Clinicalethicscanbedefinedas:
A. Clinical ethics is the attention to the actual problems of ethics & values which arise in the direct care of patients & in the organization & processes of the institutions & settings where health care is delivered, providing a foundation for the entire field of bioethics.
B. In the context of patient care as well as medical & health professionals' education, clinical ethics is the core content area which provides the foundation & anchor point for a multitude of humanistic approaches to medicine & health care such as history, sociology, law, & literature.
Clinical ethics depends on the larger discipline of bioethics, which in turn draws upon disciplines such as moral philosophy, health law, communication skills, & clinical medicine.
D. Central to the practical application of clinical ethics is the ability to identify & analyze an ethical question & to reach a reasonable conclusion & recommendation for action.
Bioethics identifies 4 ethical principles that are particularly relevant to clinical medicine:
A. beneficence
B. nonmaleficence
C. autonomy
D. justice
Clinical ethical problems and/or dilemmas can be caused by following reasons:
A. 1. Professionals who have a genuine knowledge deficit about ethics.
B. 2. Autocratic behaviour of committee or an authoritarian professional.3. Groupie moral standards.
C. 4. Insensitivity of the professional/s involved.5. Amorality when the group lacks moral standards or concern for others.
D. 6. Health professionals having different values and beliefs from each other.
Idealmoralbehavioursofhealthprofessionalsare:
A. Caring — The concept of caring indicates a commitment to the protection of human dignity and the preservation of health. First, caring is a natural human sentiment and is the way all people relate to their world and to each other. Second, caring is entwined or inextricably linked with to the social need for/of love, and so there is the need by the health professional to show compassion and kindness. Ethical caring includes valuing caring for a client or patient so that there is a shift from just wanting to be caring to actively fostering the wellbeing of others. This means that, for a health professional to be caring in the moral sense, their actions need to demonstrate or manifest the caring behaviours of respecting dignity, compassion and kindness.
B. Advocacy — Advocacy can be defined as the active support of a patient or a cause. When health professionals adopt this role as part of their ethical behaviour it can greatly influence the standard and quality of care. This is because the advocacy role involves assisting in the selfdetermination of clients or patients. The two ethical moral concepts of fidelity (being honest and truthful) and respect for human dignity are rooted in the role of advocacy. Respecting the human dignity of patients also extends to privacy and choice. This means that the health professional taking on the role of advocate assists in the truthful self-determination of a client or patient. They ensure that other professionals and the information provided is accurate and honest, and that the patient's integrity and their dignity (and privacy) is respected so that they can make their own choices.
C. Accountability — The health professional who is morally accountable is not only responsible for their ownbehaviour but also answerable to the patient. This means that when the professional does something wrong, they need to apologise to the patient and explain their actions. They also need to do so to their employer. Although hospital insurers do not like health professionals apologising to patients, there is growing evidence that, when the patient knows the reason and how a mistake occurred, they are less likely to take legal action against the organisation and professional.
D. Collboration— Collaboration is twofold. The first is the collaboration with the patient as equal partners to facilitate and negotiate the delivery of their care. The second part of collaboration is the participation with other professionals to achieve the best possible outcome for the patient. It is going beyond multiprofessional care to achieve the gold standard of interprofessional practice (or provision of care). It certainly does not mean participating in moral problems caused by groupie behaviour or authority. These moral behaviours of caring (including protection of human dignity and the preservation of health, and demonstrating to fellow human beings compassion and kindness); advocacy (ensuring that the patient's integrity, and their dignity, privacy and choice is respected); accountability (to patient, their employer, the legal system and also their professional body or council); and collaboration in interprofessional provision of care will improve the standard and quality of client or patient care.
Vulnerablepatientsinclude:
A. women,babies,children,theelderly.
B. personswithalearningdisabilityorwhoismentallyillorsufferingfrompsychiatricdisturbance,thehandicapped
C. detainees, prisoners,thehomeless
D. newimmigrants,refugees
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