Case: Right to Refuse to Participate in Abortion

Health care providers have the right to refuse to participate in abortions and can abstain from participating in abortions based on their conscience, religion, or moral belief. In Missouri case, Doe verses Peoler, the city was ordered to obtain the services of physcians and personnel who had no moral objections with being involved in abortions. Additionally the city was required to pay the pantiff's attorney's fees because of the deliberate disregard of the destitute woman's rights and the continuation of a policy to disregard and/or avoid the U.S. Supreme Court's rulings on abortion.

What are the ethical and legal issues in this case? The ethical issues raised in this case are the following: from the plaintiff’s perspective it may be ethical for her to follow through with her abortion since it may be for a life threatening reason such as her losing her life. Also, the person may believe it is not the right time to have a child since they may be too young, their parents or significant other opinions factoring into the matter. In addition the person may have been raped by an unknown person and doesn’t want to go through with having a child from an anonymous person not knowing his family health history, nationality, and the fact of not having the father in the child’s life. Ultimately autonomy plays a role in this woman’s decisions. On the other hand, the health care provider has a right to refuse to participate in abortions due to their on morals, beliefs, and conscience if they are not comfortable with the decision the patient wants as in this scenario so the caregiver should assist the patient with finding someone else to help the patient follow their wishes that hopefully were well thought out with other alternatives and consequences.

From the caregivers perspective they have a right to refuse to participate in certain aspects of patient care and treatment. In this case with Doe verse Poelker in Missouri, a conflict with the caregiver’s cultural, ethical, and/or religious beliefs. However, in an attempt to honor the staff member’s rights, a patient’s health must not be compromised which in a way is a way of being beneficence and nonmaleficence. If a caregiver cannot administer or refuse to administer care it should be addressed with an organization’s ethics committee for review and consultative advice. Things that can cause a conflict of interest would be blood products, taking place in elective abortions, and end-of-life matters like a respirator. Also, in my opinion if a caregiver is not going to provide the patient with the best quality of care then they should not participate in the patients care. The patient would most likely be better off seeing another health care provider in the office or going to a different health care provider office. Unfortunately, if a caregiver refuses to treat a patient he or she may be losing out on business as well as jeopardizing their reputation as a health care provider and the patient may spread the news about what happened to them and tell others not to seek care from that provider.

Restraints on Patients

At what point does the application of restraints become cruelty? The application of restraints can become cruelty when the restraints can be placed on the patient incorrectly, meaning that the health care professional could purposely tighten the restraint so that it would cut off circulation throughout the patient’s body and a side effect would be bruising and possible health conditions could develop such as bed sores and other infections. If the health care provider were to totally ignore her or his patient that was restrained all day or throughout her or his shift, she or he would be neglecting her or his patient since as a human being he would need to eat and possibly use the bathroom so, he would need to be released from his restraints to do any of these actions. If the health care professional was being negligent and malfesance then the evidence would be obvious with the patient, left in their bed covered in their urine and feces which is not healthy or sending out a good message on behalf of this health care provider. This would show that the nurse had not checked on their patient throughout their shift and possibly did not care to check on the patient and treat them equally with the best of care. If the health care professional used the opportunity to either verbally or physically abuse their patient while they are literally defenseless, (since the patient is restrained) the professional would be classified as being cruel. Even if there is no physical evidence, if the patient is uncomfortable with the hospital staff because of threats or some form of harassment, then that is also a way of being cruel to ones patients. Therefore, a patient may be afraid to report these incidents since they think if they do, matters may worsen for them in the future by the same health care provider. Moreober, by having ones patient restrained and in their bed all day, unless ordered by the physician, the patient should have times throughout the day when they can stretch and relax without having to be forced to stay in the bed, somewhat enjoying themselves. Overall, the act of being restrained with prolonged usage, unless recommended by the doctor in charge can affect the patients mentality and overall health.

