Public Services Ethical Analysis
Ethical considerations in Public Services provision.
This assignment will examine in depth into the moral and also ethical issues which are within the Public Services it will also show the need in which we need to be able to appreciate the ethical standards and also the professional codes of conduct within the Public Services. It will also show different elements of their own integrity, accountability and the ethical conduct within the public sector organisations. The term ethics is defined as a set of moral principles that govern an individual’s behaviour, this essay is going to investigate the implications ethical considerations impacts upon the NHS. Ethics effects on how people make decisions and lead their own lives. Ethics is concerned …show more content…
in the way in which is good from individuals and also the society.
These can be implemented into how the NHS and the Ambulance service in particular use ethical considerations. As the role of a paramedic often has a high demand for rapid decision making. They need to be able to make an on the spot decision when caring for a patient. This however can be argued as being that any ethical considerations are then put aside for that of the clinical decisions which need to be made, made. Within the ambulance service there is a broad clear guidelines which they need to adhere to and follow, but this is very rarely considered when making ethical decision making processes which can accompany them.
“Staff have a duty of care to the patients and clients utilising services as well as to other staff. Staff must ensure that, as far as practicable, the best interests of patients and clients are maintained in decision-making and when undertaking duties within the Ambulance Service, having regard to the duty of care the Ambulance Service has to staff as well as patients and clients.” (Ambulance service of New South Wales, 2007) The difficulty with these type of ethical dilemmas which from the perspective of the ambulance staff becomes that which tend to be focused on situations which occur in a non-emergency environment, which therefore can make this to be views as not relevant to the paramedic services. Although, paramedics job roles are ever expanding which now have to include alternative treatment pathways, where they try to use alternative routes to refer patients to other areas other than the emergency department. Ethical decision making should be more considered as a must for paramedics who now deal with the front of line out of hospital rather than the pre- hospital care.
“The principles of ethics proposed by Beauchamp and Childress (2001) are a good starting point for the paramedic. Their four principles approach provides paramedics with the basic tools to enable them to consider ethics in their practice” (Vince Clarke)
‘These four principles approach to ethics are:-
1. Respect for autonomy – Self Rule.
Autonomy is a principle which allows an individual to have control over their own being.
2. Nonmaleficence – Do no harm.
This is a principle which advocates not causing any undue harm to a patient.
3. Benefience – Do good.
This is a principle which also advocates maximizing benefits to minimizing harm to any patients.
4. Justice – What is right.
The justice principle is there to look at what is right and also what is fair within any given situation.’ (Vince Clarke)
By giving paramedics these four principles it can help them then to be able up weigh up their decision and also ensure that they are in the best interests to the patient which they are caring for, whilst also having the paramedic being ethically sound. This is because each of the four principles which they have been given all related to that of the patients within their care. The first principle respect for autonomy, means that any decision which any patient makes about their own care and also treatment must be respected. Nonmaleficence, Takes into consideration the direct physical harm which patients may receive such as having a cannula inserted. Or when leaving a patient who is unwell or within a vulnerable state of mind at home, when the need hospital care will cause more harm to that patient rather than good. “The negative impact of any harm must be balanced against the potential benefit achieved.” (Vince Clarke) Beneficence, this underlines all of the actions which is carried out by paramedics, it can been deemed as being said as what is in the best interests of the patient. Although this can become under scrutiny, as everyone has a different opinion which can be related to that of a patient who needs care, but does not see the same as a paramedic would deem to be within their best interests. Within these type of cases however it will conflict between all of the beneficence, nonmaleficence and that of autonomy. And the last principle is that of justice, patients who have mental health problems have the exact same right to any treatment to those who do not have mental health problems. Although when looking at a paramedic’s perspective, situations where availability of their own resources and the time which they are able to spend on the scene with a patient can vary, which then can lean it to be considered when looking into the justice.
Within recent findings, service users have said that they feel publicly funded services should be looked at more closely and scrutinised more than what they are.
The public have also spoken out saying that they want responsibility for any malpractice and also misconduct when it is used and identified, to be address quickly and more effectively. “An estimated third of all public spending on services is now delivered by third party providers such as private companies, social enterprises and charities – from hospitals and ambulance services to libraries and social housing. Often the public do not make a distinction. In many cases, they do not have a choice.” (Bew, 2014) The cost of failure within the NHS is momentous. Last year was scandals regarding staff altering their performance data, and also the fraudulent actions of individuals who recruited for government funded employment and also training schemes which were in place, with these type of scandals this threw away the importance of ethical behaviour within the public services as a whole into a much wider focus.
