scholarly journals Ethical practice in medicine: a review

2020 ◽  
Author(s):  
Kasaw Adane ◽  
Ligabaw Worku ◽  
Teshiwal Deress ◽  
Adino Tesfahun

Abstract Objective A patient with health problems seek healthcare services from healthcare professionals. Their patient-provider relationships are usually affected by roles, gifts, services, and physical contact. The major ethical healthcare practices focus on respecting patient’s freedom and basic human rights. However, there are only limited references materials issued on medical ethics and ethical medical practices. Hence, this review article tries to describe the important aspects of ethical practices in healthcare delivery. Methods Initially, idea conceptualization, planning and keyword defining were for the development of this material. The keywords were medical ethics, code of ethics, bioethics, ethical practice, quality service and healthcare ethics. Result Then, two authors independently assessed published materials using EndNote® program from PubMed (NML) and Google Scholar databases. Finally, from a total of 721 full-text articles downloaded, 34 published article meeting inclusion criteria were included in this article. Conclusion Adherence to high ethical and moral standards, responding to societal needs and reflection social contract, subordinating self-interest to the interest of others and the manifestation of the core human values are all expected from healthcare professionals. Ethical and legal dimensions of medicine are very important. Hence, providing high-quality patient care at low cost and compliance with ethical and moral standards is the most common reason for the incompliance with medical ethics. Hence, healthcare professionals are expected to have a minimum level of knowledge on ethical concepts, favorable attitude, and a minimum level of skill to comply with regulatory and ethical requirements in all situations.

2017 ◽  
Vol 31 (3) ◽  
pp. 317-330 ◽  
Author(s):  
Anna Svarts

Purpose The purpose of this paper is to explore how healthcare managers perceive economies of scale and the underlying mechanisms for how scale/size affects performance. Design/methodology/approach Data were collected in 20 in-depth interviews with healthcare professionals from 13 healthcare delivery organizations and from a public authority that finances and contracts healthcare services. Data were coded and analysed using content analysis. Findings The study concludes that the impact of scale on performance is perceived by healthcare professionals to be different for different types of healthcare services: For surgery, significant scale effects related to spreading of fixed cost, the experience curve, and potential for process improvement. For inpatient care, moderate scale effects related to spreading of fixed costs and costs of doctors on on-call duty. For outpatient care, small or no scale effects. Research limitations/implications The small sample of interviewees from a single geographical region and healthcare system limits the applicability of the findings. Originality/value The paper provides insights into how healthcare managers experience scale effects and how they consider economies of scale when planning hospital configuration. Also, past studies of economies of scale in hospitals proffer mixed results and the findings in this paper indicate a possible explanation for this inconclusiveness, i.e. differences in service mix between different hospitals.


Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1233
Author(s):  
Ernest Osei ◽  
Kwasi Agyei ◽  
Boikhutso Tlou ◽  
Tivani P. Mashamba-Thompson

Mobile health (mHealth) technologies have been identified as promising strategies for improving access to healthcare delivery and patient outcomes. However, the extent of availability and use of mHealth among healthcare professionals in Ghana is not known. The study’s main objective was to examine the availability and use of mHealth for disease diagnosis and treatment support by healthcare professionals in the Ashanti Region of Ghana. A cross-sectional survey was carried out among 285 healthcare professionals across 100 primary healthcare clinics in the Ashanti Region with an adopted survey tool. We obtained data on the participants’ background, available health infrastructure, healthcare workforce competency, ownership of a mobile wireless device, usefulness of mHealth, ease of use of mHealth, user satisfaction, and behavioural intention to use mHealth. Descriptive statistics were conducted to characterise healthcare professionals’ demographics and clinical features. Multivariate logistic regression analysis was performed to explore the influence of the demographic factors on the availability and use of mHealth for disease diagnosis and treatment support. STATA version 15 was used to complete all the statistical analyses. Out of the 285 healthcare professionals, 64.91% indicated that mHealth is available to them, while 35.08% have no access to mHealth. Of the 185 healthcare professionals who have access to mHealth, 98.4% are currently using mHealth to support healthcare delivery. Logistic regression model analysis significantly (p < 0.05) identified that factors such as the availability of mobile wireless devices, phone calls, text messages, and mobile apps are associated with HIV, TB, medication adherence, clinic appointments, and others. There is a significant association between the availability of mobile wireless devices, text messages, phone calls, mobile apps, and their use for disease diagnosis and treatment compliance from the chi-square test analysis. The findings demonstrate a low level of mHealth use for disease diagnosis and treatment support by healthcare professionals at rural clinics. We encourage policymakers to promote the implementation of mHealth in rural clinics.


