Duties Of Health Care Professionals Research Articles

The duty of care and the right to be cared for: is there a duty to treat the unvaccinated?

Vaccine hesitancy or refusal has been one of the major obstacles to herd immunity against Covid-19 in high-income countries and one of the causes for the emergence of variants. The refusal of people who are eligible for vaccination to receive vaccination creates an ethical dilemma between the duty of healthcare professionals (HCPs) to care for patients and their right to be taken care of. This paper argues for an extended social contract between patients and society wherein vaccination against Covid-19 is conceived as essential for the protection of the right of healthcare providers to be taken care of. Thus, a duty of care is only valid when those who can receive vaccination actually receive it. Whenever that is not the case, the continuing functioning of HCPs can only be perceived as supererogatory and not obligatory.

Providing healthcare outside working hours: moral and legal aspects

It would often be in the public interest for persons with special knowledge, including the so-called liberal profession-als, to exercise their skills voluntarily, as long as a need for their services arises: for example, a healthcare practitionerwould provide treatment to anyone in need of emergency care, architects would act as soon as there is a mention ofa crack in the load-bearing wall of an apartment building and judges would judge a court on holidays if need arises.But the legal duty to act can be demanded from those who are legally assigned this task only. For all the stakeholders,legal certainty in healthcare is an issue of major importance. To contribute to this aspect, this study aims to detect thelegal and ethical framework of the medical practitioner’s obligation to provide treatment outside of working hours. Thescientific literature, case-law, legal acts and court judgements were studied; the analytic, doctrinal, comparative andmodelling methods were applied; the general legal norm interpretation methods were used. The authors conclude thatoutside of working hours, medical practitioners are exempt from their legal responsibilities, are guided by moral normsand general citizens’ obligations only and have the right to refuse to provide professional healthcare services. Theinconsistency among legal scholars and legal and medical practitioners concerning the duties of healthcare profes-sionals during their rest time was detected. The recommendations are proposed to ensure legal certainty and achieveconsentaneity among the stakeholders.

What has Kant got to say about conscientious objection to reproductive health in South Africa?

A woman's right to a safe legal abortion in South Africa conflicts with a health care professional's freedom of conscience. Conscientious objection or treatment refusal on the basis of conscience may be protected by the constitution but its morality has not been explored. This study uses Kantian Deontology to elucidate the ethical duties of health care professionals based on the Physician's Pledge. It concludes that conscience is morally empty and that health care professionals have a duty to treat all patients equally irrespective of the condition they present. Drawing on Kantian promise keeping, the study also concludes that health care professionals should place patients health and wellbeing above all other considerations. Using the categorical imperative, the study shows that health care professionals have a perfect duty not to refuse treatment. The study recommends that conscientious objection be rejected in all circumstances except where the psychological wellbeing of the health care professional will be affected. This can be achieved through legislative and professional body regulation of conscientious objection.

Clinical Performance of Decision Support Systems in Anesthesia, Intensive Care, and Emergency Medicine: A Systematic Review and Meta-Analysis.

Medical technology is expanding at an alarming rate, with its integration into health care often reflected by the constant evolution of best practices. This rapid expansion of available treatment modalities, when coupled with progressively increasing amounts of consequential data for health care professionals to manage, creates an environment where complex and timely decision-making without the aid of technology is inconceivable. Decision support systems (DSSs) were, therefore, developed as a means of supporting the clinical duties of health care professionals through immediate point-of-care referencing. The integration of DSS can be especially useful in critical care medicine, where the combination of complex pathologies, the multitude of parameters, and the general state of patients require swift informed decision-making. The systematic review and meta-analysis were performed to evaluate DSS outcomes compared to the standard of care (SOC) in critical care medicine. This systematic review and subsequent meta-analysis were performed after the EQUATOR networks Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). We systematically explored PubMed, Ovid, Central, and Scopus for randomized controlled trials (RCTs) from January 2000 to December 2021. The primary outcome of this study was to evaluate whether DSS is more effective than SOC practice in critical care medicine within the following disciplines: anesthesia, emergency department (ED), and intensive care unit (ICU). A random-effects model was used to estimate the effect of DSS performance, with 95% confidence intervals (CIs) in both continuous and dichotomous results. Outcome-based, department-specific, and study-design subgroup analyses were performed. A total of 34 RCTs were included for analysis. In total, 68,102 participants received DSS intervention, while 111,515 received SOC. Analysis of the continuous (standardized mean difference [SMD], -0.66; 95% CI [-1.01 to -0.30]; P < .01) and binary outcomes (odds ratio [OR], 0.64; 95% CI, [0.44-0.91]; P < .01) was statistically significant and suggests that health interventions are marginally improved with DSS integration in comparison to SOC in critical care medicine. Subgroup analysis in anesthesia (SMD, -0.89; 95% CI, [-1.71 to -0.07]; P < .01) and ICU (SMD, -0.63; 95% CI [-1.14 to -0.12]; P < .01) were deemed statistically supportive of DSS in improving outcome, with evidence being indeterminate in the field of emergency medicine (SMD, -0.24; 95% CI, [-0.71 to 0.23]; P < .01). DSSs were associated with a beneficial impact in critical care medicine on a continuous and binary scale; however, the ED subgroup was found to be inconclusive. Additional RCTs are required to determine the effectiveness of DSS in critical care medicine.

