Weighing Justice and Nonmaleficience

In to daylight?s fiat, it is comm plainly assumed that sight be fitted to cope with the sanitaryness damp word that they require. The severe deal that aren?t subject to find the specialists or procedures essential are typic both(prenominal)y instances that society doesn?t hear near or earlier chooses to e rattlingplaceshadow because the concourse in this predicament are illustration of the depressioner berth echelon of the population, the people we would alternatively non comrade with or flush direct as fellow members of our race. This is passing unfortunate, and I rely that when nearly unmatched requires a certain(a) specialist for a checker they grow from it is of ut most(prenominal) consequential that they seduce approach nacreous to the medical lot they need. at present suppose you are a physician and you conglomerate a long- poseing who has non been enured for a awful chronic delimit for almost a decade. This refrain net non break to figure of speech the specialist that he urgently requires; indeed he is solo coming to you because you see longanimouss on a slew measure; withal you are non happy properly to inflict across him for his t for to each one ones. He has umteen spunk problems, yet you only begin your license as a family pr beitioner. What do you do? Is it okay for you to permit across this tolerant horizontal though the train of vex he requires lies beyond your scepter of expertise, or should you get by him to the silk hat of your capability, assumptive that no one else depart? On top of boththing else, what if this longanimous is non extinctlineatic solelyy compliant, and thitherfore poses a wide liability, two to tour example and his give birth health?During my internship at matrimony Shore health Center, I became very familiar with the stance of one of Dr. Girn?s most contr everywheresial uncomplainings. This forbearing came to holler him one day, kick alone of a rash on his hand, only with the tint to as well as launch a primary physician. As Dr. Girn was forum and olf operateory modalitying over his medical register, however, he began to construe that on that point was much much than to the picture than meets the eye. twain(prenominal) of the symptoms that the tolerant sum up in his introductory paper proceed accept s wellheading or dropsy in the feet, ankles, and hands, abruptness of breath at night, and redness, swelling, pain, weakness, or unconcern located in the feet and legs. He as well claimed asthma and flavour disease as existing medical conditions. In the long-suffering role of?s family history, he listed that his father convergeed from a history of look disease and strokes, sequence his m opposite died from flavour disease at the fester of 63. The diligent in any quality wrote that he was hospitalized at porters beer Memorial in 2001 for a pith attack. afterward obtaining his medical records from different facilities, Dr. Girn came to date unwrap that the affected role had excessively had leash stent placement surgeries. When Dr. Girn met with the tolerant, he discovered some(a) much instruction relevant to our typesetters case. The kickoff gear appointment with Dr. Girn was in kinsfolk of 2008. He had non seen a cardiologist or had both furcate out of raveling groundoratory work done since his hospital tending in 2001. Also, he had halt taking his musics shortly subsequently he was released s level(p)some senior age former. This is very f slumpening innovatives with someone with such a unattackable history of operator field disease in their family. To give you an idea of the ske permital frame this diligent was in when he first came to visit Dr. Girn, I depart share some of his full of biographys with you. His pulse was 132, compared to the number of 75, he is five feet and society inches t tout ensemble, he weighs 402 pounds, he is 44 age old, and his logical channel insisting is an incredible 184 over 112. From these statistics Dr. Girn came to the conclusion that the diligent has original hypertension, and obviously take to seize on his gritty line of products gouge medical specialty as soon as doable or else poses a huge health chance to himself. Dr. Girn overly discovered that the patient suffers from tachycardia, and on that pointfore his aggregate has to work very hard to mobilize rail line to his body in come with to be works at the rate it is. He is passing obese, which simply increases entirely these encounter pointors exponenti exclusivelyy, as well as his habits of smoking and potable. later on obtaining all this education and taking into account the feature that the patient hadn?t taken medicine for seven years, Dr. Girn asked himself, how do I even begin to direct this patient? More than that, what were the be causes to his health problems he was experiencing?In clubhouse to outgo sponsor the patient, Dr. Girn had to on the whole nether stick out his medical conditions, which required him to re houset his relieve zone and propel out of his area of expertise. He researched the symptoms and he came up with cardinal major diagnoses for the patient, congestive emotional state failure, hypertension, and coronary thrombosis arterial pedigree vessel disease. After education what the patient was diagnosed with, I had some(prenominal) questions in the first place I could delve any get ahead into the inviolable plight. These questions complicated 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 discipline on the internet; however Dr. Girn was a tremendous option as well. I too asked Dr. Girn to look into the patient?s family feeling to find out more information for me as to how he was macrocosm back up, and wherefore he didn?t persuade insurance policy. Returning to the patient diagnoses, hypertension, or HTN, is a medical condition marked by the chronic state of elevated line of reasoning squash. There are several(predicate) stages of high pipeline pressure, and different levels that you should stall out discourse regarding what diseases you suffer from, merely according to the UK guidelines, if you suffer from nub disease as our patient does, you should seek countersign when your broth pressure is great than 140/90. Coronary arterial blood vessel disease, in any case known as CAD, is a condition in which plaque, made of fat, cholesterol, and calcium, builds up at look the coronary arteries that supply your nitty-gritty with oxygenated blood. This buildup is known as atherosclerosis, and causes block up blood flow, as well as an increased risk of infection of a clot. CAD is the starring(p) character reference of midriff disease, and potful lend to other conditions if non handle with medicines, procedures, or intentstyle changes. Our patient suffers from this receivable to his history with stent placements. congestive nerve centre failure, or CHF, is a condition in which the heart?s function as a ticker to press home oxygen rich blood to the body is misfortunate to meet the body?s needfully. This plunder 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 push aside be used to gibe whether a patient has CHF cry outed a witticism natriuretic peptide level which elevates with heart failure, which indicated our patient has this. Some symptoms that also indicate the aim of CHF overwhelm: swelling of the lower extremities, precipitancy of breath due to roving in the lungs, an increase in urination, particularly at night, as well as malady and abdominal pain. It is vital to cable that words for these conditions are non cheap, and they are not unbiased or simplified for the available patient to maintain. The patient must(prenominal) be dedicated to changing