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Ethical Health Care Issues

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Ethics is crucial in all facets of human endeavor. A major element of the health care practice is ethics, and it will continue to be vital in the delivery of health care. Healths care "professional duties include the balance between competency in skills, and application of ethics that will help promote the provision of the quality of care to the public" (Harris, 2008, p. 108). However, there can be challenges with ethical decisions in health care. Some of these ethical challenges that health care providers encounter can be the refusal of a patient to accept treatment, these usually occurs because of patients cultural or religious beliefs.

For example, some religious sects are barred from receiving blood transfusion or risk denouncement from the sect. Accepting blood transfusion by members is at a risk of "peril to their spirituality" (Berend & Levi, 2009, p. 208). These include segregation from their families and friends. "In June 2000, the governing body of Jehovah's witness called the Watchtower Society changed its policy regarding members who choose to receive blood transfusion to denounce willfully themselves from the group, and consequently to abjure from the congregation"(Berend & Levi, 2009, p.208).

Blood transfusions are provided in cases of major surgeries, injury and blood disorders. When a patient refuses blood transfusion but asks instead for treatment with the best available non-blood products and would rather die than accept blood transfusion, the health care provider is faced with a daunting ethical decision.

In this paper, the conflicting ethical principles associated with the refusal of a patient to take blood transfusion will be discussed, and the four major ethical principles to be applied in order to resolve it.

Conflicts of the Four Major Ethical Principles

There exists a conflict of ethical principles when a competent adult in need of care in a health care facility refuses treatment. Within the law, an individual has a right to autonomy as well as informed consent, which grants an individual the right to make a decision or choice with regard to a plan of care, such as blood transfusion. The authenticity of treatment plan must consist of three factors.

"First the patient is competent to give an informed consent by verbalizing or acknowledging understanding of the nature of the treatment plans. Second, the patient should give consent willfully without an undue influence or threat from other individuals. Third, the patient should receive disclosure, including the risks, and benefits of the treatment plans"(Mclnroy, 2005, p.272).

Therefore, the basic ethical principles of a patient's autonomy, beneficence, nonmaleficence, and justice ultimately outweigh the principles of beneficence and nonmaleficence expected of a health care provider.

Ethical Principles surrounding Blood Transfusion

Ethical principles in health care guides and assist health care providers to respect patient beliefs, morals, dignity, and wishes while delivering quality health care. Autonomy is the freedom or right to determine one's action. "The actions are determined by a person's independent stance and ability to think" (Morrison, 2011). Health care providers must respect patient wishes from refusing treatment that against their beliefs or values. "It is unethical to precede any blood transfusion without consent, information and respecting patient's rights" (Grainger, 1997).

Within the legal and ethical framework involved for blood transfusion, informed consent is needed and must be granted in order to proceed. The patient's wishes, not to be treated with blood transfusion needs to be respected irrespective of the consequences of mortality or morbidity. The ethical



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