Ethics, health risks, the need to save lives, etc. ; these all play a role in the decision on whether or not xenotransplantation should be implemented in our healthcare. To fully understand the points of each outlook, the pillow method will be used to explore and illustrate each point of view in more detail. The first stance taken in the pillow method is the “My view is right, the other view is wrong” position. Using xenotransplantation as a therapeutic option to rid the problem of poor organ donor numbers and low rate of organ transplants is a poor solution.
The purpose of this paper is to discuss that as a patient’s life deteriorates care is no longer able to improve a patient’s quality of life but their projected outcome is thought to be a continued degeneration. It is further considered to be in the best interest of the patient and their family to terminate active care. Also, ethical issues need to be addressed concerning what is right for the patient and how making decisions on withdrawing care affects nursing. As stated in Hickey and Montgomery (2009) “with the continued growth of technology, it is difficult to determine if the patient ‘truly benefits’ from such advances”. “Truly benefits” will be used to mean the patient will, in time, have an improved quality of life (Hickey and Montgomery, 2009).
Leaving a medical facility against a physician’s advice puts a patient at risk for untreated or incompletely treated medical issues, increases the need for subsequent readmission or visits to emergency departments and increases the risk of mortality. DAMA presents a dilemma not only to the attending physician but to the nursing staff caring for the patient. Ethically and legally, patients do have the right to agree to or retract consent for medical treatment; however the nursing management of DAMA is much more complicated and multi-faceted than the patient’s right to consent or dissent to treatment. Problems occur with the understanding of the different types of self-discharge from emergency departments, as well as how best to document such encounters and ultimately, how to improve upon current nursing
The first dilemma involves the doctors of Health Net i.e. Dr Gupta, Dr. Schinke and Dr. McMillan wherein they have an interest in keeping the costs per patient within the capitation fee so that they can either earn extra income or avoid having to pay money to cover the extra costs above the capitation fee, while on the other hand they have a duty as doctors to provide the best possible treatment that gives Christy a chance to overcome her illness regardless of the costs involved. The second dilemma involves UCLA Medical Clinic’s Cancer unit who could possibly lose an extremely profitable business relationship with Health Net thus putting them in a financial crisis if they allowed the transplant to occur but on the other hand they had already agreed to give Christy a transplant and not doing so under pressure from Health Net would be immoral and could possibly open them to a potential lawsuit by Christy and her family. Common Sense Morality: With regards to Health Net and some of their doctors like Dr. Gupta and Dr. McMillan, they have certainly violated the ideals of ‘Common Sense’ morality which consists of being honest, fair and doing no harm to the parties involved. They were not honest to Christy when they deemed her treatment to be “Investigational” whereas it was a pretense to keeping their costs below the capitation fee since the bone marrow transplant would cost $100,000.
In the event of an appeal, it can perform a more rigorous analysis of the situation. For example, a cancer patient who will die may not receive approval for a medication that adds two weeks of life, on the grounds that the drug is expensive and the benefit is minimal. Hospitals and clinics can use cost-benefit analysis in healthcare to make policy decisions as well. An obligation to treat patients at serious risk of death is present in many regions, but hospitals can be selective about the kind
In recent years patients started to look into other directions, since predictions for limiting expenses faded. Managed Care I believe can be bad for healthcare providers. With this said what exactly is Managed Care??? Managed Care is a system of health care that commands cost of services, manages the use of services, and measures the use of services, and measures the performance of health care suppliers. On an international foundation, the development of health care policy is aggressively being influenced by cost considerations.
Also mentioned, is the increased risk of localized hypothermia and risk for infection as wet gauze to the wound can cause vasoconstriction and in theory, also decrease leukocyte mobility and efficiency of phagocytes. Gauze fibers may also be retained in the wound bed further increasing risk of infection. Lastly, the author suggests that the use of wet to dry dressings are not cost effective since they are labor intensive, require secondary dressings to contain exudate, and usually require nursing care within the community. The article closes by saying that further research is needed to fully understand the impact that dressing selection has in wound healing but suggests that practitioners should question the continued use of wet to dry dressings. Currently, Greenville Hospital System’s policy for healing of wounds by second intention is best met with the use of wet to dry dressings.
The waters become murky, however, when one takes into account the amount of resources allocated to providing some services or procedures to certain patients. In Plato’s argument, he asserts that essentially, healthcare should be served in a manner that reflects the interests of the greater good. At what point does the greater good become more important than an individual though? Dr. Craig Wax asserts that in Plato’s society “physicians responded to the needs of the state by devoting resources to the workers, in the process ignoring the elderly, very young, critically ill, and those who were considered genetically inferior. Such practices can lead to vile immorality and atrocities.” By all accounts, empathy is one of the most important qualities in a humane society.
Dangers of Ineffective Communication Successful client health care is dependent on effective communication between both the client and health care professionals and amongst health care professionals. Care is client-centered and therefore individual; however, some generalities exist that affect the quality of care. Clear, concise communication is one such element. Effective communication between the client and the health care providers (HCPs) is important for everyone involved. If the client initially provides incomplete information to the HCPs, this could cause unnecessary diagnostic tests, or the exclusion of a necessary test, which could further contribute to a worsening of the client’s health status.
The Joint Commission also tracks information on “sentinel events which result in unanticipated death or permanent loss of function.” These sentinel events refer to loss of function due to pressure ulcers. With good assessment and intervention protocols most pressure ulcers for at risk patients may be prevented. Only then can quality begin to improve. Patient outcomes are essential to licensure, accreditation and reimbursement. Healthcare plans are beginning to offer financial incentives for quality patient care referred to as pay-for performance programs.