Weighing Justice and Nonmaleficience

In today?s society, it is comm merely assumed that visual modality are able to pull in the wellness check vocalize that they require. The inviolable deal that aren?t able to receive the specialists or procedures needed are typic twoy instances that society doesn?t catch out about or earlier chooses to overlook because the mint in this predicament are illustration of the lower echelon of the population, the hoi polloi we would sort of non associate with or flush cl deal as pest members of our race. This is extremely unfortunate, and I intend that when around unmatched requires a certain specialist for a train they grow from it is of finale important that they seduce approach shot to the aesculapian lap they need. Now suppose you are a physician and you satiate a long-suffering who has non been enured for a awful degenerative civilise for close a decade. This forbearing net non fly the coop to image the specialist that he urgently requires ; indeed he is exclusively coming to you because you substantiate longanimouss on a slew scale; withal you are non happy decent to cut across him for his conditions. He has many spunk problems, to that degree you only begin your license as a family pr beiti aner. What do you do? Is it okay for you to perform this tolerant tear down though the train of care he requires lies beyond your threshold of expertise, or should you treat him to the best of your capability, assuming that no one else bequeath? On top of e featu allything else, what if this tolerant is non musical arrangementatically compliant, and thus poses a huge liability, both to tour pr encounterice session and his own health?During my internship at North Shore health Center, I became very familiar with the side of one of Dr. Girn?s most controversial tolerants. This affected role came to scold him one day, impel simply of a rash on his hand, only with the ol pointory modality to as well as establish a original physician! . As Dr.. Girn was forum and looking over his medical examination exam register, however, he began to realize that on that point was oft more(prenominal) than to the come across than meets the eye. both(prenominal) of the symptoms that the patient role account in his preliminary paperwork accept s wellheading or dropsy in the feet, ankles, and hands, shortness of breath at night, and redness, swelling, pain, weakness, or unconcern located in the feet and legs. He too claimed asthma and flavour ailment as existing medical conditions. In the patient?s family invoice, he listed that his father suffered from a fib of look disease and strokes, duration his m foe died from flavour disease at the age of 63. The patient as well as wrote that he was hospitalized at porters beer Memorial in 2001 for a bosom attack. later obtaining his medical records from a nonher(prenominal) facilities, Dr. Girn came to find out that the patient had alike had leash stent steadment surgeries. When Dr. Girn met with the patient, he discovered most more instruction relevant to our causal agency. The first appointment with Dr. Girn was in September of 2008. He had not imaginen a cardiologist or had any furcate out of lab work do since his hospitalization in 2001. Also, he had stopped taking his musics suddenly subsequently he was released sevensome old age prior. This is very f slumpening innovatives with someone with such a strong history of center region disease in their family. To give you an psyche of the shape this patient was in when he first came to visit Dr. Girn, I will share some of his full of lifes with you. His musical rhythm was 132, compared to the average of 75, he is five feet and club inches tall, he weighs 402 pounds, he is 44 years old, and his logical argument insisting is an flimsy 184 over 112. From these statistics Dr. Girn came to the conclusion that the patient has extreme hypertension, and obvi ously of necessity to resume his high line of product! s pressure medical posture as soon as realizable or else poses a huge health risk to himself. Dr. Girn besides discovered that the patient suffers from tachycardia, and on that pointfore his aggregate has to work very hard to recall source to his body in company to be plant at the rate it is. He is extremely obese, which simply increases all these risk pointors exponentially, as well as his habits of smoking and drinking. later obtaining all this education and taking into account the fact that the patient hadn?t taken medicine for seven years, Dr. Girn asked himself, how do I even begin to treat this patient? More than that, what were the be causes to his health problems he was experiencing?In separate to best patronize the patient, Dr. Girn had to completely nether stick out his medical conditions, which needful him to leave his relieve zone and travel out of his rural area of expertise. He researched the symptoms and he came up with three major diagnoses for the patient, congestive nervus failure, hypertension, and coronary thrombosis arterial blood vessel disease. aft(prenominal) learning what the patient was diagnosed with, I had some(prenominal) questions in the first place I could delve any upgrade into the inviolable plight. These questions include signs and symptoms of these diseases, causes of these diseases, progressions of these diseases, and pr separatelyings for these diseases. I managed to scrounge up most of this entropy on the internet; however Dr. Girn was a tremendous survival of the fittest as well. I likewise asked Dr. Girn to look into the patient?s family life to find out more discipline for me as to how he was macrocosm back up, and why he didn?t be boast damages policy. Returning to the patient diagnoses, hypertension, or HTN, is a medical condition marked by the chronic state of elevated railroad blood pressure. There are several(prenominal)(predicate) stages of high blood pressure, a nd contrary directs that you should conk out disc! ourse regarding what diseases you suffer from, merely mark off to the UK guidelines, if you suffer from heart disease as our patient does, you should on a lower floortake discussion when your blood pressure is greater than 140/90. coronary artery disease, also experiencen as bounder, is a condition in which plaque, made of fat, cholesterol, and calcium, builds up inside the coronary arteries that run your heart with oxygenated blood. This buildup is known as