МЕТОДОЛОГИЯ ПОСТРОЕНИЯ КОНЦЕПТУАЛЬНЫХ СХЕМ РАСПРОСТРАНЕНИЯ ЭПИДЕМИИ COVID-19 ДЛЯ ПРИНЯТИЯ РЕШЕНИЙ О РИСКАХ ИНФИЦИРОВАНИЯ

Drawing conclusions about the coronavirus infection risks and real-time decision-making is a primary duty of health-care professionals. The agent-based modeling of events allows look closely at expectable hazards and paths of immediate infection as the grounds for planning personal tactics of infection prevention. The event modeling transforms verbal information (objects, relations, factors etc.) in constructs of knowledge for computer analysis of COVID-19 contagion. The knowledge constructs or information ontology may be helpful to health-care professionals in bringing to people of risky occupations true information of hazards and validity of the existing rules and regulations.

Medico legal perspective in dentistry

Medico legal perspective in dentistry - IDJSR- Print ISSN No: - 2394-708X Online ISSN No:- 2278-3784 Article DOI No:- 10.18231/j.idjsr.2020.018, International Dental Journal of Student's Research-Int Dent J Stud Res

Legal and Ethical Issues Arising from the Use of Emerging Technologies in Paediatric Healthcare

Mobile health apps and wearable devices are widely available. They provide an opportunity to monitor and track health metrics continuously, and in real time, thus enabling diagnosis and chronic condition management to take place outside a hospital setting. The digital data produced can be shared with healthcare providers, researchers, and on social media. In this paper, we explore some of the legal and ethical challenges for doctors of these emerging technologies, by focusing on the example of management of childhood diabetes using continuous glucose monitors and insulin pumps. We identify and explicate these challenges through an analysis of three different case scenarios, all hypothetical but all realistic and reflective of current experiences of doctors caring for children with Type I Diabetes. We argue that current legal and ethical approaches can effectively be applied in determining duties of healthcare professionals using emerging technologies, whilst recognising the significant change in the nature of the doctor-patient relationship and the perception of therapeutic benefit of some technologies.

NHS Activism: The Limits and Potentialities of a New Solidarity

ABSTRACTUsing Thompson’s conceptualization of the moral economy, I describe how NHS activists in the UK utilize moral arguments to form alliances between different occupational groups, in a political battle against health care privatization, reflecting how a consciousness is being built upon solidarity and shared interests. In this context, professional duties of health care professionals are linked to the interests of all citizens. I explore how the deployment of professional ethics elides a moral hierarchy that may hinder the movement’s egalitarian potential.

Antibiotics Risk of Obesity in Children: Major Threats in Healthcare System

One of the health related topics, which is consistently receiving attention in recent years, is antibiotic misuse. Interestingly, there is a high-profile report claiming that antibiotic consumption could trigger obesity risk in children. The exhaustive study was undertaken by Schwartz and his team considering 163,820 children between the ages of 3 and 18, wherein they examined body mass index and antibiotic use in the earlier years of life.An association between an average weight gain of approximately 1.4 kg at the age of 15 years and antibiotic consumption in the early age has been found.1 The striking feature of the study was that antibiotic use at any age in children contributes to weight gain during the later age. The medical literature has much to say in this context, whereas the biomedical literature is scarce in portraying the association between antibiotics and obesity, although antibiotics account for the majority of the medications prescribed to children. This incited us to present this note. Unhealthy eating habits and lack of exercise are the main reasons for getting obese. Should, therefore, health care professionals consider the antibiotic-obesity link as a medical issue? Given the answer yes’ would leave us with a false impression on the present paper. Everyday our health problems are facing threats from new links. In the best interests of public health, it is the duty of health care professionals to welcome new insight with open minds. One such is the deadly link between antibiotics and obesity in children Read More. . .

