The ethical framework that I choose for guidance of my clinical practice is mainly focused on how to act in the patient’s best interest by managing effective physician-patient communication, and how to encourage patient’s right by allowing autonomous decisions.
I have chosen to become a PA because I want to be a bridge between patients and the health care team. From my previous experience of working in clinical office, there are actually a lot of patients who are not able to speak a word or two in English. Even if they are suffering from severe pain during the night, they still refuse to go to the emergency room and rather wait to see their primary care physician the next morning. They are frightened to communicate with any physicians that doesn’t speak their languages. Patient should not be shut down from the health care system due to communication barrier. They should have to right to choose how they want to be treated without worrying about physician-patient communication. I want to introduce a comfortable environment for patients so that they can trust and rely on the healthcare system.
The most important aspects of clinical practice are effective communication and respecting patient’s right. Communication plays an important role in every step of treatment and diagnoses. Not only that we have to communicate with other colleagues in order to promote team work, we also have to communicate with patients to get their history. Effective communication with patients will show emotional support and caring for their health status. The effort spent on communication with patients will also increase the quality of care. Patient’s right is also significant because they should understand the impact of every medical decision on their health conditions. They have the right to accept or reject any suggested treatment by physicians, instead of being forced to sign any document to agree with the procedures. Physician’s suggestion should not override the patient’s preference.
Two ethical principles that will play the strongest role in my ethical decision-making in clinical practice are beneficence and autonomy. Beneficence is action that is done to benefit the patients. (Yeo, 2010) Any medical decisions should be made in the obligation to remove harm and to help patients. Physicians can also simply produce goods when acting in patient’s best interests. Autonomy is patient’s right to make autonomous decisions and choices regarding to one’s own life. It comprised of free action, effective deliberation, authenticity, and moral reflection. (Yeo, 2010) Free action is being able to do what one wishes to do, and not being forced to what one does not want to do. Effective deliberation is making a choice through a process of reasoning and understanding of the outcome. Authenticity is when the given choice of action is consistent with one’s expressed values and character. Moral reflection is self-examination and consistency with choice.
Effective physician-patient communication in clinical practice is supported by the principle of beneficence. Communication includes the ability to gather information in order to make accurate diagnosis, to give instructions, and to build caring relationships with patients. Making accurate diagnosis and giving therapeutic instructions are preventing harm from the patient because the patient can be cured without further complications of the disease. Building a caring relationship with patient is also acting in patient’s best interests by ensuring that the patient is receiving the best possible care for improving health conditions. These elements of communication are promoting quality patient care and inhibiting medical errors. Respecting the patient’s right in clinical practice is supported by the principle of autonomy. For example, informed consent shows significance in the right to self-determined. Informed consent means more than a plain signature. Patients are allowed to have free action in choosing the care they want to have. They need effective deliberation, as in decision-making capacity, to understand the treatment options and outcomes in order to rationally decide. This informative discussion and ongoing process is allowing the patient to receive adequate information regarding his health status in helping him to decide upon treatment options. Therefore, they are signing the informed consent with understanding of the outcomes and treatment, rather than being forced to sign without knowing the possible complications.
In conclusion, communication is significant because it benefits patients by increasing the quality of care and reducing the chance of potential medical errors. Patient’s right is significant because it is the self-determination to make autonomous decision without external pressures. I will be using these principles as a guidance for my clinical practice.
Reference:
- Yeo, Michael et al. (2010). Beneficence. In M Yeo et al. (eds.). Concepts and Cases in Nursing Ethics.[3rd edition] Ontario: Broadview Press, pp. 103-116.
- Yeo, M et al. (2010). Autonomy[selections]. In M Yeo et al. (eds.).Concepts and Cases in Nursing [3rd edition] Ontario: Broadview Press, pp. 91-97, 103-109.
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