Set of Codes and Ethics in the Profession - Assignment Example

?Every profession in the world has a regulated set of s and ethics according to which they try to solve any form of ethical or moral dilemmas that the professionals may encounter. As with all professions there is a need to instill in the field of midwifery some forms of ethics that in one way or another govern the way that the practitioners do their work (Faster and Lasser, 2010). Professional ethics are not only meant to be a guideline but they also help to protect both the caregiver and those who come to them. When women come to a midwife they expect that there will be certain standards that will be followed along with certain practices that will be looked at. Ethics also help to prepare a midwife of the eventuality that there will be certain conflicts that may appear in the course of his or her professional careers that need to be anticipated and their solutions need to be mapped out. There is also a notion that ethics evolve over time with respect to the problems that professionals face and with the establishment of ethics there is a promotion of confidence in the profession. In its Code of Ethics the American College of Nurse-Midwives it is states that “midwives support and maintain the integrity of the profession of midwifery and thus contribute to a profession worthy of being considered by society as a public good” (Midwife). Ethics can also help to solve any professional ethical or moral dilemma that one might face (Husted and Husted, 2008). As a professional in the field of midwifery there have been moments where there is a certain ethical/legal situation that one comes across and does not know how to deal with (Frith and Draper, 2004). At times patients divulge certain facts about their lives and health that they wish others not to know and expect that they be kept a secret from others. Such facts may well be of such a nature that it becomes difficult not to discuss them with others for the fear of the safety of the patient. A situation similar to what I was confronted with when a 28 year old Russian woman in her twelfth week of pregnancy came for her booking appointment. A registered midwife was supervising the booking which I was doing at that particular time. Once the booking had begun the midwife told me that she had to step out of the room for some time and told me to carry on with my work. Once the midwife had left the room the woman who had come in started to disclose to me that she was a victim of domestic abuse at the hands of the man who was now her ex. The woman had told me this information in confidence and requested that I keep it as such and not tell anyone else what she had told me, especially not the midwife. She even requested that I not make a note of it anywhere in the documents. I tried to make her understand that though I would keep the conversation between us a secret, I still needed to inform my superior of the facts upon which she begged me not to. I was in the process of asking her questions about whether she felt safe when the midwife returned to the room and the conversation ceased and I resumed the booking. During the time the woman remained in the room I said nothing to the midwife about the disclosure of domestic violence that the woman had made. Once the woman took her leave I told the midwife what the woman had told me upon which she said to leave the matter the way it was for now. I had concerns about the situation the woman was in and it seemed to me that there should have been a referral and support given to her. I was trying to support the woman into getting herself some support and perhaps break free from the violence that she was in. by telling my supervising midwife I was hoping that something would be done to help the situation the young woman was living in or she would be shown other routes that would help her cause. Nothing was done for her who made it difficult for me as I had thought otherwise. It is not clear what the consequences of the decision to sit by and do nothing were that day but they may not have been well received. Making the decision to tell my supervisor was perhaps something that many would not choose to do due to the request by the patient not to, however, there were many ethical concerns. One was that the patient had asked not to disclose the information and by doing so I would have done something wrong but then again by not saying anything I would be allowing for the domestic abuse to continue. The consequence of the latter would be a lot direr than the former. There are several decision making models that may be used to help professionals solve their ethical problems. The Thompson and Thompson Bioethical Decision-Making model is one of the more used models by those in the midwifery profession (Bosek and Savage, 2007). With regards to the above provided situation a decision has to be made along line certain steps. The situation with the Russian women should be reviewed and any health problems that the patient may suffer should be noted whether they are physical or mental in nature. This stage of the decision making process is to help determine what might be done for the patient is such a situation. Ethical problems that may stem out from the situation, no matter the decision to reveal to the supervisor the abuse or not, should also be noted and their results and consequences foreseen. What is perhaps more important is whether the decision with regards to this ethical dilemma needs to be taken in the immediate future or whether there is time to weigh the situation and options and decide at a later stage. Any decision would certainly bring with it a string of potential consequences and it is pertinent that the professional look over each and every step taken to ensure that there are no violations taking place that may later cause a concern. Once the determination process has taken place the midwifery professional should start to gathering data in order to help them understand the situation better (Kearney-Nunnery, 1997). As in this situation when the professional decides to tell the supervisor they need to ensure