Medical ethics education

Ethics education is essential for everyone but indispensable for health care professionals. Health care professionals must strive for excellence as much as possible. The moral duty of health care professionals is to do the best for their patients and take healthcare decision based on evidence and clinical, technical and ethical ground. However, most of the times ethical aspects are either ignored, undermined or overlooked. There seems to be some gap in teaching and learning and its application in practice. The fundamental idea to teach medical ethics at undergraduate level is to sow the seeds to ethics at an early stage in the minds of health care professionals to deliver excellent health care to the community. All religions prescribe ethical and moral behaviour and thought for their followers. Hinduism through Bhagwat Gita preaches karma as the only dharma, Islam speaks of Khuluq, Buddhism of the 10 meritorious deeds, Jainism of three ratnas, Christianity of service and stewardship. Let’s invest our efforts in enhancing medical ethics education in our institutions besides technical education and produce quality healthcare professionals who can take healthcare decision based on evidence, and clinical, technical and ethical ground.DOI: http://dx.doi.org/10.3126/jcmc.v5i1.12557

Terminal Suffering and the Ethics of Palliative Sedation

Until quite recently bioethicists have had little of depth and probity to say about the duty of healthcare professionals in general and physicians in particular to relieve pain and suffering associated with disease and/or its treatment.

Knowledge about patients’ rights among professionals in public health care in Finland

The legal rights of patients include civil rights for patients and the duties of healthcare professionals. Knowledge of legislation and the ability to put juridical norms into practice are among the main aspects of professionals. The aim of the study was to describe the level of healthcare professionals' knowledge about patients' legal rights and to describe background variables associated with the knowledge. The legal rights are based on the Finnish Act on the Status and Rights of Patients. The data were collected from healthcare professionals (nurses and physicians) in public health care in Finland (recruited N = 290, responded n = 191) with a questionnaire designed for the study. The response rate was 66%. The data were analysed statistically. Healthcare professionals were partially familiar with patients' legal rights. The right to good health care, treatment and access to care and right to self-determination were the best-known areas. The respondents lacked knowledge on the right to information and the right to use the services of patient ombudsman. Based on self-evaluation, half of the respondents thought that they had weak knowledge of the legislation on patients' rights. However, they perceived knowledge about patients' rights as being important. There was no correlation between respondents' self-evaluated knowledge and actual scoring on the knowledge test. These results implicate a need for further education aimed at healthcare professionals and development of professional training about patients' legal rights.

Adapting the severe mental illness physical Health Improvement Profile for use in primary care

People with severe mental illness (SMI) have a higher incidence of long-term physical conditions, including diabetes and cardiovascular disease. This can dramatically reduce their life expectancy. In the UK, it is the duty of health-care professionals in primary care to monitor the physical health of this group of people. However, these professionals have been given no specific training in order to do this effectively. The Northampton Physical Health and Well-Being Project has been developed in order to reduce the mortality of people with SMI, improve their physical and emotional health, and increase their support network. We have adapted the Health Improvement Profile (a tool to help mental health nurses profile the physical health of people with SMI) for use in primary care by creating a manual and website and will provide bespoke training in its use to the health-care professionals.

Stealth voluntarism: An expectation of health professional work in underserviced areas?

Voluntarism can take many forms, and its boundaries are not always straightforward. In this paper, we explore a particular type of voluntary activities carried out as an add-on to formal duties of health care professionals and administrators. We outline some impressions of what we term ‘stealth voluntarism’, which we situate at the interstices of health care professionalism, place integration, and welfare retrenchment. Our discussion draws on exploratory research looking at health care and social support in smaller urban centres in the interior of British Columbia, Canada. While stealth voluntarism can occur anywhere, we highlight its unique implications for systems of support in rural and small town places. We conclude by considering the wider implications of stealth voluntarism as an expectation of professional work in underserviced areas, particularly in the context of welfare retrenchment and the offloading of care.

