In health and social care sector, medical and health professional are having major responsibility to provide best care treatment to their patients. Continuous monitoring of patient is required to be done in order to examine their condition and providing treatment (Munn-Giddings and Winter, 2013). Present report is based on analysis of case study of Charlie Gard who was an infant boy from London born with the Mitochondrial DNA depletion syndrome which is considered as rare genetic disease which causes progressive brain damage and failure of muscles. It has no treatment and usually causes death infancy. The has become controversial because medical team and his parents were disagreed about whether experimental treatment was in the best interest of child. Later on Charlie was transferred to the London GOSH when he was not able to breath. A neurologist from new York London was called to provide treatment. Hirano and GOSH has founded that patient was suffering from brain damage and his further treatment can be futile and might prolong sufferings. They have further begun discussion with the parents about ending life support and providing the palliative care. This statement was denied by parents because parents of child still wants to try experimental treatment and raised funds for transfer to hospital in new York. In Feb 2017. Later on, medical professional of NBT have provided suggestion for NBT therapy to his parents but the doctor of previous hospital have denied for this treatment (Miller and et.al., 2012). Doctors have made appeal in High court to switch off the ventilator and allow patient to die on ethical grounds and dignity because there was no solution of this disease and chances of improvement in the health of patient. Further, parents of patient have also filed case against this in court of appeal where decision was held by authority in favour of GOSH.
In this present study, ethical issue related to the case have been discussed along with the ways to increase respect for Charles dignity. Further, confluence of this case on health care value and development have also been evaluated. At last, critical analysis of ways through which through these types of situations will resolve is also discussed effectively.
(A) Ethical issues in case of Charles William Gard
Health care ethic is analysed as set of moral principles, values and beliefs which provide assistance in making choice about heath care. At core, heath care ethics is considered as sense of right and wrong and professional belief s about rights and wrong and their beliefs about rights they possess and responsibilities they Owe others. Mainly there are four important principles of health care ethics such as Autonomy, beneficence, non maleficence and Justice. In present case, role of health care professional and administrator in Gosh was to plan and analyse function of facilities in health and social care at which they work and other member of staff who also work their involving doctors and nurses (.Blais and et.al, 2015). Thus, they have important role in ensuring that patient in hospital will receive high quality and effective treatment. In case, there are some ethical issues have been identified which are mentioned above:
Freedom of getting treatment was an important issue in Charley's case because family members was having desire to improve health of their children whereas doctors have decided to take him off from ventilators and let him die for sake of dignity. As per law, Medical professional are required to understand feelings of family member of patient and also need to provide them guidance about case that his condition cannot be improved therefore, it essential for them to allow for switching off the ventilator (Andersen, Rice and Kominski, 2011). Principle of ethics in health care stated that, professional should right to take decision about treatment of every patient.
Importance to value of family members are required to be provided by professional while providing treatment and they should provide them information about every treatment which they have provided to patient for removing discrepancies. In this case, Solicitor of GOSH has directly appealed in court and provide information that Charles is suffering from brain damage however they have switch ventilator.
Non fulfilment of medical responsibilities was also analysed as unethical consideration by Medical team in GOSH (Minkler, 2012). It was an ethical responsibility of health care professional to diagnose medical condition of patient properly on basis which they have to provide treatment to Charley. In this, Doctors of new York have recommended family member to provide NBT treatment which is suitable for animal.
Health care ethics principles that applies in case was considered as Non- maleficence that implies that medical professionals does not provide any harm to patient. Moreover, they have to get away from providing unethical treatment and therapies which are harmful for patients can not be applied. However, in present case professional of healthcare in New York provided suggestions to apply NBT therapy and due to which muscles and other organs of Charles have damaged. Further, Respect and justice are other principles in the health and social care which implies that it is essential for medical professional to treatment each patient effectively and proving them respect as well. On Ethical grounds, it was identified against justice and behaviour of care professional was not fair with the patient but justice provided by court was fair on legal and moral backgrounds.
(B) Communication held by court in this case
In this case, information about Charles treatment was properly communicated by health care professional to family members. Further, they have also not provided important to their view and not used positive behaviour towards them. Due to this, parents was not able to analyse situation of patient (Etain and et.al, 2013). Informal communication between parents and professional have created chaos because both the parties was unable to consider view point of each other. Further, it was also important for parents to get information properly about diseases and it treatment before providing suggestion of treatment. NBT therapy suggested by doctors was also unethical consideration. Medical professional in every hospital should posses equal opportunity to make decisions and should provide their consideration to cultural aspects, values and moral principle of patient family members before making nay decisions. Nurses at care home are required to consider view point to Charles Family members effectively in order to take clinical decision in accordance with treatment.
