Honesty as a Core Value for All Health Professionals - Essay Example

Health sciences and medicine, Essay Topic: Honesty as a core value for all health professionals - how it impacts on patient care Introduction: Next to God, a patient remembers and relies upon his healthcare provider. A healthcare provider has two responsibilities. Firstly from the secular point of view, he has to survive in a highly competitive industry. Secondly and most importantly, he has to promote wellness of the patients to move with the emerging new trends with the job. Two things remain constant. The patient is a human being, so also the health care provider is a human being. Impacted by the materialistic civilization, some questionable trends have begun to cast influence on the medical fraternity. Everyone in the medical profession has to strongly resist temptations and abide by honesty in all the circumstances, without exception. If compromise is done in this area, the whole edifice of medical service will begin to crumble. Highlighting the responsibilities of personnel in the health profession, Joseph Michelli argues, “…imagine that your mandate demands that you be a world-class educator, your work product holds life and death in the balance, and you are responsible for discoveries that shape the future of medicine.”(1) Without compromising on honesty, health professionals have the dual responsibility of “….both maintaining product quality in their core offerings and taking the risks necessary (171) for well-being of the patient under their care. No compromise on honesty: Honesty in medical profession is a core value. No compromise can be made on this. Do no harm is an oath and all health-care providers need to follow it in letter and spirit. If one deliberately fails in this area for some economic or any other gains, he does not deserve to be in the medical profession. He can be termed as the white-collar robber. In the article, “Honesty will mean better health care” the author argues, “We are all human, including nurses, doctors and patients. It is one of my goals to not judge anyone’s lifestyle when caring for them. This includes their religion, choices they make, and their background. Unless I have walked a mile in their shoes, who am I to judge them?”(Rhoten) Best possible care naturally follows and flows from honest disposition towards the patient. Is honesty the core value for health professionals only? The dilemma relating to lifestyles of patients: One expects the health professionals to be angels, but the type of patients they are expected to handle should also be looked into, before pointing out any deficiencies in the honesty aspect of caring for the patients. It is imperative on the part of the patients to open up and tell the caregiver about one’s lifestyle. The caregiver is not interested in passing the moral judgment. The information is necessary to enable the authorities to help the patient to overcome addiction or abuse. Drug screening is one of the investigating tools to know whether the patient is under the influence of drugs. If this is not done, the physicians may be in trouble, if they administer medications which may cause serious interactions with illegal drugs or alcohol. Health professionals are not law enforcing authorities. The concern is to give the best possible care and in the process to see that no harm is caused. So honesty is the best policy for both! By providing wrong information, the patient invites wrong line of treatment, done in good faith by the care provider. Under the provisions of the federal law, the privacy of the patients is protected and all the information provided is treated as confidential and no one will have access to the health history, except those directly involved in treating you and those with whom you wish to share the information. Drug abuse affects the health of everyone whether one is a cab driver or a multimillionaire and it is the duty of the caregiver to educate the patients, for their reformation and rehabilitation. Fatal complication may result in, if vital information is withheld from the care giver. The Dilemma on Honesty While discharging the duties related to patient care the health professionals often face choices of actions that can be dishonest or honest. The urge to be dishonest may arise out of the desire for self-protection, the doctor or the patient. Being dishonest undermines the trust reposed on the concerned individual and in principle, dishonesty can never be justified. It amounts to lack of self-respect and such an individual cannot expect respect from others. Lack of trust from patients and fellow-workers leads to lack of credibility and may end up in litigations. But admitting clinical errors is not always the best policy. This should not be taken as a sweeping statement, applicable to all the patients and contingencies. The merit of disclosure should be decided on case-by-case basis and not as a general rule. Disclosure may harm and increase the anxiety of the patients or their near and dear ones. Ethical benefit of disclosure may outweigh the danger involved in such a revelation and the patient may be psychologically harmed. Thus, disclosure may be warranted but non-disclosure would also be justified and the best policy is to give credit to the discretion of the health professionals who have no questionable intentions. Though honesty is the core value for all health professionals, in the institutional set-up (especially when the institutions/hospitals employ a large number of employees) a systematic process for disclosures needs to be formulated. Such a policy should also make provisions for media interaction for informing the correct position and to provide truthful information. Honesty and professional integrity This example will illustrate how difficult at times, it is to maintain the level of honesty. A general practitioner goes through the results of the blood tests of a male patient and finds that he is HIV positive. He is engaged and to be married soon. The doctor tells him to inform the position to his fiancée as she has the right to know about the consequences of this serious ailment to their children. His reaction is emotional and be thinks that she will refuse to marry him. He requests the doctor to withhold the information, stating that the doctor is bound by the principle of patient confidentiality. In his article, “Professional Integrity” the author argues, “The principle of respect for my patients autonomy by observing confidentiality is a very important one, and it does indeed constrain my conduct. But the competing obligation I have to prevent harm is also very relevant in this case, and if I cannot persuade my patient to tell his fiancé himself, then I may judge that my duty to prevent harm overrides my duty to observe confidentiality in this case.”(M. M. Wakin) Strong overriding considerations prevent the medical practitioner from giving the desired assurance that he will withhold the information from his fiancé. The moral principles involved are too important to be swept under the carpet. Physicians in many cases will not tell the truth to the patients to relieve them of their anxieties and fears. Not telling the absolute truth and disclosing that which is appropriate from the point of view of psyche of the patient, is in the interest of the patient. Doctor/patient relationship is a sensitive one. Patients today are enlightened and are willing to discuss their problems without inhibitions. If they are lied to and if any serious harm occurs to the condition of the health of the patients, legal consequences cannot be ruled out. This fear exists in the minds of the treating health professionals at all levels, more than ever now. In his article “Honesty in Medicine: should doctors tell the truth?” the author argues, “Inattention to truth or violations of honesty by medical personnel is serious business. There is a lot at stake as well for nurses, researchers and other health professionals. The truth issue is worth thinking about by all health-care professionals. In some cases the harm from not telling the truth may be less. Some degree of dishonesty may even be excusable sometimes in order to avoid more serious patient harm.”(Drane) The important issue is about the demarcation between honesty and lie in a clinical context. “Lying in a clinical context” merits careful consideration (Drane) Some clinical contexts are complex. “Doctors and nurses in some cultures believe that it is not wrong to lie about a bad diagnosis or prognosis. Certainly this is a difficult truth to tell but on balance, there are many benefits to telling the truth and many reasons not to tell a lie. ….Determining the appropriateness of less than full disclosure is one thing, but trying to justify a blatant lie is another thing entirely.” (Drane) “Subtleties of the doctor/patient relationship” (Drane) need to be carefully understood, and they differ from patient to patient. Much difference exists between a normal patient and a patient totally depressed and whose tendencies are “irrational and suicidal.”(Drane) Medical ethics also require regard for cultural practices and in a joint family, group responsibility for the treatment of the patient has to be given due respect. Conclusion: The clinical judgment to reveal the truth needs to be humane and the responsibility of the health professionals increases manifold. Honesty is the best policy for all, the patients as well as the health professionals. It is like the scale of justice; both arms of the scale are equally important. Works Cited Michelli, Joseph. Prescription for Excellence: Leadership Lessons for Creating a World Class Customer Experience from UCLA Health System. McGraw-Hill; 2011 Drane, J. F. “Honesty in Medicine: should doctors tell the truth?” Web: 21 July 2012 Rhoten, Keena. Honesty will mean better health care- Kingsport Times-News, Published July, 3, 2010 Web: 21 July 2012 Wakin, BGENMM. Professional Integrity. Published Airpower Journal - Summer 1996 Web: 21 July 2012 Read More