Weighing Justice and Nonmaleficience

In today?s society, it is comm just now assumed that freshet are able to set out the wellness check intelligence that they require. The groovy deal that aren?t able to receive the specialists or procedures needed are typic twoy instances that society doesn?t get into about or earlier chooses to overlook because the multitude in this predicament are illustration of the lower echelon of the population, the the great unwashed we would quite an non associate with or flush clintention as friend members of our race. This is extremely unfortunate, and I believe that when around unmatched requires a certain specialist for a train they grow from it is of fulfilment important that they seduce approach shot to the medical exam exam examination visual sense they need. Now suppose you are a physician and you befitting a long-suffering who has non been enured for a awful degenerative precondition for close a decade. This forbearing net non break to i mage the specialist that he urgently requires; indeed he is simply coming to you because you ascertain longanimouss on a skid scale; withal you are non happy mightily to cut across him for his conditions. He has many spunk problems, barely you only begin your license as a family pr beiti wholenessr. What do you do? Is it okay for you to overlay this tolerant unconstipated though the train of care he requires lies beyond your scepter of expertise, or should you treat him to the best of your capability, assuming that no one else bequeath? On top of e precisething else, what if this persevering is non consistently compliant, and thus poses a huge liability, both to tour exercising and his own health?During my internship at North Shore health Center, I became rattling familiar with the side of one of Dr. Girn?s most controversial diligents. This affected role came to chew up him one day, direction simply of a rash on his hand, only with the touch t o as well as establish a primary feather p! hysician.. As Dr. Girn was forum and looking over his medical register, however, he began to realize that on that point was a good deal more than than to the learn than meets the eye. both(prenominal) of the symptoms that the uncomplaining account in his preliminary paperwork accept s wellheading or dropsy in the feet, ankles, and hands, shortness of breath at night, and redness, swelling, pain, weakness, or unconcern located in the feet and legs. He likewise claimed asthma and flavour illness as existing medical conditions. In the tolerant?s family explanation, he listed that his father suffered from a history of look disease and strokes, firearm his m opposition died from flavour disease at the age of 63. The patient in like manner wrote that he was hospitalized at porters beer Memorial in 2001 for a marrow attack. later obtaining his medical records from naked(prenominal) facilities, Dr. Girn came to find out that the patient had besides had leash stent rear endment surgeries. When Dr. Girn met with the patient, he discovered more or less more instruction relevant to our study. The first appointment with Dr. Girn was in September of 2008. He had non jawn a cardiologist or had any furcate out of lab work do since his hospitalization in 2001. Also, he had stopped taking his musics concisely subsequently he was released sevensome old age prior. This is very f slumpening innovatives with someone with such a strong history of center matter disease in their family. To give you an composition of the shape this patient was in when he first came to visit Dr. Girn, I bequeath share some of his full of lifes with you. His beatnik was 132, compared to the average of 75, he is five feet and club inches t on the whole, he weighs 402 pounds, he is 44 years old, and his logical argument insisting is an marvelous 184 over 112. From these statistics Dr. Girn came to the conclusion that the patient has ext reme hypertension, and obviously require to resume h! is high line of products pressure medical medium as soon as realizable or else poses a huge health risk to himself. Dr. Girn besides discovered that the patient suffers from tachycardia, and on that pointfore his aggregate has to work very hard to summons railway line to his body in company to be deeds at the rate it is. He is extremely obese, which simply increases all these risk pointors exponentially, as well as his habits of smoking and drinking. later obtaining all this education and taking into account the f effect that the patient hadn?t taken medicine for seven years, Dr. Girn asked himself, how do I even begin to treat this patient? More than that, what were the be causes to his health problems he was experiencing?In exhibition to best suspensor the patient, Dr. Girn had to completely nether stick out his medical conditions, which essential him to leave his relieve zone and travel out of his bailiwick of expertise. He researched the symptoms and h e came up with three major diagnoses for the patient, congestive nitty-gritty failure, hypertension, and coronary thrombosis arterial blood vessel disease. afterward learning what the patient was diagnosed with, I had some(prenominal) questions in the first place I could delve any upgrade into the inviolable plight. These questions include 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 learning on the internet; however Dr. Girn was a tremendous plectron as well. I likewise asked Dr. Girn to look into the patient?s family life to find out more info for me as to how he was macrocosm back up, and why he didn?t be set out policy. Returning to the patient diagnoses, hypertension, or HTN, is a medical condition marked by the chronic state of wondrous blood pressure. There are some(prenominal)(predicate) stages of high blood pressure, and divers(prenominal) take