“Our new report argues that ethical considerations need to be built in to the commissioning process.” (Bew, 2014) This won’t mean that there will be new procurement paperwork needed, however it will put into place the most important principles are then set down as a very clear expectation in contracts. Although this doesn’t happen as often as would be liked as commissioners and also providers report that they are aware …show more content…
of the ethical issues which are there, but they are rarely made explicit within procurement and also that of the contracting process.
Within Great Ormond Street Hospital the frequency of ethical dilemmas which they face is very common. Because of this they have established a clinical ethics service to help ensure that the patients within their care feel that they are being supported and also prepared to make decisions which they need to daily.
“Concerns about the frequency with which ethical dilemmas arise and the lack of an organised structure to provide analysis, support and training for those involved led to the establishment of a Working Party in 1995 to consider how these needs might be met.” (Great Ormond Street Hospital for Children , n.d.) This clinical ethic service serves an aim which is to create a culture within the hospital where each ethical issue which staff, families, and also the patients themselves face can be discussed openly and freely and be dealt with as swiftly as they possibly can.
This group is faced with new ethical dilemmas everyday whether that be regarding the treatment which patients decide to have or those which relate to the withdrawing of life saving care.
However this group which has been set up aim to help navigate with the increasingly complex and complicated areas which are being provided by a service, they do this by being able to support staff, parents, families, and also patients with dealing with the very delicate ethical aspects of their own
decisions.
The National Association for Healthcare Quality, have documents which are intended to help assist healthcare professionals in a professional manner and efforts to help improve the healthcare for every service user which uses them. “Healthcare Quality Professionals promote the dignity of the profession and are committed to practicing the profession with honesty, integrity, and accountability, respecting all laws and refusing to participate in or conceal any unethical, false, fraudulent, or deceptive activity.” (NAHQ, n.d.)
There primary concern and also commitment is to the health, wellbeing and also the safety of the patient’s which uses the service. When this is applicable they must always take appropriate actions which have to abide by the organisations policy when regarding any instant where incompetent, unethical, illegal or have impaired the practice, they need to be able to work to :-
- Practice the profession with honesty, integrity and also be able to be accountable.
- They need to maintain the level of competency which has been outlined within the standards of practice for healthcare quality professionals.
- They also need to support the standards pf practice for healthcare quality professionals.
These are to just name a few which they need to be able to abide by. Within the Ambulance service they are expected to be able to know and also recognise their own scope for their own practice. Within particular they are expected to know when they need to defer to someone who has the skill level/experience and also competency to be able to manage the patient who has that experience a lot better. Registered paramedics are also reminded of their own responsibilities which has been expressed under the new standards of conduct performance and ethics or SCPE, which is issued by the health and care professions council or it can be formerly known as HCPE.
“Primacy of care and standard of care is primarily dealt with by Standard 1 of the SCPE – You must act in the best interests of service users.” (London Ambulance Service NHS; London Ambulance Service NHS) Staff which are aspiring to be registered paramedics are reminded of the guidance which is issues by the HCPC within their publications guidance on conduct and ethics for students. The primacy of care and also the standard of care which is primarily dealt with this guidance. “You are responsible for the appropriateness of your decision to delegate a task. You must be able to justify your decisions if asked to.” (London Ambulance Service NHS )
To conclude, within each of the different roles within the NHS they all have a very different sent of ethical codes. Paramedics will have a set of ethical codes which are drastically different to that of a doctor who is working within Great Ormond Street hospital. Although they both need to know that a patient’s care and their decisions should be within the forefront of any decision which is made, with the best wishes of that of the patients considered. However when dealing with children, this can become blurred, as parents, paramedics and doctors will all have a different set of opinions and also ethical codes. However there is a large amount of policies which are set into place to make sure that every healthcare worker adheres to.
