Blog # 6

For BLOG #6, discuss your own "working" definition of healthcare ethics. You may need to refer back to previously covered chapters, in addition to consulting Chapters 13 and 14. Think about the following: What morals/values are important to you? What are your moral bottom lines (i.e. how far is too far; what would you quit your job over, etc.)? What kind of healthcare employee (clinical or managerial) do you want to be?

My working definition of healthcare ethics is far from perfect but nonetheless, it is my personal definition. I think healthcare ethics is about being able to distinguish what is right and what is wrong and then being able to actually do what is right and leave the wrong behind. Healthcare ethics involves respect, unity, and being a good person.

I originally stated Viktor Frankl as the theorist that I resonated the most with primarily because I share his philosophy in my life. Frankl believed that people weren't just a body; they were a "total person", with a mind, body, and spirits. Furthermore, he believed that people made decisions based on what they believe in or are committed to and that our conscience is used to choose the best action to finding meaning to any given situation. That is a strong philosophy and those are the type of values/morals that I try to live my life by. I believe in respect, compassion, honesty, in the rightness of things, and seeing people for more than just a "being".

My moral bottom lines include the wrongness aspect of things in life, especially in the healthcare setting. I think my moral bottom line has to be drawn when I see a company/administration doing things that are not ethically correct. Deliberately tampering with billing, talking about patient's private health information, verbally mistreating patients/employees are some of the things that I would definitely not want to be associated with.

The kind of healthcare employee that I currently am and I will continue to be is the kind of person that will stand up for things/people when things are not right/unfair. I am compassionate, honest, respectful, and I believe in unity, and the fact that people are more than just a "being". What we ought to be, not what is: if we were to all follow this motto, the healthcare world and the entire world really, would essentially be near perfection.

Blog # 5

For BLOG #5, think like an "interdisciplinary" ethics committee.  Chapter 10 contains information on Ethics Committees.  

Review the case below and adopt 2-3 roles (below) and develop a response to this case.  The perspective of each role you choose may look different.  For example, a CEO will respond differently than a physician than will a nurse.

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. 

Adopt 2-3 of these roles and develop a response to the case.  Include specific perspectives for each role you adopt:

- Administrator/CEO
- Physician
- Nurse
- Oncologist
- Social Worker
- Psychologist
- Clergy/Chaplain
- Community member
- Lawyer
- Ethicist
- Health Services Administration/Health Professions Undergraduate Student

I decided to adopt the roles of a nurse, physician, and a clergy/chaplain for this particular case.

Nurse: When I think about the nursing profession, I instantly think about the qualities/characteristics that encompasses that profession. Nurses are usually caring, compassionate, comforting, provide advocacy services, and the list is pretty much endless. In Jimmy’s case, the nurse can provide comfort for him and make sure his quality of life is good as he is dying. Although the situation is extremely sad, I think the nurse is strong enough to help Jimmy and his family transition and help comfort them during the end stage of his disease. The nurse can help the family understand why Jimmy is feeling that way and try to comfort them during their time of need.

Physician: As a physician, one has a lot of responsibilities (patient/medical) and patients/family look to them for answers as they are able to diagnose and treat diseases. In Jimmy’s case, I think the physician is able to reiterate Jimmy’s options but also advise the family that his wishes should be taken into consideration. The physician may feel as though respecting Jimmy’s wishes would be the best route to pick, ethically he may feel his parents requests to prolong his life his life has to be taken into account since Jimmy is a minor.  I think the physician can and should tell the parent’s that Jimmy’s quality of life is going to suffer tremendously has he has two active/detrimental diseases.

Clergy/Chaplain: The clergy or chaplain may be able to directly relate with Jimmy as his belief in God is directly impacting his decision to no longer seek treatment to prolong his life. Jimmy was raised in a strong religious environment and the clergy/chaplain will be able to address the family and help them understand life’s events as it relates to their spiritual and emotional well-being. The clergy/chaplain can comfort Jimmy and his family through prayer and reflection during this difficult time in life.  

Blog # 4

For BLOG #4, discuss how technological advances can challenge our ethics. Please read Chapter 8 and also review the associated Powerpoint before responding to this blog. On a personal level, how has the increased use of technology helped or hindered your health care experiences?

·         There are always going to be pros and cons associated with any presented situation. Technological advances have immensely helped our society; however, there are some cons that come along as well in turn challenging our ethics.

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·         For instance, IVF has been a huge technological advancement in the medical world that has helped/given women across the world the ability to have children. The presented case about the postmenopausal woman seeking IVF because she has made the decision to have children at that age has caused many medical professionals to question her desire. It is true that there are greater risks associated with the advance age, however, should anyone judge her simply because she is older than the average female trying to have children?

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·         The case about the 32 year old female carrier for Huntington's disease is another example of how far technology has taken us. The mere fact that technology/science has the ability to perform vitro fertilization and sort out the eggs that do not carry the defective gene is in essence, amazing. Some people question the ethics of this specific procedure because they wonder if it is ethically okay for a mother to have a child even though she knows she may one day have HD. Again, I pose this question, who are we to judge individuals for taking advantage of such offered technologies? I think it is completely up to the individual and their respective family/spouse to make that important decision in life.

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·         On a personal level, the increased use of technology has helped me have a speedier recovery after laparoscopic gallbladder removal. If I would have had the traditional surgery, it would have been an automatic 6 weeks out of work and I simply cannot afford that much time off. I also only have 4 tiny incision scars which will hopefully fade away with the use of vitamin E oil as opposed to one giant scar. The availability of the internet is extremely powerful and I personally struggle with this resource. I wouldn't know what to do without the ability to access the internet and at the same time it gives me grief because I Google every medical symptom I experience.