The Importance of Patient Safety

As a healthcare consumer, I was not completely satisfied with the level of patient safety practices implemented at the primary care physician’s office that I went to at the time. The phsyican was a health care provider who demonstrated malfeasance since he only cared about receiving the payment first before even treating his patients, which caused a bit of confusion since it should not be all about the money especially if the physician has not seen the patient yet. However, I guess maybe in the past a patient or two did not pay for their visit and ruined it for everyone. He made me as well as other patients wait in the examination room for about an hour to two hours, and then he would briefly ask a few questions and at the most be finish with the visit within a matter of minutes that seemed to sometimes be unbelieveable, time wasted, and money. It was like he did not want to hear about the problems we had and if I even got him to do a thorough checkup, at the most it was about 5 minutes. And since he was one room from the next so quickly he probably was not washing his hands as much as needed or using the gloves as he was supposed to be. In the end, I only went to that doctor when I was in a car accident for some pain medication, checkup, or for a prescription refill. I believe that everything needs to be improved at that facility. I would hope that before seeing each patient that the assistants and the physician himself would follow universal precautions such as hand washing for preventing the spread of germs or proper disposal of sharps for patient safety. It would be helpful to provide a questionnaire guide to ask informative questions for the patient every time they visit for feedback on the services they recieved and in case anything has changed in their life such as the addition of new medication so the physician can avoid medical mistakes which would overall make the doctor and his staff a better place where people leave happy/healthier instead of sad/unheathier. Patients have the right to be treated the same and with the best quality of care available.

Case: Spousal Rights in Decision Making

In the case of Mr. Martin, he sustained debilitating injuries due to an unfortunate car accident. As a result, his injuries included sever e brain damage that dramatically impaired his physical and cognitive functions. In addition, his injuries left him completely paralyzed on the left side of his body. He could communicate with others little by the movement of his head nodding.
It was decided by a trial court that Mr. Martin could not maintain the four-part test which determines whether a person has the requisite capacity to make a decision. He would not ever have the ability to have the capacity to make decisions regarding withdrawal of life-support equipment. It was proven that Mr. Martin made many aware that he preferred not to be on life-support if a situation occurred like the one that did, which was his autonomy; his physician, wife, and two friends knew of his wishes before this incident happened since he told them.

The ethical issue in this case was his wife a suitable guardian to make decisions? Yes, she was since first of all she was his wife and looking out for her husband since once again she knew his wish was not to have his life sustained on life support that was documented. His mother and sister got involved in the matter stating that Mrs. Martin be removed as the guardian for making the decision of keeping Mr. Martin on life support or not. Her decision did not have anything to do with financial issues or pressure from another person, it was strictly for the best interest of her husband.

Why should Mr. Martin be kept alive? It was ruled by the Michigan Court of Appeals that Mr. Martin would never regain sufficient decision making skills, that his condition, and cognitive level of functioning would not improve in the future. Plus he did not want to be put on life-support before the situation took place.

Case: Disclosure of Physician’s HIV Status

A resident, Doe, in obstetrics and gynecology at a Medical Center in 1991 cut his hand with a scalpel while he was assisting another physician. Due to the fact that he was not sure if blood was transferred from his cut to the patient he got tested for HIV and was diagnosed HIV positive. After finding out that he stopped participating in surgical procedures. The hospital he was an employee at, The Medical Center, identified 279 patients and Harrisburg identified 168 patients who fell into patients that were operated on with Doe. Although Doe did not want patients of his in the past to know they could have possibly be exposed to the virus through an operation that he was part of the patients were still notified but were not told what the physician’s name was, only the fact that a resident physician who participated in their care tested positive for HIV.

I personally think there was definitely a need for disclosure of this information to the patients who could have possibly contracted this serious disease from this physician during an operation since their lives may be changed for ever. For those who were possibly infected they could have passed on to others individual’s like their husbands, wives, fiancés, boyfriend, girlfriend, or random people they may have sex with who are not infected through sexual contact through unprotected sex or body fluids. Also, if any of the patients’s become IV drug users they could possibly pass the virus in that manner too. Additionally, if any of his past patients became pregnant after possibly being exposed by him through a cut of his during an operation, they could pass it on to their unborn child. If the mother is not checked for STD’s such as HIV her child will most likely be born with HIV since she did not know. If she knew she could have taken some precautions such as medicine to prevent her child from being born with the virus.

