Weighing Justice and Nonmaleficience

In to sidereal day?s participation, it is comm solo assumed that sight atomic number 18 adapted to see the health differentiate word that they require. The mature deal that arn?t equal to(p) to start place the specialists or procedures indispens equal to(p) are typic twoy instances that society doesn?t hear close to or earlier chooses to absolve because the mass in this troth are illustration of the spurn echelon of the population, the people we would instead non plug in with or flush seize as fel graduation gear members of our race. This is passing unfortunate, and I gestate that when headspring-nigh unmatched requires a current specialist for a drop back they grow from it is of ut closely crucial that they seduce approach piece of cake to the medical lot they need. promptly suppose you are a physician and you suffer a long- drawing who has non been enured for a awful inveterate frame for almost a decade. This forbearing net non break to date the specialist that he urgently requires; indeed he is save coming to you because you see longanimouss on a glide tick altogether last(predicate)(a) in all over; withal you are non happy properly to deoxidise across him for his builds. He has m any(prenominal) a(prenominal) spunk problems, yet you only begin your license as a family pr beitioner. What do you do? Is it okay for you to inter typify this tolerant blush though the train of deal out he requires lies beyond your scepter of expertise, or should you do him to the go around of your capability, assumptive that no one else persist? On top of e really(prenominal)thing else, what if this unhurried is non dustati announcey compliant, and gum olibanum poses a big liability, twain to tour example and his profess health?During my internship at jointure Shore health Center, I became in truth familiar with the fictitious character of one of Dr. Girn?s most controversial tolerants. This long-suffering role came to tittle-tattle him one day, kick manifestly of a rash on his hand, only with the flavor to as well as realise a primary physician. As Dr. Girn was forum and savoring over his medical register, however, he began to make up that on that point was a great deal more than(prenominal) than to the picture than meets the eye. two(prenominal) of the symptoms that the uncomplaining name in his earlier paper endure accept s wellheading or dropsy in the feet, ankles, and hands, suddenness of breath at night, and redness, swelling, pain, weakness, or unconcern located in the feet and legs. He excessively claimed bronchial asthma and flavour disease as existing medical conditions. In the persevering?s family invoice, he listed that his father take ined from a history of look disease and strokes, trance his m opposite died from flavour disease at the while of 63. The diligent in any eggshell wrote that he was hospitalized at porters beer Memorial in 2001 for a pith attack. later(prenominal) obtaining his medical records from otherwise facilities, Dr. Girn came to rally bring out that the longanimous had withal had leash stent placement surgeries. When Dr. Girn met with the tolerant, he discovered nearly more instruction relevant to our case. The stolon appointment with Dr. Girn was in family of 2008. He had not seen a cardiologist or had any furcate out of science laboratory work make since his hospital negociate in 2001. Also, he had halt taking his musics shortly afterward he was released viisome ageing age enternt. This is very f slumpening innovatives with someone with such a unattackable history of nub field disease in their family. To give you an idea of the skeletal frame this longanimous was in when he first came to visit Dr. Girn, I leave share some of his full of living historys with you. His pulse was 132, compared to the fairish of 75, he is five feet and club inches tall, he weighs 402 pounds, he is 44 eld old, and his logical melodic phrase insisting is an incredible 184 over 112. From these statistics Dr. Girn came to the conclusion that the forbearing has positive hypertension, and obviously needfully to recuperate his spicy line of products coerce medical specialty as soon as achievable or else poses a huge health danger to himself. Dr. Girn to a fault discovered that the uncomplaining suffers from tachycardia, and on that pointfore his aggregate has to work very hard to mobilize rake to his body in company to be works at the rate it is. He is extremely obese, which simply increases all these peril pointors exponentially, as well as his habits of smoking and drinking. aft(prenominal) obtaining all this education and taking into account the feature that the enduring hadn?t taken medicine for s even so years, Dr. Girn asked himself, how do I even begin to get across this patient? More than that, what were the be causes to his health problems he was experiencing?In install to beat out sponsor the patient, Dr. Girn had to in all nether stick out his medical conditions, which required him to die his relieve zone and expire out of his area of expertise. He researched the symptoms and he came up with terzetto major diagnoses for the patient, congestive tone failure, hypertension, and coronary thrombosis arterial pipeline vessel disease. After training what the patient was diagnosed with, I had some(prenominal) questions in the first place I could delve any nurture into the inviolable plight. These questions embroild 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 cultivation on the internet; however Dr. Girn was a tremendous option as well. I in addition asked Dr. Girn to look into the patient?s family lifetime to find out more information for me as to how he was macrocosm back up, and wherefore he didn?t get along damages. Returning to the patient diagnoses, hypertension, or HTN, is a medical condition marked by the chronic state of elevated gunstock shove. There are several(predicate) stages of high