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Burn injury is one of the most common types of trauma after accidents. The case study 1 is about a man with burns who has been sent back to his home. The random assessment made by the medical team revealed that the pressure garments have been damaged as elasticity is gone. According to Fins & Bernat, (2018), the ethical issues that rely on this framework are practical and face ethical challenges. The preference of patients, medical indications, their quality of life quality and the features such as social, economic and legal. Patient preference is the choice of the patient to pursue their medications (Fins & Bernat 2018). The above case study can be analysed on this basis because the burn injury can cause harm to the person and for his safety, the pressure garments have been provided. The ethical principle followed by the doctors, in this case, is taking utmost care and providing with all necessary equipment to manage the burn centre. The burn puts a severe effect on the minds of the patient as well. The consent of the patient in taking the medications is also important. As stated by Akbari et al., (2015), the burn injuries are so sensitive that chances of infections are high. The doctors must make sure that the burn must not come in contact with any such things that might elevate the infections. It is one of the four approaches in ethical principles. Nonmaleficence is important here when it is subjected to others in society. Many people can not take the visuals of burns that occur to other people. It puts mental pressure on other people. The chances of infection are more if the patient comes in contact with the other people. These non-harming situations must be avoided and the doctors must make sure that the norms are maintained (Akbari et al., 2015). In the given case study, the prison removes the pressure garments due to the loss in elasticity. Here the autonomy of the choice must be provided under the ethical provisions. As stated by Scherer et al., (2017), the patient must be given that choice to inhabit what he wants to take or refuse. The medical professionals must provide the patient with other equipment or options to secure the burn and to decrease the chance of infections. This step comes under the beneficence in which the doctors would make sure that the patients must be provided to good by the practitioners (Scherer et al., 2017). According to Coghlan et al., (2019), the rule of providing equipment or medical treatment to the burn patients can help in adopting the provision of Justice where the doctors would maximize the benefits of providing with the equipment and that would in return provide impartiality to the society by assessing the chances of infection (Coghlan et al., 2019). This is mentioned here because any patients who suffer from any communicable diseases are at higher risk and put the society as well at risk. Thus the following ethical provisions can be followed in the provided case study and all the four quadrants of the approaches can be followed in treating the burn patients and also benefiting the society by hindering the infections that follow the burn injury.
The case study 2 is about a teenage girl who had unprotected sex with her boyfriend and has to take a morning-after pill to prevent pregnancy. The morning-after pill is the contraceptive pills that help in hindering unwanted pregnancy. According to Broadhurst et al., (2015), the morning contraceptive pills can have bad effects. Even if it is used as contraceptives, it can lead to termination of pregnancy after a few weeks. The prevention of ovulation is acceptable as it does not procure any harm to the body. The termination of pregnancy or abortion can have harmful effects as it has many side effects on the female body. In this case, the ethical issues addressed by the doctors can be keeping it confidential to protect the sanctity of the patient. But if it harms society in any case, the doctor has to ensure that it must be informed for the good of the people (Broadhurst et al., 2015). According to Sathyamala (2019) in her journal states that the other ethical issues that the doctors might face are not harming the body in any case. The patient might not want pregnancy due to family pressure or personal issues. But if the abortion or termination causes harm to the body of the patients in any case, it is the duty of the doctor not to proceed with the procedures. The doctors must save lives. If the EC use is safe enough, the doctors must inform the patients regarding the side effects of the pills. They must be educationally aware of the effects that this EC probe. The confidentiality matter is another important aspect of the legal duty that the doctors need to perform. By any means, the person’s identity must not be revealed. The provided case study suggests that the patient's parents are conservative and would not accept the fact that their daughter would be pregnant (Sathyamala, 2019). According to Santelli et al., (2017), the religious aspect also arises here. Many religions forbid the practice of termination as life is God's gift to the person. But the social stigma attached to the early pregnancy culminates in this fact. The doctors need to make decisions following the benefits of the patients and must strive to help the patients at any cost. There also comes an ethical issue here, when it is seen deeply. The use of EC can lead to the freedom of using it by teenage girls without fear. They can get more accustomed to unprotected sex that might lead to unevenness in society. This would be against the principles of nonmaleficence and beneficence (Santelli et al., 2017). The use of EC and availability of the pills can also put danger on the health of the women in society. To prevent this on ethical terms, women and girls must be educated enough to follow safer methods of contraception. Aa stated by The overuse of EC or morning-after pill would also affect the health and the wellbeing of the women. Counselling and education regarding this issue are very important and the doctors must take care of it by providing proper guidance.
