Main Propositions of Moral Theories

1. Outline the main propositions of a range of moral theories, e.g. consquentialism, utilitarianism, deontology and postmodern ethics.
2. Apply theories of moral philosophy to provision of health care.
3. Evaluate examples of medical issues which promote controversial debate, e.g. organ transplant, euthanasia, informed consent.
4. Identify the key moral principles underpinning decision making in medical practice.

Ethics is a code of conduct which consists of a certain code of values which are framed by the management of an organization and are managed by our own choices and actions which can determine the purpose and course of action (Ayn Rand, 1982). In short ethics is a total way in which one can treat their life.  Ethics are certain and they are required in every dimension of life and they are used as critical principles in every organization as they frame a code of conduct based on these ethical principles. In this article we would discuss about various ethical issues specific to the health industry and the ways in which one can solve them.

We would also analyze its applications across the disorder and settings in a chosen population. There would be different aspects which we would focus on like the research questions which we would focus on in terms of chronic pain and the nurses involved in curing the pain. There are a lot of health issues which people face and chronic pain is a border line personality disorder which patients face. We would choose theories like Utilitarianism which is related to normative ethics and by considering various Ethnographic studies. The measurement of the pain relief and the methods in which the pain could be alleviated would also be included in the discussion and most of the times such pain relief treatments would involve Behaviour Therapy.

Mrs Susy is a 55-year-old Aboriginal woman who has been admitted to a tertiary hospital

in Victoria for management of chronic pain that is the result of a long history of leg ulcers. Mrs

Morgan lives in a remote community in the far north of Western Australia. Prior to

hospitalization, Mrs Susy had been treated by the Royal Flying Doctor Service, which had

a scheduled monthly service to her community. On admission Mrs Susy reported the difficulties of daily living with chronic pain. She spoke of many members of her community who have similar problems, especially chronic pain as a consequence of long-term illness. She also reported that there is little assistance provided by her local community or by the government in attempting to stem the increase in the number of individuals who are developing long-term illness.

Applying Theories of Moral Philosophy to Provision of Health Care

Dealing with such issues of people in their community is the main issue based on which we would conduct a research methodology.

This can be conducted by implementing research based on surveys which are conducted, evidence based research and cases which have been solved in the hospitals or by nurses.

There could be different approaches which people would base their research on like the nature of the society, the nature of the disease type based on which the research would be conducted, people involved in various stages of treating the patient and the type of approach which could be implemented in the process. There are various discussions on the kinds of methods to be chosen for conducting a research and the various approaches which are implemented are

• Action Research
• Case Studies of previous cases which can include various types of issues
• Ethnographic studies
• Most of the field case studies conducted previously
• Focus groups or discussions to provide a great relief from unethical incidents in the hospitals
• Research methodologies which can be implemented to avoid pain and unethical issues
• Any activities which could be included as a part of research

All these models of researches adapt the 2 kinds of kinds of approaches which we have discussed earlier like the subjective and objective kinds of approaches where they have the scopes of reflecting all the aspects which they would consider and they have their own interpretations and they have their own advantages where they could be implemented in   various cases.  The most critical method which has been adapted is the qualitative method which involves a lot of case studies which would give a lot of results in a process as it is an interactive approach.  This approach by Maxwell can be chosen because it allows us to consider the case studies and facts which are related to the case to get an understanding about it.

Ethnographic studies

Ethnographic studies are a study which is conducted by a close research by reading and interpretation. Any study which is conducted is generally based on the way an activity is conducted which could be in a group or between various people through various ways of communication. This method can be considered in this case as it involves a group of aboriginal women and analysis of their cases as such cases where innocent people are involved there could be cases of ethical issues which could arise. These theories help in organizational ethics, to promote imperative and good will. Non consequentialism and moral rights which are related to obligations, ideas and effects.

The basis for all this research is experiences of these patients who have chronic pain issues and especially the cases of the aboriginal women in this context who find it difficult to share their experiences with others or with nurses. Some of the people who have experienced pain like Mrs Susy said that they live with such incidents which cause the pain and no one would understand the levels of pain which they go through and this is also related to the emotional pain other than the ulcers which cause them the pain related to their medical issue (Muris, M, 2012).

Evaluating Examples of Medical Issues and Cases

Evidence based medicine has been formed by Sackett in 1996 (Sackett, 1996). This is an evidence based practice as the policies were implemented by health and social care. This research method includes the information collection and communication which is used to communicate with the patients to help them solve their issues. This helps the medical practitioners to get access to the information related to the patients (Verheul, R., Van Den Bosch, L.M., Koeter, M.W. , 2003). The aim of the Evidence based research and all the other research methodologies which are used to find solutions to such issues focus on implementing all their previous events to future practice.

