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... of the most difficult problems in medical ethics: the value of confidentiality requires the physician who considers breaching it have the most serious justification. Among these exceptions is to report a communicable disease: The obligation to safeguard the patients confidences is subject to certain exceptions, which are ethically and legally justified because of overriding social considerations. Where a patient threatens to employ bodily harm to another person, there is a reasonable probability that the patient may carry out the threat; the physician should take reasonable precautions for protection of the intended victim, including notification of law enforcement authorities.
Also, communicable diseases, gunshot and knife wound should be reported as required by applicable statues or ordinances. In this case both communicable disease and bodily harm could be reported. Confidentiality is prima facie to these exceptions. They are worded as: justify or you may whereas, confidentiality is a doctors duty. As an example, If the patient refuses to do so, a physician may, without the patients consent, notify a sexual partner known to be at risk. Therefore, the doctor could tell her because of the exception since he is putting her at risk of bodily harm, which is contaminating her with the communicable disease, AIDS.
Another factor is the doctors friendship, if the doctor does not say anything it will perhaps ruin the relationship she once had with the patients wife. Informing the wife would not be a sure way to prevent spreading the disease because his wife probably already has the disease. The dominant motivator to tell in this scenario would be the friendship between the doctor and her clients wife. In defense of the patients rights, the doctor should not mix her personal life with her professional life.
Furthermore, due to the setting and nature of the situation the patient to doctor relationship comes first, the patient is the doctors client so the doctor should seek his benefits before anyone else. In conclusion, because of the doctors profession she would not tell the patients wife, nonetheless, leave this to the patient. In the end result the doctor will feel that she has dealt with the situation to the best of her ability without compromising her patient. It was identified, frm the perspectives f patients, the important physician skills fr high-quality end-f-life care.
Remarkable similarities were fund in the perspectives f patients with CPD, AIDS, and cancer, including the importance f emotional support, communication, and accessibility and continuity. However, each disease grup identified a unique theme that was qualitatively mre important t that grup. Fr patients with CPD, the domain concerning physicians ability t provide patient education std ut as qualitatively and quantitatively mre important. Patients with CPD desired patient education in five content areas: diagnosis and disease press, treatment, prognosis, what dying might be like, and advance care planning. Fr patients with AIDS, the unique theme was pain cntrl; fr patients with cancer, the unique theme was maintaining hpe despite a terminal diagnosis.
Patients with CPD, AIDS, and cancer demonstrated many similarities in their perspectives n important areas f physician skill in providing end-f-life care, but patients with each disease identified a specific area f end-f-life care that was uniquely important t them. Physicians and educators should target patients with CPD fr efforts t improve patient education abut their disease and abut end-f-life care, especially in the areas defined are. Physicians caring fr patients with advanced AIDS should discuss pain cntrl at the end f life, and physicians caring fr patients with cancer should be aware f many patients desires t maintain hpe. Physician understanding f these differences will provide insights that all improvement in the quality f care. Taking to matter the research made by specialists in this field, it was conducted focus groups of patients with advanced COPD, cancer, or AIDS, as well as family members and health-care providers. Their goal was to elucidate the important aspects of physician skill at providing end-of-life care.
The study offers the opportunity to compare and contrast patients perspectives across these three disease groups. Cancer and COPD represent the second and fourth most common causes of death in the United States, respectively and, since 1979, the age-adjusted mortality from COPD continues to rise. Although mortality from AIDS has declined with improvements in antiretroviral therapy, AIDS remains one of the most common causes of death for persons aged 15 to 44 years. It was sought to obtain a better understanding of the unique perspective of patients about end-of-life care in each of these groups in an effort to provide insights to help provide better, more tailored care for these patients. The results of the study show the number of patients in each disease category and the demographic characteristics of the focus group participants, also it shows the proportion of coded passages that fell within each domain for the different types of patients, and the rankings for the frequency with which each domain was identified. As the results of the study demonstrate, there were considerable similarities across disease groups in the frequency with which comments for each domain were identified.