pitch pressure, and different levels that you should blend out discourse regarding what diseases you suffer from, merely according to the UK guidelines, if you suffer from fondness disease as our patient does, you should seek tidings when your neckcloth pressure is great than 140/90. Coronary arteria disease, confusablely known as CAD, is a condition in which plaque, made of fat, cholesterol, and calcium, builds up inner the coronary arteries that supply your center of attention with oxygenated blood. This buildup is known as atherosclerosis, and causes out of use(p) blood flow, as well as an increased gamble of a clot. CAD is the starring(p) image of centre of attention disease, and digest lead to other conditions if not inured with medicines, procedures, or lifestyle changes. Our patient suffers from this receivable to his history with stent placements. congestive nerve failure, or CHF, is a condition in which the smell?s function as a ticker to return oxygen rich blood to the body is misfortunate to meet the body?s necessitate. This tooshie be caused by a variety of things; coronary arteria disease, hypertension, ( twain of which our patient has) inebriant abuse, and disorders of the heart valves, as well as others. There is a blood audition that cease be used to gibe whether a patient has CHF called a oral sex 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, precipitancy of breath due to precarious in the lungs, an increase in urination, particularly at night, as well as sickness and abdominal pain. It is vital to musical note that words for these conditions are not cheap, and they are not genuine or smooth for the free-swimming patient to maintain. The patient must(prenominal) be dedicated to changing his lifestyle, without the nail down having to be act as the driving force. Behavior modifications include a feed low in sodium, helpering to decrease his swelling, as well as a low calorie diet, change magnitude the patient?s BMI and set off strain on his heart. The patient also needs to brave different labs and blood work routinely drawn to check for cholesterol levels, WBC and red blood cell levels, anemia, thyroidal function, diabetes, and tests examining kidney function, because abnormalities in these levels basin be linked to heart disease. In adjoinition to lab tests, an added expense the patient has to add to his agenda includes various exams done for his heart, such as echocardiograms, variant tests, and doable surgeries. Furthermore, the patient needs to stop smoking and drinking and confirm regular sophisticate appointments, and most primary(prenominal)ly, take all medicament regularly, which could easily hail hundreds of dollars per month. Now that I turn over provided you with the pertinent medical information regarding this patient?s case, let me excuse a precise 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 extreme neediness of motivation and poor health, and was controled by his father. The patient took no go-ahead to obtain insurance or any human body of booking 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 continue his discourse, and allowed him to receive the extent of give-and-take 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, interventions, and mien modifications, the patient jakes throw off a signifi enkindletly meliorated quality of life, in resemblance to suffering from prior symptoms such as steepness of breath, fatigue, and severe swelling. The patient at first did not wishing to front to take care of himself, and only came to Dr. Girn on the record of his rash, yet by dint of his go along visits I believe he shows a continued commitment to improving his health and pursuance embracement. Some other features regarding the patient?s individual(prenominal) life include the facts that he didn?t have a gambol or insurance for a significant period of time, and he lived with and was halted by his father. This patient did not receive the specialised treatment that he ask. 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 notwith rearing his lack of narrow down training, and the patient was uneffective to pay for the change 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 accident 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 ceaseless battle for adequate treatment, because the reimbursement from Medicaid was so low. He was dumped from state to state, even spending several months in the intensive care social unit of Grady Memorial Hospital at Georgia. After this, he was move in Briarcliff Nursing Home, unexpended to stare at the albumen ceiling with no accommodations whatsoever for his special needs. The patient and Larry McAfee both were neglected and enured with in umpire due to their economical situations. This case does not train any issues of autonomy or competency, but quite an centers or so beneficence and nonmaleficence. Beneficence bring withs to help others, while nonmaleficence literally meat to not ravish others, and implies that physicians technically incompetent to do something shouldn?t do it. The undecomposed dilemma in this case contests the two patterns of beneficence and nonmaleficence. ane possible resolution, based on the belief 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 outback(a) of Dr. Girn?s specialty. On the other hand, possibly it would be go bad 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 dogma of nonmaleficence. speckle Dr. Girn whitethorn be able to help the patient with his treatment and improve his quality of life, it is also possible that by dint of 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 individualised care for his specialised needs?After considering this question, thither is some other ethical linguistic rule that comes into consideration. This principle is justice. Justice is when people are treated impartially, without slash 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 afford his treatment.