(C) Ways to improve respect for Charlie Gard dignity
Charlie Gard is suffering from a disease and there is no cure exept one that is related to animals only, by hearing this he got hurt and so solve this doctors should take care that they should treat people with respect even they may be a patient and pateint's family member and avoid labelling people because doctors diagnosis with any other group. Doctors should provide person centred care and support as it upholds the dignity both of the people using services and of staffs too. Doctors should focus on prevention and proportionate and should be in good communication or not using abusing words also. They should not hurt pateint mentally because mental health is all for a human being. There should be good communication power because it demonstrates respect and maintains an individual's dignity. Even professionals may be trained in the relevent attributes and communication skills. There should not be discriminstion because it creates very bad impact on hospital and even on doctors too. Always take active steps to engage people and use their views are recorded in their care plan. Doctors should ensure that people's human rights are protected at a time when their capacity,autonomy, choice and control may be comprised under mental health legislation . And if someone has deprived of their liberty under the mental health act always offer them support to deal with any related trauma. Always provide patient centred care that is individualised, comprehensive and continuous. Doctors should promote a positive organisational ethos and encourage an ethos of respect and dignity with zero tolerance of abuse.
Provide training, clinical supervision and support as staff are enable to examine their own attitude and always feel supported to their role. This will encourage them to treat others with respect tool. Patient's family members goes to doctor and ask them about the disease then its a duty of doctor to treat them in polite way and let them understand what the actual scenario . Always take a holistic approach to improving dignity on ward , should to use abusing words in front of the patient. If someone hurt the dignity of the patient then never feel ashamed by use the word sorry and should promote recovery focused services which help to gain knowledge and communication power should be strong so that listeners listen your words carefully and be respectful as if you give respect then automatically you get respect.
(A) Impacted on my values and development
As a medical professional in health and social care institution, I believe that it is my duty as well as responsibility top provide suitable care and appropriate treatment to patient. By analysing the situation in given case scenario, I have also realised that I need to develop understanding about the patients suffering from special type of disability or deadly disease. As this will help me in providing high level of satisfaction to patients and assisting them in improving their quality of life. While reading the case study and analysing the situation , I have learned that there are several ethical issues are associated with medical practices. As a medical professional I need to ethical standards in order to avoid ethical issuers in my career. I have also realised that breach of ethical principles might lead to the legal obligation on service provider. I have also identified the several factors which I need to considered while announcing decision related to patient. The situation in the case study has effected my values as well as perception towards heath and social care institutions. After analysing the case scenario, I have planned to conduct research for gaining information as well knowledge about code of ethics in nursing practice (helan and McCormack,2016) As I believe that , it will help me in delivering quality services to patient. I perceive that every patient and their families has freedom to take their own decision; medical professional or other medical staff cannot force any person for taking specific treatment. After learning from the mistakes done by medical staff I have decided to provide positive , healthy , comfortable and environment for patients. In addition to this, I have learned about the several ethical theories as well as principles which I can apply for dealing with ethical issues at workplace.
(B) Ways which I will adapt to deal with similar situation
I would be in same situations, I will prefer to facilitate discussion with colleagues and specialists, and friends. Before reaching to any solution related to the treatment of disease I would like to consult with other doctors or specialist (Almgren,2017) I will also conduct depth research for finding the appropriate treatments for disease. After identifying as well as testing the treatment and getting depth knowledge about the same , I will inform services user family about the health condition of patients and detail explanation about the procedures which will be conducted during the procedures. At the same tome I will also make patient family member about the risk associated with disease and its impact on individual health. I will concentrate on my tone as well as way of communication. As I believe that communication factor has direct as well as influence on an individual behaviour. I also perceive that It is very essential for the medical professional or staff to utilise positive language and communicate each thing effectively with the family members of patient. As ineffective communication can lead to the conflicts between two parties. I were at the place of the medical staff, I would have taken high initiatives for bringing improvement in medical practices and ensuring that all the patients in health and social care institution are given respect and proper care or treatment (Phelan and McCormack,2016) I have also decided with I will make all the important decision by considering the ethical standards.
- Andersen, R.M., Rice, T.H. and Kominski, G.F., 2011. Changing the US health care system: Key issues in health services policy and management. John Wiley & Sons.
- Blais, K. and et.al., 2015. Professional nursing practice: Concepts and perspectives (p. 530). NJ: Prentice Hall.
- Etain and et.al., 2013. Clinical features associated with trait-impulsiveness in euthymic bipolar disorder patients. Journal of Affective Disorders, 144(3), pp.240-247.
- Miller, T., Birch, M., Mauthner, M. and Jessop, J. eds., 2012. Ethics in qualitative research. Sage.