Module 6

Since I've been doing research on the debate topic, lets make the blog this week about my debate topic.  My debate topic was "members of professional staffs should be exempted from patient cae situation in which they have conscientious objections." I was told to do the negative, which was fine by me since I actually agree with it. 

Most physicians practicing today were trained to be patient advocates. They have been taught that a physician’s duty is to rally resources for the patient’s benefit. Conscientious objection goes against what physicians have been taught to do. A doctors’conscience has little place in the delivery of modern medical care. What should be provided to patients is defined by the law and consideration of the just distribution of finite medical resources, which requires a reasonable conception of the patient’s good and the patient’s informed desires. If people are not prepared to offer legally permitted, efficient, and beneficial care to a patient because it conflicts with their values, they should not be doctors. Doctors should not offer partial medical services or partially discharge their obligations to care for their patients.
Doctors have to take a Hippocratic Oath to become doctors.  With this oath, they have sworn to be patient advocates and help their patients in any legal way.  This is why I have a problem with conscientious objection.  If you don’t want to perform certain surgeries or prescribe some type of medicine, then don’t be in that area of medicine or in medicine in general.  A cop can’t just not be physical with someone or use their gun when people are in danger, because they have a conscientious objection about violence.  So a doctor shouldn’t be able to not do certain procedures or prescribe certain drugs because they think it is morally wrong or their religious beliefs.

module 5

This weeks blog is about the ethical decision of treatment when considering the cost of treatment.  The article I read was "The Value of Life: Is It Ethical to Consider the Cost of Treatment in Medical Decision Making?" by Margaret R. McLean from the Santa Clara University website.  The money elephant has caused many of us to consider whether or not there is a dollar limit to the value of human life. Is there a point when it is simply too expensive to keep heart pumping and lungs breathing? Is it ever right to consider the cost of medical intervention—even life-saving intervention—in our decisions about how aggressively to treat a patient?  The article really just brought up the topic and the questions that come with it, it didn't take any stance on the subject.

I personally have no problem with someone not having life saving treatment or any other type of treatment to save their family from the financial burden health care brings.  It's the persons life, let them live it (or in this case, not live it) the way they want.  I completely understand not wanting an expensive surgery that can only help you live for a short time when the bills will keep coming well after you're gone.

Module #4

The article, "Playing Politics with the Doctor–Patient Relationship," was published today in The New England Journal of Medicine.  It talks about a bill that has recently been passed in Arizona that basically allows doctors to LIE to their patient.  This bill gives a doctor the right to withhold information about the health of a fetus. The doctor cannot be sued for malpractice if he or she thinks that revealing these findings might influence a woman to have an abortion. In addition, once the child is born, no lawsuits can be filed regarding the child's disability.  Apparently, the medical professionals in Arizona have not come out to protest this bill like they have done in the past with other doctor-patient relationship issues.

I don't understand how this bill got passed, it doesn't seem legal in any sense of the law.  This bill violates so many ethical issues when it comes to doctor-patient relationships and the right women have to know what is happening with their body.  I feel that this bill will be brought up in front of the Supreme Court eventually and be deemed unconstitutional.

Module 3

This weeks reading was about managed care and the ethical issues it faces.  Managed care has been growing over the past 30 years and is now a major factor in the delivery of health care in the United States.  According to the United States National Library of Medicine, the term "managed care" encompasses programs intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases.  The ethical issue with managed care is that physicians and patients feel that managed care prevents the physicians from doing all they can to help treat the patient because of cost prevention.

This issue reminds me of what I wrote about in my blog last week, waste avoidance.  Waste in U.S. health care, defined more broadly as spending on interventions that do not benefit patients, actually amounts to at least 30% of the budge and is a major driver of cost increases.  Waste avoidance is a newer ethical issue compared to managed care but it also prevents physicians from doing absolutely everything they can for the patient do to cast savings.  Maybe if hospitals can other health care centers can optimize both managed care and waste avoidance, the cost of health care will go down, instead of continuing to rise