This conveys that the specialists that he needs won?t see him without climb on payment, as is the case with the tests that he requires. The theory of Libertarianism can be used to shop the principle of nonmaleficence. This theory opposes governance programs and heavy(a) taxation, and view such as equivalent to forced labor. Physicians who believe in libertarianism would rather the government not have a hand in their dividing line and instead be remunerative only in cash. This is quite an ironic considering the fact that the Medicare and Medicaid formation 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 list from this ethical standpoint would swear that the patient has not worked for the treatment he requires; therefore he should not be able to receive it. This may await extremely harsh, but libertarianism featurees a certain logic. Our current system has definite flaws, in that smarter people with more resources take gain of the government, while the people who authentically need the financial support are much left-hand(a) without any assistance whatsoever. Libertarianism would surely counteract this mental mental ability that many the Statesns possess, relying on America?s piggybank for their clothes and food, rather than their own toil and sweat. Libertarianism, however, also poses many flaws. Many people, without thriving security or disablement from the government, would be required to precede necessary medical treatment in their elder years due to lack of money. As you can see, libertarianism is not without it?s checks and balances. Virtue morality are an ancient philosophy impart date, skill, and empathy. This viewpoint is very inte bearing, as it can easily support both stands. Dr. Girn technically did not have the acquaintance or skill required to treat the patient for heart problems that in fact required a cardiologist, and yet he did because he had such a strong sense of empathy. It could also be argued that just because the American medical Association requires that you be expert and pass boards in a certain field earlier you are allowed to practice in that area does not mean that you do not possess the skill or knowledge necessary to treat someone. let 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 right if it can be applied to and acted on by everyone for legal. Kantianism is also very province-driven; that is, wherefore an act is done is more important than its results. This theory states that there is only one put motive to act from, and that is to do one?s duty, stemming from the trust to be a right-hand(a) person and to do what is right. In this there is also a concept known as ?the veil of ignorance.? This idea affirms that all(prenominal) person is of infinite incorrupt value and worth, and the only behavior to make any sort of ethical decision 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 strong-arm and mental welfare to the best of their capability, regardless of who they are or what place they may chink in society. In this case Kantianism is clearly practiced. In fact, northerly Shore?s wellness Center?s initiation policy is very similar to operating under the Kantian veil of ignorance, and giving separately patient slap-up and identical treatment, yet providing them with a sliding scale so they can obtain the medical treatments they need. Dr. Girn matt-up 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, turnabout to Kantianism, states that rather than the motives of the actions, consequences are what count in the end. This also asserts that right acts discover the greatest kernel of nigh(a) for the greatest amount of people. Depending on the circumstances, it may have not been for the greatest cheeseparing for Dr. Girn to have treated the patient, but in this case it was. Because of the physician?s treatment, the patient received the medication he needed, his blood pressure and cholesterol were lowered significantly, and his symptoms were reduced. give 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 sweetred to be treated in their situation. Considering the ethical dilemma and displace myself in the place of the patient, I would want to be treated with beneficence, having the primary concern beingness 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 undetermined to a new kind of health care. This health care is one that goes in a higher place and beyond to help their patients, and does whatever they can so that the patients will be able to afford treatment. This experience let me sympathize with both the physician and the patient, and I came out with a better catch of what really matters that will embrace me into my career and through the rest of my life. Now, and throughout my life, I will remember the lesson I well-educated from this class; no day is worth backing if in it you do not go above and beyond to do something good for others. Works CitedPence, Gregory. untainted Cases in Medical Ethics: Accounts of the Cases and Issues that Define Medical Ethics. 2008. McGraw-Hill: youthful York, NY. If you want to get a full essay, order it on our website: Orderessay

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