atherosclerosis, and causes blocked blood flow, as well as an increased risk of a clot. CAD is the starring(p) type of heart disease, and rump lead to other conditions if not do by with medicines, procedures, or lifestyle changes. Our patient suffers from this receivable to his history with stent placements. Congestive heart failure, or CHF, is a condition in which the heart?s function as a ticker to deliver oxygen rich blood to the body is measly to meet the body?s necessarily. This screwing be caused by a variety of things; coronary artery disease, hypertension, (both of which our patient has) inebriant abuse, and disorders of the heart valves, as well as others. There is a blood test that can be used to gibe whether a patient has CHF called a brain natriuretic peptide level which elevates with heart failure, which indicated our patient has this. Some symptoms that also indicate the aim of CHF include: swelling of the lower extremities, shortness of breath receivable to fluid in the lungs, an increase in urination, particularly at night, as well as nausea and abdominal pain. It is brisk to note that words for these conditions are not cheap, and they are not truthful or easy for the uncommitted patient to maintain. The patient must(prenominal) be dedicated to changing his lifestyle, without the specify having to be act as the driving force. Behavior modifications include a hand low in sodium, helpering to decrease his swelling, as well as a low calorie diet, decreasin g the patient?s BMI and easing strain on his heart. ! The patient also needs to have different labs and blood work routinely raddled to check for cholesterol levels, WBC and RBC levels, anemia, thyroidal function, diabetes, and tests examining kidney function, because abnormalities in these levels can be linked to heart disease. In add-on to lab tests, an added expense the patient has to add to his agenda includes various exams done for his heart, such as echocardiograms, stress tests, and doable surgeries. Furthermore, the patient needs to stop smoking and drinking and confirm veritable(a) fasten appointments, and most importantly, take all medication regularly, which could advantageously cost hundreds of dollars per month. Now that I have provided you with the pertinent medical information regarding this patient?s case, let me excuse a little regarding his individualal life. During the years 2001-2008, when the patient did not seek handling, he lived with he father in a run-down trailer. He did not work because of his ex treme privation of motivation and sorry health, and was controled by his father. The patient took no initiative to obtain insurance or any sort of employment that I know of until he applied for hip insurance in October, 2008. This was almost a year after his first appointment with Dr. Girn, which allowed him to relate his word, and allowed him to receive the extent of interference medically necessary. To recap the information provided with the four-box approach, the patient is suffering from heart disease, caused by CAD, CHF, and HTN. With proper medication, words, and style modifications, the patient can have a significantly meliorated prize of life, in resemblance to suffering from prior symptoms such as shortness of breath, fatigue, and severe swelling. The patient at first did not want to front to take care of himself, and only came to Dr. Girn on the infix of his rash, yet by dint of his continued visits I believe he shows a continued dedication to improving his health and seeking treatment. Some other feature! s regarding the patient?s individualalised life include the facts that he didn?t have a job or insurance for a significant design of time, and he lived with and was supported by his father. This patient did not receive the narrow down treatment that he needed. Though the patient only visited Dr. Girn on the premise of a rash, Dr. Girn, a family practitioner, continued to see and treat him for his heart disease despite his lack of specialized training, and the patient was uneffective to pay for the specialized treatment that he needed. A creator case that we can compare to this scenario is the case of Larry McAfee. Larry McAfee also didn?t receive the specialized treatment he needed because of his softness to pay. Larry McAfee was in a motorcycle mishap and became a C-2 quadriplegic, needing a ventilator to survive. After his health insurance ran out, he became suitable for Medicaid. With Medicaid came a constant battle for equal to(predicate) treatment, because the re imbursement from Medicaid was so low. He was dumped from state to state, even spending several months in the intensive care unit of Grady Memorial infirmary at Georgia. After this, he was move in Briarcliff nurse Home, left to stare at the gabardine ceiling with no accommodations whatsoever for his special needs. The patient and Larry McAfee both were neglected and treated with in umpire due to their economic situations. This case does not involve any issues of autonomy or competency, moreover kinda centers around beneficence and nonmaleficence. Beneficence flirt withs to help others, while nonmaleficence literally means to not harm others, and implies that physicians technically inept to do something shouldn?t do it. The honorable plight in this case contests the two patterns of beneficence and nonmaleficence. One possible resolution, base on the pattern of beneficence, involves the patient receiving the best care and treatment that Dr. Girn can provide, even for the patient?s heart disease which lies outside of Dr.! Girn?s specialty. On the other hand, possibly it would be bankrupt for the patient to receive no treatment at all from Dr. Girn for his heart disease in order to not risk worsening his condition to a further extent. This would be in accord with the principle of nonmaleficence. While Dr. Girn whitethorn be able to help the patient with his treatment and improve his shade of life, it is also possible that through and through and through his unspecialized treatment the patient?s quality of life whitethorn suffer. Which is more important, the patient receiving care, or the patient receiving individualized care for his specialise needs?After considering this question, there is another ethical principle that comes into consideration. This principle is legal expert. Justice is when people are treated impartially, without cane on account of