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·         So in essence, I personally believe the pros associated with technological advancements definitely outweigh the cons and I cannot wait to see how much further we can technologically advance.

Blog # 3

For BLOG #3, discuss the ethical issues presented in the PBS Frontline Documentary, "Sick Around America." You can access the documentary at:
http://www.pbs.org/wgbh/pages/frontline/sickaroundamerica/ 

Before I made the decision to have my gallbladder removed on February 19, 2013, I had to consider financial factors. I know the operation was necessary and although I do have health insurance through my employer, I knew there was going to be some out of pocket expense. Thankfully, my out of pocket expense was affordable which in turn makes me extremely grateful for the awesome health insurance my employer offers me. However, I know this is not the case for everyone and If I was uninsured, I probably would not have been able to afford the operation which was medically needed to relieve my awful gallbladder attacks. My aunt who also suffers from gallbladder disease, it unable to get the operation done because she is uninsured. The expense for such an operation is quite expensive and it is really unfortunate to have to see people in this country suffer medically because they are unable to afford health insurance/care. 

After watching "Sick Around America", my thoughts about our broken health care system was absolutely intensified. People in our country are dying because they are unable to afford health care services. These big time health insurance companies are violating many ethical lines that need to be stopped. These companies should not deny people health care coverage because they have pre-existing conditions. They should not constantly be monitoring people's health insurance claims/records and then telling them that their services will not be covered and that they are officially dropped from the policy. The insured and uninsured individual should not be subjected to such things, we should not have to suffer medically because health care costs are through the roof. 

These companies cross the line everyday and they even provide bonuses to their employers that save them the most money by finding a reason to drop the individuals they cover. In essence, ethically the lines are being crossed as our health care coverages are being denied due to pre-existing conditions, our security and privacy of health information is being violated, and intentional "mistakes" are causing people their lives. I think everyone should stop fighting the health care reform our country is currently trying to implement as we evidently need the change before it is too late. 

Blog #2

For BLOG #2, discuss your thoughts on the end-of-life issues such as death and euthanasia presented in the PBS Frontline Documentary, "Facing Death." You can access the documentary at:

http://www.pbs.org/wgbh/pages/frontline/facing-death/

When you work in emergency services, you are bound to be face to face with near death or death situations. After a while, you learn to deflect the emotions attached with such situations in an attempt to protect yourself. Unfortunately, there are times where you inevitably get emotionally involved with certain patients and that in itself can be a difficult experience to navigate. After watching the documentary, "Facing Death", I was overloaded with powerful emotions that made me think about what I would do if i was faced with death.

I think what surprised me the most about this documentary was that fact that every single patient that was featured had extreme perseverance. They wanted to survive and they wanted to test every possible outlet available to them and that in itself is very powerful. Then you come across individuals who want to end the pain and suffering and you can't help but to feel compassion in both scenarios. As mentioned in the documentary, " no one wants to die, no one wants to die horribly". I agree with that statement 100 percent and I think a large part of the medical community, patients, and family believe in that statement as well. Everyone involved in end-of-life issues go through a difficult time. Doctors have to tell patients and their families that they have either come to the end of the road or that they have to end life sustaining treatments. Doctors are faced with the burden of the "unknown" because patients can either improve or not after treatment is stopped. Families are burdened with making life and death decisions for their loved one's if they are unable to communicate. The patient is burdened with the "what if" situations if they don't try a treatment that could potentially save their lives.

In essence, the documentary was very powerful and I definitely had strong emotions (and tears). Ultimately, I think the patient has the right to choose when to die as I think it is an extension of the patients autonomy. I think the patient has the right because he/she is the one going through the pain and suffering. I also back up patients who want to go through every possible available outlet to prolong their life. Even though these type of situations are extremely sad, at the end of the day , i believe the patients wishes should be respected and honored.

Blog # 1

 Identify a theorist from Chapter 1 who you most resonated with. Provide specific examples, from your life and/or job, that mimic your theorist's basic concepts. Additionally, how can your theorist's ideas be used in healthcare?

The theorist that I resonated the most with was Viktor Frankl. After reading Frankl's short biography and the horrific struggles that he went through in life, I immediately felt a connection. Frankl's theories developed after suriving the Holocaust, believing that " those who had a sense of meaning and purpose kept their humanity even in this unbelievable suffering" (Morrison, 21). Frankl believed that people weren't just a body, they were a "total person", with a mind, body, and spirit. His theories extended into believing that decisions are made based on what you believe or are committed to and that the conscience is used to choose the best action in order to find meaning in the situation.

I identify with Frankl because I also went through a life changing experience. I suffered a lot both psychologically and physically in the abusive relationship I was involved in for five years. After I was able to escape, I did a lot of soul searching and realized that my conscience eventually allowed me to choose the best action that suited me, even though the situation was unfortunate. I found a lot of meaning in that specific situation because I learned a lot from it and it has helped shape who I am today. As Frankl stated, each person has dignity and is unique, there is no one else like me.

All of Frankl's theories can be used in healthcare. In healthcare, you can take a look at everyone involved (including patients) and realize that they are in fact a total person. Every single person has a mind, body , and spirit and a lot of decisions could potentially be based on that theory alone. Additionally, being involved in the healthcare world means that you make a lot of important decisions throughout your career. The theory of making decisions based on what you believe or are committed to can be utilized in healthcare. In essence, I resonated the most with Frankl's theories because I already use his theories in my personal and professional life.