Freedoms for Health Care Professionals Essays

Professional boards are lobbying for freedoms for health care professionals. As a health care administrator, how do you ethically balance board-granted freedom with quality of care concerns to create a sustainable model for your organization? Support your view.Freedoms for Health Care Professionals Essays

Topic 3 DQ 1
Professional health care providers in direct contact with patients are required to be licensed and credentialed demonstrating current competencies of both quality care and safe healthcare practice. Should similar licensing and credentialing requirements be imposed on health care leaders and other collaborative workers in the health care industry (e.g., business office personnel, CEOs, CFOs, or other administrators) who may not be directly serving patients? Why or why not?

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You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.Freedoms for Health Care Professionals Essays
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.Freedoms for Health Care Professionals Essays

Patient care is a discrete and important aspect of the right to health that merits attention and scrutiny as a human rights issue. A vast and severe range of human rights violations occur in the patient care context that violate rights in addition to the right to health, including many civil and political rights. In response to growing concern about this abuse in many parts of the world, the phrase and concept “human rights in patient care” has recently grown in usage as a framework for monitoring, documenting, and analyzing abuses in patient care settings, and in some cases, holding governments and other parties accountable. This article outlines a framework for human rights in patient care that is closely related both to the right to health and to the more colloquial notion of “patients’ rights” but is distinct from them—as well as from complementary frameworks such as patient safety and bioethics—in important ways.

Instead of the humane and appropriate health care expected, patients and health providers in many settings encounter a variety of abuses that affront basic human dignity and jeopardize health outcomes. These abuses range from pervasive violations of patients’ rights to informed consent, confidentiality, privacy, and non-discrimination to more egregious abuses, including torture and cruel, inhuman, and degrading treatment. Health providers likewise may face abuses such as unsafe working conditions, sanctions for providing evidence-based health care, limits on their freedom of association, and denial of due process when patients make complaints against them.Freedoms for Health Care Professionals Essays

The concept of human rights in patient care refers to the theoretical and practical application of general human rights principles to the patient care context, particularly to interactions between patients and providers. It applies rights principles universally to a context or setting. While centered on patients, it does not limit rights to a particular group of people. Dorland’s Medical Dictionary defines “patient care” as “the services rendered by members of the health profession and non-professionals under their supervision for the benefit of the patient.”1 This differs from “health care,” where services are provided “for the purposes of promoting, maintaining, monitoring, or restoring health.” 2 Patient care highlights patients as fundamental agents and the ultimate beneficiaries of services. The focus on patients, while not exclusive, is consistent with the way the human rights approach helps to identify and address vulnerabilities.

The human rights lens reveals issues of discrimination and social exclusion that often underlie abuse against patients. This is critical, since abuses against groups such as people living with HIV, ethnic minorities, sexual and gender minorities, people who use drugs, and people with disabilities are especially rife in health settings.3 Often these abuses are related to the perception of groups as deviant or in need of curative forms of “treatment,” leading to horrific abuses in psychiatric facilities, drug rehabilitation centers, detention centers for sex workers, and similar settings. In a recent report, the Special Rapporteur on torture recognized the particular vulnerability of marginalized groups to torture and ill treatment in health settings, citing “[s]tructural inequalities, such as the power imbalance between doctors and patients, exacerbated by stigma and discrimination.”4 The Campaign to Stop Torture in Health Care, launched in 2011 by a coalition of organizations working in the fields of health and human rights, highlighted some of the most egregious of these abuses such as forced sterilization of Roma women and women living with HIV, forced detention and punishment of people who use drugs, and unjustified denial of pain relief.5 Concretely, the human rights in patient care approach calls for a focus on the most marginalized and vulnerable in the formulation of health law and policy, guidelines and trainings for health care providers, and advocacy and litigation to address violations.Freedoms for Health Care Professionals Essays

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At the same time, the concept of human rights in patient care recognizes health care providers as important actors, whose rights must be respected both as a matter of principle and for the benefit of the patient. The relationship between patient and provider rights is critical. Providers are unable to provide high-quality care unless their rights are respected and they can work under decent conditions with professional independence. There is no shortage of examples of health providers who have been punished for providing evidence-based health care to their patients, ordered to destroy medical records or disclose confidential health information to the state, or coerced into participating in (or covering up) torture and crimes against humanity. Even in open societies, health providers may be denied safe working conditions, punished for alleged ethical breaches without any due process, or forced to provide a standard of care that violates their ethical principles.6 These violations not only offend basic human dignity, but also pose a risk to patients. These violations thrive on a culture of disrespect and abuse that has the potential to harm everyone who comes into contact with the health care system. In this way, the human rights in patient care approach does not pit patients against providers, but rather recognizes links that may lead to joint advocacy to address systemic issues.Freedoms for Health Care Professionals Essays

A related concept to human rights in patient care is “dual loyalty,” or a health provider’s “simultaneous obligations, express or implied, to a patient and to a third party, often the state.”7 Such simultaneous obligations can, depending on the circumstances, pose a risk of human rights violations. In cases where the interests of the patient and the state are aligned, dual loyalty poses little risk. However, where they conflict, the result is often that doctors are compelled to abuse the rights of their patients. The International Dual Loyalty Working Group, convened by Physicians for Human Rights in 1993, observed that, in both repressive and open societies, “Governments and other third parties often demand that health professionals put allegiance to their patients aside, in deference to the demands of these powerful actors—often in a manner that violates patients’ human rights.” The Working Group provides examples of contexts that may give rise to dual loyalty conflicts, including health practice under repressive governments; closed institutions such as prisons and the military; and open societies with institutionalized bias against women, ethnic and religious minorities, immigrants and refugees, and socially stigmatized patients.8

The Working Group goes on to describe six common types of human rights violations that stem from dual loyalty conflicts. Many of these violations will seem familiar to those who advocate for the health and human rights of marginalized populations:Freedoms for Health Care Professionals Essays

  1. Using medical skills or expertise on behalf of the state to inflict pain or physical or psychological harm that is not a legitimate part of medical treatment;
  2. Subordinating independent judgment, whether in therapeutic or evaluative settings, to support conclusions favoring the state or other third party;
  3. Limiting or denying medical treatment or information related to treatment of an individual to effectuate the policy or practice of the state or other third party;
  4. Disclosing confidential patient information to state authorities or other third parties in circumstances that violate human rights;
  5. Performing evaluations for state or private purposes in a manner that facilitates violations of human rights;
  6. Remaining silent in the face of human rights abuses committed against individuals and groups in the care of health professionals.9

Dual loyalty sheds light on the causes and manifestations of human rights abuses in patient care, and it also provides a framework for preventing abuse by resolving dual loyalty conflicts in a fair and transparent manner.Freedoms for Health Care Professionals Essays

The International Dual Loyalty Working Group has produced guidelines to assist health providers in resolving dual loyalty conflicts, which can be incorporated into medical education, training, and policy as part of a broader global campaign to promote human rights in patient care.

The concept of human rights in patient care thus widens out from the individual patient-provider relationship to examine systemic factors and state responsibility in the provision of patient care.  As Health and Human Rights: A Reader explains, “a human rights perspective, which takes individual rights to information, privacy, and bodily integrity seriously and treats all people as equals” transforms “government approaches to the physician-patient relationship.”10 Additionally, the human rights in patient care concept refers not just to entitlements for actual patients, but also to human rights standards in the provision of care that concern health providers and the entire community. It calls for a pervasive human rights frame to govern the delivery of care to patients in all its aspects, which also highlights equality, participation, transparency, and accountability concerns.Freedoms for Health Care Professionals Essays