that there are no legal ramifications that may follow. The patient can perhaps bring a suit that what they told the professional was in confidence and that by revealing the conversation that took place was a breach of the doctor patient confidentiality. A major factor in this situation is the impact of the decision on the patient. Whether the patient will themselves take a step to stop the abuse and if a lending hand is put forward then will she take it. Here the ethical concern would be whether to tell the supervisor or not and subsequent to that, how to help the patient when they are clearly voicing out that they do not wish any help in the first place. It is important to keep in mind what the current authorities and professionals in the same field are doing about matters that are similar to this particular dilemma and how these decisions impact the patients. While keeping current practices in mind a regard for the cultural and societal ideology and practices need to be adhered to as well. It would be wholly wrong to not only pry into a patient’s life if they do not wish for it but to be culturally insensitive would only aggravate the matter even more. In making the decision of how to solve this dilemma personal ideas and positions need to be considered and here it is of value to understand how one feels about certain situations and what ones moral standings are. The codes that are set out by relevant authorities are present to ensure a manner of conduct and to consult that and behave accordingly is expected and if a decision to act outside that is in play then one needs to weigh where their loyalties lie. With the patient or in the profession and to the codes of ethics set out. Taking a little guidance from others who are working in the same profession and have faced similar situations would be helpful as they have experience. Help from others can also make us aware of any conflict of interest that may arise if we decide to proceed in a certain way and if that conflict is inevitable then how best to go about solving it. According to the Thompson and Thompson model of decision making what is important is that we not lose sight of who is to be helped by the decision. Whether making a decision to do something to stop the woman from being abused will benefit her situation in later life or will it worsen it when she will eventually go back to her way of life. Whether she will have more to gain from an intervention or not? When making all these choices with regards to one’s life it is important to be as through as possible and develop a backing for our choice and have some justification for our action. Accordingly, on the basis of the Thompson and Thompson decision making model it would perhaps a more ethical and morally correct choice to intervene on behalf of the patient and help her. This would be best as she has much more to gain from being pulled out of a violent environment then in staying in it and the moral and ethical consequences do not seem to be too steep. The Midwives Ecosystemic Model of Ethical Thinking (MEMET) is also another decision making model that can help to solve ethical dilemmas. This model is based on the relationships that are established between a midwife and their patient and it is accordingly on the basis of this relationship that the decision is made. The MEMET model expects a midwife to take into account the relation that they have made with the patient and take in the background of the relationship. The history behind the relationship as well as the cultural and social network through which they have set up the relation needs to be considered. If the bond between the patient and midwife is strong then it would be considered that the decision to the ethical dilemma would be inclined to help the patient. As in this case, the bond is not well set and so it would most likely be expected that the decision would be to observe the decision of the supervisor. There are various other models which can help a professional to deal with the ethical dilemmas that do crop up almost daily in every individuals life. What is probably common in all these is that there is a benefit to one party, preferably the one in need of the aid. In the midwifery profession, the answer is not always too clear as to who to help as the legal and sociopolitical constraints are such and not all those in need are willing to admit that they need it. Here there has been a reflective model applied to the situation using John’s reflective model (HCC) and other ethical decision making models used to determine what would be the better answer to this situation. Yet it is still not clear which model is of a better help as Faye Thompson (2004) has concluded herself that the normative ethical theories are not the right way to determine how midwives will behave in a particular situation. Midwives, according to her, do not focus on the relationship aspect yet others may disagree. Hence to choose one model would be immature yet perhaps for the intent of future purposes it would be best to use a model such as Thompson and Thompson which is through so as to limit the probability of a “wrong” decision. If there ever is such a decision. \ References Bosek, M.S.D. and Savage, T. A. (2007). The ethical component of nursing education: integrating ethics into clinical experience. 1st. ed. Philadelphia: Lippincott Williams & Wilkins. Foster, I. R. and Lasser, J (2010). Professional Ethics in Midwifery Practice. 1st. ed. London: Jones . Frith, L. and Draper, H. (2004). Ethics and midwifery: issues in contemporary practice. 2nd. ed. China: Elsevier Health Sciences. HCC [online]. (n.d) [Accessed 6 February 2011]. Available from: Husted, J.H. and Husted, G.L (2008). Ethical decision making in nursing and health care:  the symphonological approach. 4th. Ed. USA: Springer Publishing Company. Kearney-Nunnery, R. (1997). Advancing your career: concepts of professional nursing. 1st. ed. London: Davis. Midwife [online]. (n.d) [Accessed 6 February 2011]. Available from: . Thompson, F. (2004). Mothers and midwives: the ethical journey. 2nd. Ed. London: Elsevier Health Sciences. Read More