Experiences of widows with children: A qualitative study about spousal death in Iran

The experience of the spousal bereavement of widows who are single parents has been largely neglected in the literature. This qualitative study provides insight into how such women grieved over their spouse's death in Iran. In-depth interviews with 24 participants were held and field notes were written. The generated data were analyzed by using the constant comparative method. The results indicated four main categories: "intense grief", "becoming hopeless", "internalizing bereavement and continuing bonds", and "the contexts of experience of spousal death". The fourth category consisted of two subcategories: "the unexpected nature of death" and "full dependence". The findings suggested that hopelessness related to spousal death changed the lifestyles of the participants, which led to health risks in these women. We conclude that it is the duty of health-care professionals, especially nurses, to first identify widows at risk, with the help of the contexts of experience of spousal death and the symptoms presented in this study, and then to provide hope therapy, which can facilitate positive bereavement outcomes for healthier living after spousal death.

Non-Professional Healthcare Workers and Ethical Obligations to Work during Pandemic Influenza

Most academic papers on ethics in pandemics concentrate on the duties of healthcare professionals. This paper will consider non-professional healthcare workers: do they have a moral obligation to work during an influenza pandemic? If so, is this an obligation that outweighs others they might have, e.g., as parents, and should such an obligation be backed up by the coercive power of law? This paper considers whether non-professional healthcare workers—porters, domestic service workers, catering staff, clerks, IT support workers, etc.—have an obligation to work during an influenza pandemic. It uses data collected as part of a study looking at the attitudes of healthcare workers to working during a pandemic to suggest the philosophical arguments explored. These include: being in a position to do good, the ethics of work, competing obligations to family members and in particular to children and the obligations of citizens in a state of national emergency. We also look at whether compulsory measures are justified to support a national health service during a health emergency. We conclude that even if they are, compulsion should not be restricted to non-professionals who happen to be working in the health service at the time. Rather, compulsion involving a larger pool of people with the relevant skills and abilities is more equitable.

Responsible Antibiotic Prescribing: The Duty of Health Care Professionals

Responsible Antibiotic Prescribing: The Duty of Health Care Professionals

Some ethical issues that arise from working with families in the National Health Service

Through a case study, this paper addresses ethical issues and dilemmas faced by a Family Therapist working in a Child and Adolescent Mental Health Service (CAMHS) in the National Health Service. When there are legal and societal obligations on parents/carers to ensure that the needs of children and young people are met within a family context, working with a young person in a health care setting oriented to the individual raises ethical dilemmas around consent. When the values of young people and their parents conflict, legal, ethical and political issues can be raised. These have implications for the duties of health care professionals and the rights, interests and autonomy of the individual young people and their parents. The importance of justice to CAMHS practitioners' ethical decision-making about when to prioritize the individual over the family, or vice versa, is emphasized.

The Ethical Imperative to Relieve Pain at Life's End

Evidence continues to amass, revealing that many patients, and especially the terminally ill, experience serious, debilitating pain, in a variety of medical settings. 1–4 Only recently has pain at end of life been viewed as a public health problem of significant enough proportions to instigate widespread efforts at improvement. 5,6 Traditionally, pain (other than that associated with painful medical/surgical procedures) has been seen as a harbinger of illness and as a symptom whose patterns are useful to aid in diagnosis. However, it became clear a few decades ago during the expansive years of critical care, surgery, and anesthesiology that pain was more than a symptom signaling tissue injury, inflammation, or ischemia. Uncontrolled pain with its resultant physiological stress responses contributed to pathophysiological events, leading to preventable morbidity and mortality from cardiovascular and pulmonary catastrophes. Aggressive treatment of pain in perioperative and trauma settings is becoming the standard of care, as a response to the ethical obligation to prevent and cure disease and its manifestations when possible. What has been slower to develop is the same sense of urgency around researching and treating persistent debilitating pain associated with chronic progressive disease states. This, in spite of overwhelming evidence pointing to the high prevalence rates of pain that greatly impact quality of life and functional capacities in many chronically ill patients. At one end of the spectrum are patients with imminently life-limiting diseases, such as those with advanced malignancies, that account for more than 20% of deaths in the United States. 7 On the other end is the common occurrence of chronic pain associated with osteoarthritis, other joint and spinal degenerative disorders, postherpetic neuralgia, diabetic neuropathy, post-stroke central pain, and many more common conditions experienced by our aging population. 8

Facing up to health and safety - or not?

Like taxes and bad television game-shows, the importance of managers‘ health and safety responsibilities never ends. This article provides an overview and reminder of the legal duties of health care professionals at all levels to keep up to date with this issue.