The evidence based medicine could be used with their customers, practitioners based on their service and evidence. This process can be conducted in various stages like

• Asking practice based questions and asking questions in a way they get an answer
• Search and access the potential evidence
• Evaluate the evidence which they get and decide on the factors they get
• Choose the suitable methods which they get to the relevant cases (Sackett 2000).

All these aspects would involve different set of skills and competencies which are taught specially in the nursing schools in order to help the treating nurses communicate effectively with the patients and provide them the required care and attention. They would have to be effective in their treatment when they communicate with the women to provide them the care they require like cases of Mrs Susy.

The research questions which we have focussed on relate to cases of chronic pain, ways of solving such issues and also referring to the cases of the aboriginal women who suffer with some other issues apart from chronic pain can be solved with the use of the questions we have discussed earlier by implementing the knowledge and cases which have been dealt with the nurses earlier.

Concept Map

Behaviour Therapy is a cognitive behavioural treatment which was originally developed by Marsha M Linehan as a treatment of chronically ill patients. This was first used for the suicidal women who were diagnosed with the border line personality disorder. These patients are in the group of 14 – 20% of the in patients of a hospital who are admitted for some kind of long standing illness. These patients consume 40% of the medical resources in a hospital. This is a disorder which most of the people suffer and they need some treatment interventions which are used for various customers by therapists with a common understanding of the issue. This therapy is helpful for this case where these women were also dealing with issues related to emotional pain (Linehan M.M., Tutek D.A., Heard H.L., 1994). An ethical practice is important to be implemented in this case and this has the basis for a lot of decisions to be made and they are for the patients, families, nurses and people who are a support in the hospitals for caring for such patients

Identifying Key Moral Principles in Medical Practice

Border line personality disorder is a condition which is a personality disorder which is increased with various emotions of a person which are also influenced by some symptoms which are also called as psychotic symptoms. The individuals who suffer with such conditions are influenced by various intense emotions which are influenced by the central nervous system. This can be the following medical condition which might occur in people who would have to deal with various issues like the aboriginal people where they might not be able to share any of their instances. There could be ethical issues where the nurses who are involved in the treatment might not render great service with utmost required care and sometimes there could be issues where the doctors are not timely informed about the patients issues. The limitations of these research methods is that they don’t have a method in which they can analyze the situations of the patients after the surveys and the ways where they could conduct training for such patients to communicate with others where this could help them get relieved of their pain.

These disorders cause a great pain to the patients and they are generally down and they begin to exhibit an averse behavior which can force them to isolate themselves to be mentally apart from the pain and their current situations.

This has been implemented in a way where the knowledge of self – injury and the ways to cope are used to predict the effects of such disorders on people. The analysis was conducted with the knowledge of this relationship between various factors to possibly cope up with such strategies to solve the personality disorders of such patients. The research was conducted based on surveys which were done on some individuals however the experiences of such patients in a descriptive way would have provided a much more clearer understanding of the disorder and this would have resulted in providing a research analysis to all the non medical people to evaluate such measures and solve the issues of the people to an extent which would be possible to them as human relations and maintaining a perfect coordination between all types of people would help solve a lot of psychological disorders (Muris, 2012).

Conclusion

We have seen the various aspects which can trigger personality disorder in people and the aspects which might enhance the feelings of isolation in people which might also result in ethical issues to be raised by the patients. We have also discussed that the individuals who suffer with such conditions are influenced by various intense emotions which are influenced by the central nervous system.  These people can get trained and can be spoken to which can motivate them to start communicating with others and the nurses. These nurses can in turn help the patients in overcoming their pain and help them lead a happy life.

References

Muris, M. (2012). Reduction of Self-injury and Improvement of Coping Behaviour during Dialectical Behaviour Therapy (DBT) of Patients with Borderline Personality Disorder: International Journal of Psychology and Psychological Therapy. Pgs 21 – 34

Linehan M.M., Tutek D.A., Heard H.L. (1994). Interpersonal Outcome of Cognitive Behavioral Treatment for chronically suicidal Borderline patients American Journal of Psychiatry 151,1771-1776

Linehan M.M. (1998). An Illustration of Dialectical Behavior Therapy

Journal of Personality Disorders 10(2), 153-163

Mental Health Centre of Greater Manchester, New Hampshire (1998) Integrating Dialectical Behavioral Therapy into a Community Mental Health Program. Psychiatric Service 49 (10),  1338-1340.

Verheul, R., Van Den Bosch, L.M., Koeter, M.W. (2003). Dialectical Behavior Therapy for women with Borderline Personality Disorder: 12 month randomised trial. British Journal of Psychiatry, 182, 135-140.

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midwifery. Pathways to evidence-based practice. Melbourne: Oxford University Press.