Author(s):  
Yoshito Nishimura ◽  
Tomoko Miyoshi ◽  
Hideharu Hagiya ◽  
Yoshinori Kosaki ◽  
Fumio Otsuka

The coronavirus disease 2019 (COVID-19) global pandemic has drastically changed how we live and work. Amid the prolonged pandemic, burnout of the frontline healthcare professionals has become a significant concern. We conducted a cross-sectional survey study to provide data about the relationship between the COVID-19 pandemic and the prevalence of burnout in healthcare professionals in Japan. Healthcare workers in a single Japanese national university hospital participated in the survey, including basic demographics, whether a participant engaged in care of COVID-19 patients in the past 2 weeks and the Maslach Burnout Inventory. Of those, 25.4% fully answered the survey; 33.3% were doctors and 63.6% were nurses, and 36.3% engaged in care of COVID-19 patients in the past 2 weeks. Compared to those belonging to General Medicine, those in Emergency Intensive Care Unit were at higher risk of burnout (odds ratio (OR), 6.7; 95% CI, 1.1–42.1; p = 0.031). Of those who engaged in care of COVID-19 patients, 50% reported burnout while 6.1% did not (OR 8.5, 95% CI; 1.3–54.1; p = 0.014). The burnout of healthcare workers is a significant concern amid the pandemic, which needs to be addressed for sustainable healthcare delivery.


BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041108
Author(s):  
Isabella Joy de Vere Hunt ◽  
Abigail McNiven ◽  
Amanda Roberts ◽  
Himesh Parmar ◽  
Tess McPherson

BackgroundThere is little qualitative research in the UK focussing on adolescents’ experience of their healthcare providers, and inflammatory skin conditions are a common heath problem in adolescence.AimTo explore the experiences of adolescents with eczema and psoriasis with healthcare professionals, and to distil the participants’ key messages for their healthcare providers.DesignThis is a secondary thematic analysis of interviews with adolescents with eczema or psoriasis.ParticipantsThere were a total of 41 text transcripts of interviews with young people with eczema or psoriasis who had given permission for secondary analysis; 23 of the participants had eczema, and 18 psoriasis. Participants were living in the UK at time of interview, and aged 15–24 years old.ResultsWe have distilled the following key messages from young people with eczema and psoriasis for healthcare providers: (1) address the emotional impact; (2) give more information, with the subtheme and (3) appreciate patient research. We identified the following eczema-specific themes: (ECZ-4) ‘It’s not taken seriously’; (ECZ-5) offer choice in treatment and (ECZ-6) lack of structure/conflicting advice. Two psoriasis-specific themes were identified: (PSO-4) feeling dehumanised/treat me as a person; and (PSO-5) think about how treatments will affect daily life.ConclusionThis qualitative data analysis highlights the need for greater recognition of the emotional impact of skin disease in adolescence, and for more comprehensive provision of information about the conditions. We call for greater sensitivity and flexibility in our approach to adolescents with skin disease, with important implications for healthcare delivery to this group.


Author(s):  
Duygu Ayhan Baser ◽  
Özge Mıhcı ◽  
Meltem Tugce Direk ◽  
Mustafa Cankurtaran

Abstract Aim: The aim of this study was to describe the attitudes, views and solution proposals of family physicians (FPs) about primary healthcare problems of Syrian refugee patients. This study would be the very first study for Turkey that evaluates the attitudes, views and solution proposals of FPs about primary healthcare problems of Syrian refugee patients. Background: Following the anti-regime demonstrations that started in March 2011, the developments in Syria created one of the biggest humanitarian crises in the world and the largest number of asylum seekers continue to be hosted in Turkey. There are some studies evaluating asylum seekers’ access to healthcare services in Europe, and the common result is that refugees have free access to primary healthcare services in most countries; however, they face many obstacles when accessing primary healthcare services. While there are studies in the literature evaluating the situation of access to primary healthcare services from the perspective of asylum seekers; there are few studies evaluating the opinions/views of FPs. Methods: A qualitative methodology informed by the grounded theory was used to guide the research. A total of 20 FPs were interviewed face to face through semi-structured interviews, using 12 questions about their lived experience and views caring of refugee population. Interviews were analysed thematically. Finding: The following themes were revealed: Benefiting from Primary Health Care Services, Benefiting from Rights, Differences Between the Approach/Attitudes of Turkish Citizens and Refugees, Barriers to Healthcare Delivery, Training Needs of Physicians, Solution proposals. FPs reported that there is a need for support in primary care and a need for training them and refugees in this regard and they specified refugee healthcare centres are the best healthcare centres for refugees; however, the number of these and provided services should be increased.


Author(s):  
Karan Chawla ◽  
Angesom Kibreab ◽  
Victor & Scott ◽  
Edward L. Lee ◽  
Farshad Aduli ◽  
...  