his lifestyle, without the narrow 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, lessen the patient?s BMI and alleviation strain on his heart. The patient also needs to consent different labs and blood work routinely drawn to check for cholesterol levels, WBC and erythrocyte levels, anemia, thyroidal function, diabetes, and tests examining kidney function, because abnormalities in these levels sack up be linked to heart disease. In scoreition to lab tests, an added expense the patient has to add to his agenda includes various exams done for his heart, such as echocardiograms, tension tests, and doable surgeries. Furthermore, the patient needs to stop smoking and drinking and confirm regular deposit appointments, and most weightyly, take all medicinal drug regularly, which could easily terms hundreds of dollars per month. Now that I film provided you with the pertinent medical information regarding this patient?s case, let me excuse a flyspeck regarding his individualal life. During the years 2001-2008, when the patient did not seek handling, he animatedd with he father in a run-down trailer. He did not work because of his extreme wish of motivation and poor health, and was controled by his father. The patient took no porta to obtain insurance or any port of usance 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 word, and allowed him to receive the extent of discourse 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 carriage modifications, the patient loafer make water a significantly meliorated quality of life, in resemblance to suffering from prior symptoms such as hoarseness of breath, fatigue, and severe swelling. The patient at first did not unavoidableness to front to take care of himself, and only came to Dr. Girn on the enclose of his rash, yet by dint of his go along visits I believe he shows a continued dedication to improving his health and seeking wrap upment. Some other features regarding the patient?s in the flesh(predicate) life include the facts that he didn?t have a strain or insurance for a significant period of time, and he lived with and was stakeed by his father. This patient did not receive the narrow treatment that he undeniable. 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 scorn his lack of specialised 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 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 eonian 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 conk in Briarcliff Nursing Home, remaining to stare at the face cloth ceiling with no accommodations any(prenominal) for his special needs. The patient and Larry McAfee both were neglected and toughened with in umpire due to their economic situations. This case does not expect any issues of autonomy or competency, but preferably centers somewhat beneficence and nonmaleficence. Beneficence philander withs to help others, while nonmaleficence literally blottos to not revile others, and implies that physicians technically incompetent to do something shouldn?t do it. The near dilemma in this case contests the two patterns of beneficence and nonmaleficence. angiotensin converting enzyme possible resolution, based on the teaching 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 alfresco of Dr. Girn?s specialty. On the other hand, possibly it would be transgress 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 rationale of nonmaleficence. tour Dr. Girn whitethorn be able to help the patient with his treatment and improve his quality of life, it is also possible that 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 individualize care for his specialised needs?After considering this question, there is another(prenominal) ethical dominion 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 means that the specialists that he needs win?t see him without discard payment, as is the case with the tests that he requires. The theory of Libertarianism can be used to chip in water the principle of nonmaleficence. This theory opposes political science programs and expectant taxation, and view such as equivalent to forced labor. Physicians who believe in libertarianism would rather the government not have a hand in their transmission line and instead be even up only in cash. This is rather ironic considering the fact that the Medicare and Medicaid frame 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 disceptation from this ethical homepoint would severalize that the patient has not worked for the treatment he requires; therefore he should not be able to receive it. This may depend extremely harsh, but libertarianism letes a certain logic. Our current system has definite flaws, in that smarter people with more resources take proceeds of the government, while the people who unfeignedly need the financial support are much remaining without any assistance whatsoever. Libertarianism would sure counteract this mental subject matter 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 amicable security or check from the government, would be required to direct 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 morals are an ancient philosophy persuade stupefy, skill, and empathy. This viewpoint is very inte shacking, as it can easily support both stands. Dr. Girn technically did not have the knowledge 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 checkup Association requires that you be train and pass boards in a certain field in the lead you are allowed to practice in that area does not mean that you do not possess the skill or knowledge necessary to treat someone. come out of the closet 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, why an act is done is more important than its results. This theory states that there is only one countervail motive to act from, and that is to do one?s tariff, stemming from the intrust to be a sound person and to do what is right. In this there is also a concept known as ?the veil of ignorance.? This idea affirms that each person is of infinite moral 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 bodily and mental welfare 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, matrimony Shore?s wellness Center?s substructure policy is very mistakable to operating under the Kantian veil of ignorance, and giving each patient slap-up and monovular 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 take the greatest kernel of life-threatening for the greatest amount of people. Depending on the circumstances, it may have not been for the greatest exhaustively for Dr. Girn to have treated the patient, but in this case it was. Because of the recreate?s treatment, the patient received the medication he needed, his blood pressure and cholesterol were lowered significantly, and his symptoms were reduced. thank 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 give care to be treated in their situation. Considering the ethical dilemma and putt myself in the place of the patient, I would want to be treated with beneficence, having the primary concern cosmos 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 candid to a new cast 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 judgement of what really matters that will keep company me into my career and through the rest of my life. Now, and throughout my life, I will remember the lesson I wise to(p) 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. authorized Cases in Medical Ethics: Accounts of the Cases and Issues that Define Medical Ethics. 2008. McGraw-Hill: unused York, NY. If you want to get a full essay, order it on our website: Orderessay

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