In case study 5, the scenario is the refusal of treatment by aged Harry is because of his motor neuron disorder. He had been treated with medication 6 months back and after the medication, he had given his consent on the refusal of treatment. The medical practitioners must make sure here that respect must be given to the choice of refusal by the patient. There can be underlying terms and values for the refusal. The advanced health directive helps the doctors in maintaining whatever the patients have instructed. But in this case, it is seen that the patient suffers from chest congestion and breathing disorders. The wife assures the doctors that there have been plans of an outing with family and had an upcoming birth of his grandchildren. She also assured that her husband would like to have the treatments that are available to cure him if it is effective enough to cure him for the time being. The doctors can consider this because Harry was not able to speak much about his feelings or condition due to his health. The doctors must consider this information for taking care of the patients. According to Benjamin (2016), there are faces and goals in treatments, that include curative, preventive, management and palliative. The goals here used would be preventive and palliative. The patient must be provided with the proper medications so that the problems he has been facing are warded off followed by the provision of palliative care where he could be enrolled for leading his life following goals he had decided. The right of refusing treatment goes parallel with the patient right and that is the right to informed consent (Benjamin, 2016). The doctors must give consent only if they have sufficient information regarding the patient and his diagnosis and treatment options available. Before applying any treatment as well, the doctors must make sure that the patient is well informed about the process that would be followed. The doctor must give as much information as possible so that the care does not invite any legal dispute from the patient's side. When the patient is informed about the treatment and its procedures properly then he would have the right to make decisions regarding the acceptance and refusal of the treatment. As stated by Karnik & Kanekar, (2016), a point that must be taken into consideration that it is unethical to force the treatment on the person if he is mentally sound to take his decision. In the provided case study, the patient is not audible and legible enough to make doctors understand what he wants. In this case, it becomes important for the doctors to save his life by preventing the dangers of the symptoms that are seen in his body functioning. The state here is questionable as the patient is unable to inform anything legally, then the instructions or information of his family member or a closed one can be assumed to follow (Karnik & Kanekar, 2016).
Benjamin, R. (2016). Informed Refusal. Science, Technology, & Human Values, 41(6), 967–990. https://doi.org/10.1177/0162243916656059
Broadhurst, K., Shaw, M., Kershaw, S., Harwin, J., Alrouh, B., Mason, C., & Pilling, M. (2015). Vulnerable birth mothers and repeat losses of infants to public care: is targeted reproductive health care ethically defensible? Journal of Social Welfare and Family Law, 37(1), 84–98. https://doi.org/10.1080/09649069.2015.998007
Coghlan, N., Copley, J., Aplin, T., & Strong, J. (2019). How to improve compression garment wear after burns: Patient and therapist perspectives. Burns, 45(6), 1447–1455. https://doi.org/10.1016/j.burns.2019.04.018
Fins, J. J., & Bernat, J. L. (2018). Ethical, palliative, and policy considerations in disorders of consciousness. Neurology, 91(10), 471–475. https://doi.org/10.1212/WNL.0000000000005927
Karnik, S., & Kanekar, A. (2016). Ethical Issues Surrounding End-of-Life Care: A Narrative Review. Healthcare, 4(2), 24. https://doi.org/10.3390/healthcare4020024
Santelli, J. S., Kantor, L. M., Grilo, S. A., Speizer, I. S., Lindberg, L. D., Heitel, J., Schalet, A. T., Lyon, M. E., Mason-Jones, A. J., McGovern, T., Heck, C. J., Rogers, J., & Ott, M. A. (2017). Abstinence-Only-Until-Marriage: An Updated Review of U.S. Policies and Programs and Their Impact. Journal of Adolescent Health, 61(3), 273–280. https://doi.org/10.1016/j.jadohealth.2017.05.031
Sathyamala, C. (2019). In the name of science: Ethical violations in the ECHO randomised trial. Global Public Health, 1–16. https://doi.org/10.1080/17441692.2019.1634118
Scherer, M., Lühmann, D., Kazek, A., Hansen, H., & Schäfer, I. (2017). Patients Attending Emergency Departments. Deutsches Aerzteblatt Online. https://doi.org/10.3238/arztebl.2017.0645
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