I think the court failed to inform the patients. If it were me in their shoes I would want to know it was physician, Doe, who could have possibly exposed me to the virus so I would not have to try to figure it out if I have had numerous operations especially in that hospital. I could possibly still be a patient of his and probably would not wan t to be if I knew. In this case, I think malfeasance was put into act since Dr. Doe and the court wanted the patients to be informed of the matter since they could have been exposed under the condition that the physician’s name was not mentioned protecting his confidentiality as well as his reputation as a physician.

However, beneficence could have taken place in this case amongst the court and physician since revealing the physician’s name would have helped patients find out who possibly infected them or infected them with a life-threatening virus if they were tested and diagnosed as HIV positive since their life will be changed with people viewing them differently (if they know), possibly expensive medications, frequent doctor visits, and expensive blood work. This could have been avoided if patients knew so they could have made their mind up to go through with the operation or not, knowing the possible risks which is a person’s autonomy.

How beneficial is sleep?

I think in order to maintain a healthy life sleep is a necessity. If you are not receiving enough sleep, you need to figure out how to get more. There are a few reasons that contribute to people having sleep disorders such as: insomnia, sleep hygiene, and snoring while sleep. Insomnia for instance is a chronic sleep deprivation that can cause errors at work. It also impairs reaction reflexes and concentration. Lack of sleep can cause a bad temper and crankiness. Also sleep can be a disorder resulting from physical, mental, or emotional abuse that prevents someone from getting a good night’s sleep. A person with a sleeping disorder may need to seek professional help for a better understanding of their condition. If sleep problems are left untreated the results could make life very difficult, can lead to serious health complications, and even death. Snoring can be a sign of more severe breathing disorders. In addition, getting less than six hours of sleep every night could increase the risk of dying and diabetes. As a result I believe people should do their best to get between six to nine hours of sleep every night for optimum health that increase their life span, even though some people can function off of three to five hours of sleep which is not good in the long run for their health. Therefore, it is the autonomy of the individual to do what they need to do to improve their health.

Laughter is valuable

I believe laughter is one of the best medicines based on information from experts. It is extremely beneficial for the following reasons: it increases a person's immune system response, lowers blood sugar levels in diabetics, increases oxygen flow throughout the entire body and helps induce a state of relaxation promoting better sleep, which many people are unaware of .

According to a medical doctor at the University of Maryland Medical Center, there is evidence that laughter can be healthy for your heart in preventing a heart disease. There was a study done in which forty percent of the individuals who had heart disease did not laugh in certain situations compared to people of the same age who did and did not have heart disease. The exact reason is not quite known why laughing protects the heart. However, it is known that mental stress is linked to impairment of the endothelium that is the protective barrier lining blood vessels. Furthermore, a series of inflammatory reactions that can lead to cholesterol and fat increase in the coronary arteries and unfortunately a heart attack.

Laughter is considered to be natural or a learned trait that may be vital signs in the United States where heart disease is the number one killer. I think in today’s time people need to include laughter in their daily routines like we do with other heart healthy actions such as taking the stairs rather than the elevator. Even watching a funny movie or reading something hilarious should strike a funny bone and keep people from taking themselves so seriously. Therefore, for a healthy heart people should exercise, eat properly, and laugh a couple of times throughout the day.

Are yearly doctor check ups necessary for everyone?

I personally believe yearly examinations are very beneficial for everyone. It does not matter what nationality, religion, age, or sex I think it is very important for everybody to be physically examined by a general physician. A visit to the doctor’s office once a year could help catch or prevent illnesses. For example, if high blood pressure is not found and treated, major health complications like heart disease, eye problems, or kidney failure could be a result. In addition, a sexually active person could have an STD and not know while possibly infecting others. Well a simple visit to the doctor’s office could reveal this information through a series of questions that may lead the doctor to do additional blood test. An annual exam should include a blood pressure check, bone density test, cholesterol, and sugar level screening as well as extra blood test that may be needed. Also, examination of the reflexes, throat, ears, and nose should be done.

Autonomy is involved in this situation as far as the person’s decision to do what they want to do. Hopefully, after a person is educated on the benefits on why they should be seen by a physician once a year, they will be convinced that it is necessary for them to be checked out especially when it could save their lives by the prevention and treatment of ailments that could significantly extend their life-span. If seeking medical attention once a year could make a dramatic difference in a person’s life then people should be trying there best to at least do that on a yearly basis. To me it would be better to know than not know and possibly hurt yourself or others worse.