In this paper, I will reflect on our discussions about healthcare ethics and propose a framework to guide my clinical practice when I am a licensed PA.
I chose to become a PA because it was my passion to help people in need. From a young age, I gravitated towards volunteering and actively giving back to the community. In school, I excelled in science classes, because I found that most interesting, being able to relate to actual human life. My passion for medicine began to grow when my mom suffered her first bell palsy’s attack. It was honestly lack of medical interventions, limited clinics, and uninterested clinicians that caused a decline in my mom’s health. So that is when I promised myself that I would strive to become a competent PA.
The most important aspect of clinical practice that would enable me to help people is developing good relationships. I anticipate in acting in this manner such that I am making an impact on patients lives. First and foremost, I feel employing this aspect in my practice will cultivate open conversations with my patients, that facilitate trust. I would review patients charts prior to encounters so I am informed and have a wholesome understanding of the patient situation. Also, I would be truthful with the patient about their conditions/treatments. By spending time with patients, providing specific attention, I hope to educate and therefore enhance their overall care. I feel following these practices would satisfy the patient, as they would feel more respected, taken care of and more involved in their health.
These aspects operationalize many ethical principles we’ve discussed. A few that I believe will play the strongest role in my ethical decision making in practice will be autonomy, beneficence, and truthfulness. According to Yeo and Moorhouse, the autonomy chapter, autonomy can be emphasized as the freedom of self-determination, which is valuing ones independence to make decisions for oneself, implemented by the ability to act freely as one wishes (93). In the next chapter, beneficence is described as the “good health of patients”, which means as clinicians we are to act in a manner that will promote health by providing care that will benefit and outweigh harms for the patient (134). Lastly, truthfulness is another ethical principle that reinforces building relationships. According to Surbone article, truth telling is the art of communicating with patients, disclosure of factual medical information as well as the medical providers own perspective, which is also upheld by doctrines like informed consent (944).
As a clinician focusing on interactions with patients encouraged by these principles can not only improve quality but cultivate deeper meaningful relationships. When developing relationships, I would practice patient autonomy by offering patients options, enabling them to make choices about their care, and invoking greater patient satisfaction. This would give patients control of their care, as their concerns are being heard and validated. This can increase quality of life, being given the opportunity to decide what is best for yourself instead of being forced into a situation. Beneficence is used when maintaining the notion of producing good for the patient as it would help to increase my awareness for what is important to the patient. Getting to know the patient, would lay the foundation for greater compliance and healing. I would be better equipped to monitor their safety, and care for their physical and psychological needs. By actively educating the patient, I would increase their competencies in regards to their conditions, by providing benefits/harms/alternatives. This is an important ethical principle to use during relationship building because it reminds the patient that they are your primary concern. Lastly, being open and honest in the beginning of the relationship fosters trust and allows the patient to feel respected. I would empower disclosure to patients, because they have a right to know about their body, which means we are intrinsically providing good, by recognizing the welfare of the patient as most important. Truthfulness encourages patients to act according to their true preferences. This creates a social bond that allows the provider to have greater understanding of the patients conditions and personhood, nurturing a deeper relationship.
Together, developing relationships is preserved by autonomy, upheld by beneficence, and fostered by truthfulness which are some aspects and ethical principles that I will utilize in practice. This paper was a great way to reflect on the semester, detailing aspects of health care ethics and linking it to my future clinical practice as a PA.
Surbone, A. Telling the truth to patients with cancer: what is the truth? Lancet Oncology, 2006. pp 944-950.
Yeo, Michael and Anne Moorhouse. Concepts and Cases in Nursing Ethics, 3rd ed., Broadview Press, 2010, pp. 91-100 and 103-135