For all three disease groups, emotional support was the single most commonly identified domain, and communication with patients and accessibility and continuity were consistently among the top three in frequency of identification. Despite these similarities in the frequency of domain codes, each disease group had a facet of care that qualitatively emerged in analyses as uniquely important for that group. For patients with COPD, this unique difference was the relative importance of one of the domains, patient education about end-of-life care. This domain was ranked fourth among domains for COPD, with 12 % of the codes categorized as patient education. In contrast, patient education ranked seventh and 11 th for AIDS and cancer, respectively, with [less than or equal to] 5. 5 % of the codes.
Considering the aforementioned data we may clearly state that no matter what disease any particular patient has it is important for physicians to give them equal treatment. As it was already mentioned one of the significant things for the patient with communicable disease in their way to recover is emotional support. The ones that are able to give that support are the doctors. Therefore it is vital for them to adhere to the specific mandates that were created for treatment of patients.
My suggestion for the topic would be for the doctors to treat all patients similarly in terms of the medical practice. Of course there are some special techniques for patients with communicable diseases. First of all they definitely need more attention in terms of moral support. Doctors need to encourage those people so they feel better and have hopes for future recovery.
Again we do not know what the contemporary medicine may come up with within the very close future. This may be one of possible ways for giving patients an idea that everything is not that bad. Consequently patients will feel better in moral standpoint and therefore it will be easier for them to receive treatment at dentist or physicians place. Having that good state of mind towards the communicable disease a patient has, it is possible for him or her to find that strength that is present in everybody that is able to overcome any disease, no matter of what origin it is. That is my personal opinion. Bibliography: Field MJ, Cassel CK.
Approaching death: improving care at the end of life; Institute of Medicine Report. Washington, DC: National Academy Press, 1997 Council on Scientific Affairs AMA. Good care of the dying patient. JAMA 1996; 275: 474 - 478 The SUPPORT Principal Investigators. A controlled trial to improve care for seriously ill hospitalized patients: the study to understand prognoses and preferences for outcomes and risks of treatments (SUPPORT). JAMA 1996; 274: 1591 - 1598 Schneider man LJ, Kronick R, Kaplan RM, et al.
Effects of offering advance directives on medical treatment and costs. Ann Intern Med 1992; 117: 599 - 606 Danis M, Souther land LI, Garrett JM, et al. A prospective study of advance directives for life-sustaining care. N Engl J Med 1991; 324: 882 - 888 Wachter RM, Luce JM, Hearst N, et al. Decisions about resuscitation: inequities among patients with different diseases but similar prognoses. Ann Intern Med 1989; 111: 525 - 532 Levenson JW, McCarthy EP, Lynn J, et al.
The last six months of life for patients with congestive heart failure. J Am Geriatr Soc 2000; 48: S 101 -S 109 Somogyi-Zalud E, Zhong Z, Lynn J, et al. Dying with acute respiratory failure or multiple organ system failure with sepsis. J Am Geriatr Soc 2000; 48: S 140 -S 145 Classes MT, Lynn J, Zhong Z, et al. Dying with lung cancer or chronic obstructive pulmonary disease: insights from SUPPORT. J Am Geriatr Soc 2000; 48: S 146 -S 153 Gore JM, Brophy CJ, Greenstone MA.
How do we care for patients with end stage chronic obstructive pulmonary disease (COPD)? A comparison of palliative care and quality of life in COPD and lung cancer Thorax 2000; 55: 1000 - 1006 Curtis JR, W enrich MD, Carline JD, et al. Understanding physicians skills at providing end-of-life care: perspectives of patients, families, and health care workers. J Gen Intern Med 2001; 16: 41 - 49
Free research essays on topics related to: bodily harm, advance directives, lung cancer, communicable diseases, chronic obstructive
Research essay sample on The Treatment Of Patients With Communicable Part 2