Objective: It is unknown whether patients’ ratings of the quality of healthcare services they receive truly correlate with the quality of care from their providers. Understanding this association can potentiate improvement in healthcare delivery. We evaluated the association between patients’ ratings of the quality of healthcare services received and uptake of colorectal cancer (CRC) screening. Subject and Methods: We used two iterations of the Health Information National Trends Survey (HINTS) of adults in the United States. HINTS 2007 (4,007 respondents; weighted population=75,397,128) evaluated whether respondents were up-to-date with CRC screening while HINTS 4 cycle 3 (1,562 respondents; weighted population=76,628,000) evaluated whether participants had ever received CRC screening in the past. All included respondents from both surveys were at least 50 years of age, had no history of CRC, and had rated the quality of healthcare services that they had received at their healthcare provider’s office in the previous 12 months. Results: HINTS 2007 data showed that respondents who rated their healthcare as good, or fair/poor were significantly less likely to be up to date with CRC screening compared to those who rated their healthcare as excellent. We found comparable results from analysis of HINTS 4 cycle 3 data with poorer uptake of CRC screening as the healthcare quality ratings of respondents’ reduced. Conclusion: Our study suggested that patients who reported receiving lower quality of healthcare services were less likely to have undergone and be compliant with CRC screening recommendations. It is important to pay close attention to patient feedback surveys in order to improve healthcare delivery.


2016 ◽  
Vol 44 (4) ◽  
pp. 639-651 ◽  
Author(s):  
Christiane Rochon ◽  
Bryn Williams-Jones

Military physicians are often perceived to be in a position of ‘dual loyalty’ because they have responsibilities towards their patients but also towards their employer, the military institution. Further, they have to ascribe to and are bound by two distinct codes of ethics (i.e., medical and military), each with its own set of values and duties, that could at first glance be considered to be very different or even incompatible. How, then, can military physicians reconcile these two codes of ethics and their distinct professional/institutional values, and assume their responsibilities towards both their patients and the military institution? To clarify this situation, and to show how such a reconciliation might be possible, we compared the history and content of two national professional codes of ethics: the Defence Ethics of the Canadian Armed Forces and the Code of Ethics of the Canadian Medical Association. Interestingly, even if the medical code is more focused on duties and responsibility while the military code is more focused on core values and is supported by a comprehensive ethical training program, they also have many elements in common. Further, both are based on the same core values of loyalty and integrity, and they are broad in scope but are relatively flexible in application. While there are still important sources of tension between and limits within these two codes of ethics, there are fewer differences than may appear at first glance because the core values and principles of military and medical ethics are not so different.


2020 ◽  
Vol 7 (1) ◽  
pp. 14
Author(s):  
Howard Stuart ◽  
Nilay Ozen ◽  
Vivian Petropoulos

In the fall of 2014 the Quebec Health Ministry announced plans for a broad restructuring of the entire Healthcare network, implemented shortly thereafter in 2015. The effect on institutions was dramatic and immediate. Local  management was eradicated, concentrating and centralizing control of the entire system ultimately into the office of the Minister. With the abrupt reorganization of services came relocation of large numbers of personnel. Management at a distance became the norm. In many institutions, the commonly held view among physicians with regard to relations with management can be summarized as, “Suddenly there was no one to talk to.”Confusion and tension were prevalent and palpable. In this context, in attempt to have a voice, a group of physicians at one community hospital formed an independent organization. It developed into an influential body which continues to remain active. This workshop will use the experiences and reflections of physicians from that organization as a basis to explore questions such as: -Is there a difference between Health Services and Health Care? Do we care? -Does worker engagement matter in Healthcare delivery? Or are good systems and modern equipment all we really need? -Does sense of community matter within a healthcare institution? If so why?If it matters, is it just for the benefit of those working for the organization? Or is there a benefit for the users too? -What is the basis for sense of community? Where does it come from? Can it be destroyed? Can it be developed? -Is there an importance to the quality of relationships between people working within Healthcare? Do these relationships have impact on quality of care? -Should the perspective of those working in the system be incorporated input Management decision making? If so how? -What can physicians, nurses and other allied Healthcare professionals do in order to have a voice? 


2021 ◽  
Vol 21 (2) ◽  
pp. 912-918
Author(s):  
Adebolajo Adeyemo ◽  
Segun Ogunkeyede ◽  
Oluyinka Dania

Background: Low and middle-income countries (LMICs) have high prevalence of hearing loss which are mainly due to pre- ventable causes. While urban communities in LMICs are likely to have functional hearing healthcare delivery infrastructure, rural and semi-urban communities may have different reality. Objectives: This study aimed to provide: (i) a snapshot of the burden of ear diseases and (ii) a description of available hearing healthcare resources in a semi-urban Nigerian community. Methods: A cross-sectional study of households selected by multistage random sampling technique. Seventy-four partici- pants: 39 males and 35 females with mean age of 34 years ± 5.24 were recruited and answered a structured questionnaire. In addition, the availability of hearing healthcare services in 15 health centers within the community were determined. Results: All participants reported recent occurrence of ear complaints or gave similar history in a household member. Com- mon complaints were ear discharge, ear pain and hearing loss. Medical intervention was sought from patent medicine stores, hospitals and traditional healers. None of the assessed hospitals within the study site was manned by an ENT surgeon or ENT trained nurse. Conclusion: Despite the heavy burden of ear complaints there is inadequate hearing healthcare delivery in a typical LMIC community. This highlights the need for urgent improvement of hearing healthcare. Keywords: Hearing loss; healthcare delivery; disease burden; ear diseases; developing countries.


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