aims that you should conk! out discourse regarding what diseases you suffer from, merely tally to the UK guidelines, if you suffer from heart disease as our patient does, you should adjudicate discussion when your blood pressure is greater than 140/90. coronary thrombosis artery disease, also chi sensen as detent, is a condition in which plaque, made of fat, cholesterol, and calcium, builds up inside the coronary arteries that show your heart with oxygenated blood. This buildup is known as atherosclerosis, and causes blocked blood flow, as well as an increased risk of a clot. CAD is the starring(p) type of heart disease, and finish lead to other conditions if non enured with medicines, procedures, or lifestyle changes. Our patient suffers from this receivable to his history with stent placements. Congestive heart failure, or CHF, is a condition in which the heart?s function as a fondness to deliver oxygen rich blood to the body is scummy to meet the body?s needfully. This can be caused by a variety of things; coronary artery disease, hypertension, (both of which our patient has) intoxicant abuse, and disorders of the heart valves, as well as others. There is a blood test that can be used to tote up whether a patient has CHF called a brain 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, shortness of breath out-of-pocket to fluid in the lungs, an increase in urination, particularly at night, as well as nausea and abdominal pain. It is critical to none that words for these conditions are non cheap, and they are non truthful or easy for the uncommitted patient to maintain. The patient must(prenominal) be dedicated to changing his lifestyle, without the specify having to be be active as the driving force. Behavior modifications include a throw low in sodium, helpering to decrease his swelling, as well as a low calorie diet, decreasing the patient?s BMI and ea! sing strain on his heart. The patient also needs to have different labs and blood work routinely haggard to check for cholesterol levels, WBC and RBC levels, anemia, thyroidal function, diabetes, and tests examining kidney function, because abnormalities in these levels can be linked to heart disease. In adjunct to lab tests, an added expense the patient has to add to his agenda includes various exams done for his heart, such as echocardiograms, stress tests, and doable surgeries. Furthermore, the patient needs to stop smoking and drinking and confirm weak doctor appointments, and most importantly, take all medication regularly, which could substantially cost hundreds of dollars per month. Now that I have provided you with the pertinent medical information regarding this patient?s case, let me excuse a little 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 wo rk because of his extreme privation of motivation and unworthy health, and was controled by his father. The patient took no initiative to obtain damages or any sort of employment 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 hatch his word, and allowed him to receive the extent of interference 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, discussions, and style modifications, the patient can have a significantly meliorated calibre of life, in resemblance to suffering from prior symptoms such as shortness of breath, fatigue, and severe swelling. The patient at first did not want to front to take care of himself, and only came to Dr. Girn on the infix of his rash, yet by dint of his continued visits I believe he shows a contin ued dedication to improving his health and seeking tr! eatment. Some other features regarding the patient?s ain life include the events that he didn?t have a job or insurance for a significant stopover of time, and he lived with and was supported by his father. This patient did not receive the alter treatment that he needed. 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 despite his lack of specialized 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 throw 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 constant battle for passable treatment, because the re imbursement from Medicaid was so low. He was dumped from state to state, even spending several months in the intensive care unit of Grady Memorial infirmary at Georgia. After this, he was move in Briarcliff treat Home, left to stare at the gabardine ceiling with no accommodations whatsoever for his special needs. The patient and Larry McAfee both were neglected and treated with in umpire due to their economic situations. This case does not involve any issues of autonomy or competency, merely sooner centers around beneficence and nonmaleficence. Beneficence flirt withs to help others, while nonmaleficence literally means to not harm others, and implies that physicians technically inexpert to do something shouldn?t do it. The honorable predicament in this case contests the two patterns of beneficence and nonmaleficence. One possible resolution, establish on the rationale of beneficence, involves the patient receiving the best care and treatment that Dr. Girn can provid e, even for the patient?s heart disease which lies ou! tside of Dr. Girn?s specialty. On the other hand, possibly it would be bankrupt 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 principle of nonmaleficence. While Dr. Girn whitethorn be able to help the patient with his treatment and improve his part of life, it is also possible that with 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 individualized care for his specialise needs?After considering this question, there is another ethical principle that comes into consideration. This principle is arbitrator. Justice is when people are treated impartially, without pitch 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 bear up below his treatment.

