p.p1 We live in a society where patients

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         CRITICALLY EVALUATE MEDICAL ETHICS AND LEGAL ISSUES 

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As a means of realisation, there are over 125 million admitted as patients or outpatient also including accident and emergencies stated by the Hospital Episode Statistic(content.digital.nhs.uk/hes); figures highlighted provide an estimation of how many admissions are submitted for urgent care either it being children or adults. We live in a society where patients can potentially take action towards the healthcare profession if they believe that the outcomes of any sort of surgery or decisions aren’t acceptable. This emphasises why medical ethics and legal issues are important and why it’s portrayed in the National Health Service (NHS). It is vital for healthcare professionals to understand the means of law and medical ethics as it can prevent issues from developing.  Law and ethics can be easily differentiated where a law is a rule which a community recognises and follows but it could also be enforced by the imposition of penalties.  On the other hand, moral principles that govern a person’s behaviour is known as medical ethics. These are crucial concepts, as the NHS build a foundation and function accordingly to the UK’s National Health Service Law, providing adequate care for patients.  
 
 
Further insight into medical ethics, can help us perceive the different perceptive which include: taking into account how medical ethics can affect healthcare practitioners respective position but also effects patients. In particular, the advanced use of technology would engage patients into knowing the surgeries they will be undergoing and the possible outcomes. Following this, patients would be well aware of the treatment they are receiving and questioning the fact if the treatment given is beneficial.  As a matter of fact, costs of healthcare delivery have been indicated as a problem. For instance, questions have been raised where people are wanting to have access to scarce medical commodities i.e. transplant organs. Published reports such as “Rising costs of negligence who pays the price,” the medical protection society are wanting to meet the expected future costs of claims and this can be done by collecting efficient subscription income. Medical protection society (MPs) are an association consisting doctors, dentists and other healthcare professionals deeply concerned about the increase of clinical negligence for multiple reasons. First and foremost, there has been an issue where the NHS has suffered from a shortage of staff and positions are remaining unfilled. This has been becoming a worry as this may potentially exacerbate in the future. But most significantly, the NHS is facing financial problems which makes it difficult to make decisions when it comes to resources that are needed; the NHS needs to focus on the compensation that is being spent. The rise in concern for clinical negligence which is approximately 79% shows that if it stays at this rate, this will threaten the sustainability of the NHS. Instead, MPs have come up with prevention strategies which may tackle this issue, which involve the following: increasing the focus on education producing greater awareness in both primary and secondary care. In addition, there has to be a set expectation within the service, followed by healthcare professionals and patients in order to understand the modern services that are provided.  
 
 
Having explored why medical ethics is fundamental in the healthcare profession, the next point to consider is abortion which is seen as a legal issue. As a fact, abortion is known as one of the most sensitive topics under the Abortion Act in 1967. In England, abortion is legal up to 24 weeks. Nonetheless, if the women are at risk or have any sort of foetal abnormalities the abortion act can be simply ignored. People generally have 2 sided views on abortion with an explanation why abortion should or shouldn’t be allowed. Those in support of abortion believe that nothing is more important than the women body. In fact, ‘women’s choice’ is highly respected regardless in what circumstances they are in, hence her opinion matters. In support of this, the foetus in the mother’s womb has limited rights either way due to the fact the person already born is a priority.  Turning to the other side of the argument, abortion is seen as murder and it is morally wrong thus seen as involuntary euthanasia. Such views are based on religion. An example of this is, Christians believe that life is sacred and Orthodox Church forbids abortion, supporting the quote “Thou shalt not kill”.(Spuc.org.uk, 2017) On the contrary, some acknowledge that it is acceptable to abort the child in cases where the women weren’t responsible for example being rape.  
 
 
Correspondingly, Euthanasia which is the act of ending an individual’s life in a way that is relatively painless. According to religion, ending someone’s life is seen as murder even if the intention is to ease the pain. In most countries, like Spain, Euthanasia is known to be illegal along with assisted suicide as it destroys many lives. Euthanasia goes against the Hippocratic Oath which is an oath taken to observe ethical principles within medicine by physicians.  There are different types of Euthanasia that differ from one another. Active euthanasia occurs when a person does something deliberately causing a patient to die. For instance, an overdose of painkillers.  Having looked at Active euthanasia, it is reasonable to look at Passive Euthanasia. This occurs when you let the patient die. A prime example would be a patient needing a kidney dialysis but the doctors switch the dialysis machine off and eventually, the patient would die. (bbc.co.uk. 2017) There are supporting case studies which explain euthanasia. The most famous case study being, Diane Pretty who had motor neurone disease where she lost the battle as permission wasn’t given for assisted suicide with the help of her husband.  Next case study is where a woman named Terri Schiavo who had collapsed at home with full cardiac arrest. She suffered brain damage and lacked oxygen and after a period of time. She asked her husband to remove her feeding tube and after a month she had passed away. (Caplan A 2017) 
 
 
There are 2 sides to the argument, however in one’s opinion, no law or ethical view effects an individual in making a choice, as a terminally ill have the ‘right to die’ with dignity. Although, Euthanasia shouldn’t be used as an alternative to palliative care. Moving on, the concept of Euthanasia fairly looks at Kant and his categorical imperatives. He stated, “Religion and morality don’t pair together.” This explains that whether we do something or not it isn’t a moral choice but instead it is just constituent on our desires. Therefore, this raises many questions in terms of if a terminally ill patient should be allowed to die and should medical profession help those patients to die?  
 
 
Anthropologists have come to a conclusion on Euthanasia where they state that social and cultural expectation along with bioethics plays an important role in Euthanasia. The concept of moral individualism and free will according to Merry, the discourse has dominated in anthropological analysis of assisted death. Anthropological questions such as “what is the meaning of human life, what determines the worth of human being?” are fundamental aspects of such topics such as Euthanasia. Such questions impact medical professionals because they are the ones who make the choices (Strinic, V. 2015). As a result, due to any sort of refusal to assist Euthanasia, no person or hospital is held liable. In turn, there are a few cases where if a patient is brain dead no further treatment is required and the court can adjudicate the hospital.  In some circumstances, a proxy is permitted to take a decision on behalf of the patient if the patient is unable to communicate. This means that any decisions made have to be made in the same way the terminally ill patient would have made if they were able to communicate. In the same way, if the terminally ill patient is unconscious, and in a state, that is life-threatening, Euthanasia could take place if a declaration has been requested in advance and has been discussed with the medical team and close members of the family; signed by the terminally ill patient. On the other hand, if a terminally ill patient is conscious but in their last stages, Euthanasia can take place if the decision has been taken solely by their own choice excluding pressure from other people. But the patient gets to know the alternative options to their illness by their physician, this being a therapeutic treatment or palliative care can be available for them.  
 
 
In conclusion, the responsibilities of all medical practitioners remain constant for instance being able to promote health, act in the best interests of the patient, prevent illness, remove suffering, and extend services that exceed the expectation of the patients and their families. Within medicine, there will be different opinions, theories and views when it comes to dilemmas however it is that important that any actions taken are informed and evaluates the situation which brings out good outcomes, which is why it’s vital that medical guidelines are followed.

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