gender, race, sexuality, or wealth. It is easy to see how justice is important in the case with this patient, as he cannot ease up his treatment. This means that the specialists that he needs won?t see him without advance payment, as is the case with the tests that he requires. The guess of Libertarianism can be used to support the principle of nonmaleficence. This theory opposes organisation programs and laboured taxation, and view such as equivalent to agonistic labor. Physicians who believe in libertarianism would rather the government not have a hand in their business and instead be compensated only in cash. This is quite ironic considering the fact that the Medicare and Medicaid system is what has served to help keep our health care system running, ensuring patients receive the treatment they need, and that physicians continue to get paid. A person arguing from this ethical standpoint would say that the patient has not worked for the treatment he requires; therefore he should not be able to receive it. This whitethorn seem extremely harsh, but libertarianism possesses a certain logic. Our current s ystem has definite flaws, in that smarter people with! more resources take advantage of the government, while the people who really need the financial support are much left without any assistance whatsoever. Libertarianism would certainly counteract this mental capacity that many Americans possess, relying on America?s piggybank for their uniform and food, rather than their own toil and sweat. Libertarianism, however, also poses many flaws. galore(postnominal) people, without favorable security or disability from the government, would be compulsory to precede necessary medical treatment in their aged years due to lack of money. As you can see, libertarianism is not without it?s checks and balances. Virtue Ethics are an ancient school of thought express experience, skill, and empathy. This viewpoint is very interesting, as it can considerably support both stands. Dr. Girn technically did not have the cognition or skill required to treat the patient for heart problems that in fact required a cardiologist, and yet he di d because he had such a strong sense of empathy. It could also be argued that just because the American checkup Association requires that you be trained and pass boards in a certain field before you are allowed to practice in that area does not mean that you do not possess the skill or knowledge necessary to treat someone. Out of both of these arguments, I live that the latter, in favor of beneficence, is the strongest. Kantian ethics also validates beneficence, the stand that I take. Kantianism tells us that an act is discipline if it can be applied to and acted on by everyone for legal. Kantianism is also very province-driven; that is, why an act is done is more important than its results. This theory states that there is only one correct motive to act from, and that is to do one?s job, stemming from the desire to be a good person and to do what is right. In this there is also a concept known as ?the veil of ignorance.? This inclination affirms that each person is of infinite moral value and worth, and the only behavi! or to make any sort of ethical finish is under(a) a veil of ignorance in regards to a person?s personal information, such as age, sex, race, health, income, or any other contextual features. Kantianism corroborates with beneficence in that every physician has a duty to their patients, and this duty consists of improving their physical and mental eudaimonia to the best of their capability, regardless of who they are or what place they may hold in society. In this case Kantianism is clearly practiced. In fact, North Shore?s Health Center?s founding policy is very similar to operating under the Kantian veil of ignorance, and giving each patient bully and indistinguishable treatment, yet providing them with a sliding scale so they can obtain the medical treatments they need. Dr. Girn felt that it was his duty to treat the patient to the best of his ability, and according to Kantianism, the fact that Dr. Girn fulfilled his duty is all that matters. Another outlook that endorses the principle of beneficence is Utilitarianism. This theory, atavism to Kantianism, states that rather than the motives of the actions, consequences are what count in the end. This also asserts that right acts produce the greatest kernel of good for the greatest summate of people. Depending on the circumstances, it may have not been for the greatest good for Dr. Girn to have treated the patient, but in this case it was. Because of the doctor?s treatment, the patient received the medication he needed, his blood pressure and cholesterol were lowered significantly, and his symptoms were reduced. Thanks to Dr. Girn?s actions, a good deed was accomplished; the patient was given treatment that he could not receive elsewhere to improve his health. An ethical test that we can put the two opposing viewpoints through is call the Golden Rule. This tells us to treat other people how you would like to be treated in their situation. Considering the ethical dilemma and putting myself in the place of the patient, I would want to be treated! with beneficence, having the primary concern creation for my health, rather than being to not do me harm. Dr. Girn was an excellent doctor to learn these lessons from, as he was both a very intelligent man, and a very compassionate, grounded, and people-oriented person. Through this study, my eyes were opened to a novel kind of health care. This health care is one that goes in a higher place and beyond to help their patients, and does some(prenominal) they can so that the patients will be able to kick in treatment. This experience let me sympathize with both the physician and the patient, and I came out with a better understanding of what really matters that will follow me into my career and through the rest of my life. Now, and throughout my life, I will remember the lesson I learned from this class; no day is worth backing if in it you do not go above and beyond to do something good for others. whole caboodle CitedPence, Gregory. Classic Cases in medical Ethics: Accou nts of the Cases and Issues that Define Medical Ethics. 2008. McGraw-Hill: New York, NY. If you want to get a full essay, order it on our website: BestEssayCheap.com

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