This means that the specialists that he needs won?t see him without advance payment, as is the case with the tests that he requires. The supposition of Libertarianism can be used to support the principle of nonmaleficence. This theory opposes governing body programs and laboured taxation, and view such as equivalent to pressure labor. Physicians who believe in libertarianism would rather the government not have a hand in their business and instead be compensated only in cash. This is quite ironic considering the fact that the Medicare and Medicaid constitution is what has served to help keep o ur health care system running, ensuring patients rece! ive the treatment they need, and that physicians continue to get paid. A somebody arguing from this ethical standpoint would say that the patient has not worked for the treatment he requires; therefore he should not be able to receive it. This may seem extremely harsh, but libertarianism possesses a certain logic. Our current system has definite flaws, in that smarter people with more resources take advantage of the government, while the people who really need the financial support are much left without any assistance whatsoever. Libertarianism would certainly counteract this psychic capacity that many Americans possess, relying on America?s piggybank for their tog and food, rather than their own toil and sweat. Libertarianism, however, also poses many flaws. some(prenominal) people, without favorable security or disability from the government, would be require to precede necessary medical treatment in their elderly years due to lack of money. As you can see, liberta rianism is not without it?s checks and balances. Virtue Ethics are an ancient school of thought express experience, skill, and empathy. This viewpoint is very interesting, as it can easily support both stands. Dr. Girn technically did not have the friendship 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 trained and pass boards in a certain field before you are allowed to practice in that area does not mean that you do not possess the skill or knowledge necessary to treat someone. 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 mature if it can be applied to and acted on by everyone for legal. Kantianism is also ver y province-driven; that is, why an act is done is mo! re important than its results. This theory states that there is only one correct motive to act from, and that is to do one?s commerce, stemming from the desire to be a good person and to do what is right. In this there is also a concept known as ?the veil of ignorance.? This stem 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 physical 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, North Shore?s Health Center?s founding policy is very similar to operating under the Kantian veil of ignoranc e, and giving each patient dandy and indistinguishable treatment, yet providing them with a sliding scale so they can obtain the medical treatments they need. Dr. Girn felt 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, retroversion to Kantianism, states that rather than the motives of the actions, consequences are what count in the end. This also asserts that right acts produce the greatest kernel of good for the greatest count of people. Depending on the circumstances, it may have not been for the greatest good for Dr. Girn to have treated the patient, but in this case it was. Because of the doctor?s treatment, the patient received the medication he needed, his blood pressure and cholesterol were lowered significantly, and his symptoms were reduced. Thanks to Dr. Gir n?s actions, a good deed was accomplished; the patien! t 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 like to be treated in their situation. Considering the ethical dilemma and putting myself in the place of the patient, I would want to be treated with beneficence, having the primary concern universe 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 opened 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 some(prenominal) they can so that the patients will be able to grant treatment. This experience let me sympathize with both the physician and the patient, and I came out with a bet ter understanding of what really matters that will follow me into my career and through the rest of my life. Now, and throughout my life, I will remember the lesson I learned from this class; no day is worth backing if in it you do not go above and beyond to do something good for others. work CitedPence, Gregory. Classic Cases in checkup Ethics: Accounts of the Cases and Issues that Define Medical Ethics. 2008. McGraw-Hill: New York, NY. If you want to get a full essay, order it on our website: BestEssayCheap.com

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