Ethics in the Healthcare Field

Currently, I work at Disney World in Orlando, Florida. We have been known for our courtesy and for making every guest feel special. And we definitely have to have our own codes of ethics while working there. If I end up working in Healthcare, I want to be the most courteous, ethical doctor/nurse/health administrator there is! Obviously, that won't be easy.

Ethics is not something I could just sit here and write a "code" for. I could never think of every possible situation and provide a solution based on my personal moral values and ethics. That would be impossible. But I can say a few of the generalized ideas I have for ethics.

I feel that, in regard to patients, all people should be treated equally and fairly. No patient deserves more of my time than another, and no patient deserves to be turned away or not treated because of any circumstance, financial or otherwise. Too often I've seen people without insurance turned away or given minimum treatment, when others are given a week stay in the hospital for the same exact symptoms. I feel that, ethically, doctors and nurses should not be focused on the money. They should focus on the patient. It is the patient that means more, not money. A person's life is worth far more than anyone could ever pay to be seen in the hospital. So, one of my personal standards of ethics is that every patient should be treated fairly and ethically, regardless of the situation. I feel that we should do no harm, and that we should do our absolute best to treat or cure the patient of whatever their ailment is.

In church, as a teenager, we had a set of "values" that we recited every Sunday, that we took an oath to live by. These values were Faith, Individual Worth, Knowledge, Choice & Accountability, Good Works, and Integrity. I feel like these values can be used in the medical field, just as in religious settings.
-Faith: As a healthcare professional, you need to have faith in yourself, in healthcare, in your team, and in medicine. If you doubt yourself or medicine, a patient is not going to receive the best care possible, which would be unethical.
-Individual Worth: As a medical professional, you have to know your own self-worth, as well as how valuable another person's life is. Everyone is here for a reason, and everyone serves a purpose. Keeping that in mind can help you make more ethical decisions as a doctor/nurse/etc.
-Knowledge: Having the knowledge from school and knowing how to apply it to work is important. But you also learn new things everyday, especially in the medical field. Having a good working knowledge will help you act more ethically. You won't do anything that you aren't knowledgable about.
-Choice & Accountability: There are tons of choices a healthcare professional will make every single day. And they need to hold themselves accountable for their actions and choices. If you do something wrong, own up to it. It is more ethical to own up to making a mistake and learning from it, than to put the blame on someone else (the patient, another physician, etc.)
-Good Works: Always go out of your way to provide superior service to patients. They get exceptional service at Disney World when they're healthy, why shouldn't they get the same (or better) at the hospital when they're sick? Ignoring patients, not speaking to them on their level, not checking on them unless it's absolutely immediate, etc. are all examples of poor ethics. But doing good works for your patients would be very ethical and would make the patients much happier and heal quicker.
-Integrity: This one seems to be included in all ethical discussions. Always be honest, no matter what. Stealing, lying, cheating...all poor ethical decisions. Have good integrity, and you'll be much more ethical.

So, if I were to go into the healthcare field, I'd take these values with me. I'd look for another coworker to be a role model, and I'd follow my organization's code of ethics. I'd quit my job if any superior made me break any of my personal values (be dishonest, don't hold yourself accountable, just guess, etc.). Putting the patient first is a big priority for me. I will never let a patient down because of a lack of money or insurance. I definitely want to be the best professional I can be, so I'm going to stick to my values and codes of ethics.

This is my last blog entry as an HSC4652 assignment. I will probably continue updating the blog with other health-related things, so keep reading! :) Thanks for your time throughout the class, and I hope I made you think. ;)

Ethics Committees

Case for review:

Jimmy is an 11-year old boy who suffers from lymphoma.  His oncologist has indicated that without chemotherapy, he is likely to die within 6 months.  She has also indicated that in most cases, chemotherapy provides an effective cure in only 20 percent of cases like Jimmy’s; in most cases, chemotherapy produces at best an additional 3-6 month extension of life. 

Jimmy is also compromised by an incurable neurological disease.  This disease will eventually make it impossible for him to walk, talk or use his hands effectively.  Already, he speech is slurred and he cannot hold a pencil.  Even without lymphoma, the prognosis– because of the neurological disease– is death by the age of 18. 

Jimmy has been raised in a strong religious environment, and his belief in God has been an important comforting factor to him.  After having the facts fully explained to him, he has accepted his situation and the inevitability of his death at a young age.  He says he does not want the chemotherapy and that he is ready to “go to God.”  His parents, however, cannot reconcile themselves to losing Jimmy.  They want to override his decision/proceed with chemotherapy. 

Clergy/Chaplain: From a clergy's standpoint, I would side with Jimmy. If he is ready to "go to God" and has made peace with the strong possibility of death, then, as a clergy, I would support that decision. I would speak to the parents about his decision and explain that he is ready to return to God, and that it is part of God's will to listen to their son.

Jesus said, "Let the little children come to me, and do not hinder them, for the kingdom of heaven belongs to such as these."-Matthew 19:14

 Also, the chemotherapy would likely cause bad side effects like anemia, fatigue, hair loss, nausea and vomiting, and appetite changes. I'd explain, if I were a chaplain that the boy has decided on his fate, and that it would be selfish of his parents to force him into chemotherapy. I'd also urge the whole family to pray about the decision, and let them know that no matter what ends up happening, it will be God's plan. 

Psychologist: As a psychologist, I would sit down with the entire family. I understand both points of view. The parents want to save their son and keep him around as long as possible. But the son wants to "go to God" and not have to suffer through chemo. So I would let the family know that I understand how each side feels. I'd have the parents explain to their son why they believe what they believe. Then, I'd have the son explain to his parents about his point of view. I'd try to urge the family to find a compromise. Maybe they try chemo for a short amount of time and see if it works, what side effects he gets, etc. If it didn't work well, maybe it's not meant to be. I'd urge the family to reach some sort of agreement so that there is no bitter feelings at all during the tough time.