patient on the informal level will enable the professional engaged in the healthcare of the patient to judiciously decide the best course of action and will inculcate consideration for values and ethics.
Funding has been a matter of discussion in healthcare as a limited deployment by the way of government and donations limits the effectiveness of the healthcare provided to patients. From studies, it has been found that 10% of GDP is deployed on health care by the government and private insurance contributes a limited share in the bills of the patient. Management suffers extensively from scarce funding. To cut costs and increase profits, unethical means are adopted by the executives (Durojaiye et al., 2018). Taxations aid the funding extensively in the UK. Some of the major aspects of insufficient allocation include improper funding by the government, charging high fees from patients, inefficient utilization of the funds available by management. Ethics play a vital role in deciding the allocation of resources as the main concern of the professionals is to earn a living rather than serving society. Due to this approach, professionals have raised fees and the healthcare units have been increasingly inefficient in managing healthcare plans and course of actions. Little resources are allocated in developing managerial activities that have led to the loss of potential progress in the respective sector. Regulations and compliance with the law have also made financing a cumbersome task and has exhorted these professionals to adopt unethical means to mint profits. Medical fee is being decided by the demand-supply forces which are again both unethical and immoral. Government interventions are necessary to control the malpractices and govern the practices by the healthcare professionals on ethical grounds (Légaré et al., 2014).
From the above report, we can discern the impact and need for ethical consideration in the healthcare sector. The concept of health, wellbeing, and quality of life are aligned with the ethical consideration to give meaning to the healthcare professions such as doctors, nurses, caretakers, and managerial staff. Assisting patients is not merely fulfilling a responsibility but justifying the profession of healthcare. Medical ethics and values play a prominent role in serving patients and satisfying their health needs. The analysis shows that feasibility criteria for decision-making have been dominating the sector despite the invincible role of normative criteria in choosing the best alternative. Ethical issues arise out of ignorance of management and healthcare professionals to do justice with their roles. Dilemmas faced by professionals to choose from the available alternatives include weighing the value of consequences appended with each alternative. in a nutshell, ethical consideration is necessary for sound decision making and its' absence dissatisfies the patient and affects the healthcare unit.
Al-Abri, R. and Al-Balushi, A., 2014. Patient satisfaction survey as a tool towards quality improvement. Oman medical journal, 29(1), p.3.
Cohen, I.G., Amarasingham, R., Shah, A., Xie, B. and Lo, B., 2014. The legal and ethical concerns that arise from using complex predictive analytics in health care. Health affairs, 33(7), pp.1139-1147.
Cooper, J., 2018. UK Health accounts: 2015. Statistical Bulletin. Office for National Statistics. Available at https://www. ons. gov. uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/bulletins/ukh ealthaccounts/2015. Accessed, 23.
Durojaiye, O.C., Bell, H., Andrews, D., Ntziora, F. and Cartwright, K., 2018. Clinical efficacy, cost analysis and patient acceptability of outpatient parenteral antibiotic therapy (OPAT): a decade of Sheffield (UK) OPAT service. International journal of antimicrobial agents, 51(1), pp.26-32.
Légaré, F., Stacey, D., Turcotte, S., Cossi, M.J., Kryworuchko, J., Graham, I.D., Lyddiatt, A., Politi, M.C., Thomson, R., Elwyn, G. and Donner?Banzhoff, N., 2014. Interventions for improving the adoption of shared decision making by healthcare professionals. Cochrane database of systematic reviews, (9).
Munthe, C., Fumagalli, D. and Malmqvist, E., 2021. Sustainability principle for the ethics of healthcare resource allocation. Journal of Medical Ethics, 47(2), pp.90-97.
Pesut, B., Greig, M., Thorne, S., Storch, J., Burgess, M., Tishelman, C., Chambaere, K. and Janke, R., 2020. Nursing and euthanasia: A narrative review of the nursing ethics literature. Nursing ethics, 27(1), pp.152-167.
Tanios, N., Wagner, M., Tony, M., Baltussen, R., van Til, J., Rindress, D., Kind, P. and Goetghebeur, M.M., 2013. Which criteria are considered in healthcare decisions? Insights from an international survey of policy and clinical decision makers. International journal of technology assessment in health care, 29(4), p.456.
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