This assignment will examine in depth into the moral and also ethical issues which are within the Public Services it will also show the need in which we need to be able to appreciate the ethical standards and also the professional codes of conduct within the Public Services. It will also show different elements of their own integrity, accountability and the ethical conduct within the public sector organisations. The term ethics is defined as a set of moral principles that govern an individual’s behaviour, this essay is going to investigate the implications ethical considerations impacts upon the NHS. Ethics effects on how people make decisions and lead their own lives. Ethics is concerned …show more content…
in the way in which is good from individuals and also the society.
These can be implemented into how the NHS and the Ambulance service in particular use ethical considerations. As the role of a paramedic often has a high demand for rapid decision making. They need to be able to make an on the spot decision when caring for a patient. This however can be argued as being that any ethical considerations are then put aside for that of the clinical decisions which need to be made, made. Within the ambulance service there is a broad clear guidelines which they need to adhere to and follow, but this is very rarely considered when making ethical decision making processes which can accompany them.
“Staff have a duty of care to the patients and clients utilising services as well as to other staff. Staff must ensure that, as far as practicable, the best interests of patients and clients are maintained in decision-making and when undertaking duties within the Ambulance Service, having regard to the duty of care the Ambulance Service has to staff as well as patients and clients.” (Ambulance service of New South Wales, 2007) The difficulty with these type of ethical dilemmas which from the perspective of the ambulance staff becomes that which tend to be focused on situations which occur in a non-emergency environment, which therefore can make this to be views as not relevant to the paramedic services. Although, paramedics job roles are ever expanding which now have to include alternative treatment pathways, where they try to use alternative routes to refer patients to other areas other than the emergency department. Ethical decision making should be more considered as a must for paramedics who now deal with the front of line out of hospital rather than the pre- hospital care.
“The principles of ethics proposed by Beauchamp and Childress (2001) are a good starting point for the paramedic. Their four principles approach provides paramedics with the basic tools to enable them to consider ethics in their practice” (Vince Clarke)
‘These four principles approach to ethics are:-
1. Respect for autonomy – Self Rule.
Autonomy is a principle which allows an individual to have control over their own being.
2. Nonmaleficence – Do no harm.
This is a principle which advocates not causing any undue harm to a patient.
3. Benefience – Do good.
This is a principle which also advocates maximizing benefits to minimizing harm to any patients.
4. Justice – What is right.
The justice principle is there to look at what is right and also what is fair within any given situation.’ (Vince Clarke)
By giving paramedics these four principles it can help them then to be able up weigh up their decision and also ensure that they are in the best interests to the patient which they are caring for, whilst also having the paramedic being ethically sound. This is because each of the four principles which they have been given all related to that of the patients within their care. The first principle respect for autonomy, means that any decision which any patient makes about their own care and also treatment must be respected. Nonmaleficence, Takes into consideration the direct physical harm which patients may receive such as having a cannula inserted. Or when leaving a patient who is unwell or within a vulnerable state of mind at home, when the need hospital care will cause more harm to that patient rather than good. “The negative impact of any harm must be balanced against the potential benefit achieved.” (Vince Clarke) Beneficence, this underlines all of the actions which is carried out by paramedics, it can been deemed as being said as what is in the best interests of the patient. Although this can become under scrutiny, as everyone has a different opinion which can be related to that of a patient who needs care, but does not see the same as a paramedic would deem to be within their best interests. Within these type of cases however it will conflict between all of the beneficence, nonmaleficence and that of autonomy. And the last principle is that of justice, patients who have mental health problems have the exact same right to any treatment to those who do not have mental health problems. Although when looking at a paramedic’s perspective, situations where availability of their own resources and the time which they are able to spend on the scene with a patient can vary, which then can lean it to be considered when looking into the justice.
Within recent findings, service users have said that they feel publicly funded services should be looked at more closely and scrutinised more than what they are.
The public have also spoken out saying that they want responsibility for any malpractice and also misconduct when it is used and identified, to be address quickly and more effectively. “An estimated third of all public spending on services is now delivered by third party providers such as private companies, social enterprises and charities – from hospitals and ambulance services to libraries and social housing. Often the public do not make a distinction. In many cases, they do not have a choice.” (Bew, 2014) The cost of failure within the NHS is momentous. Last year was scandals regarding staff altering their performance data, and also the fraudulent actions of individuals who recruited for government funded employment and also training schemes which were in place, with these type of scandals this threw away the importance of ethical behaviour within the public services as a whole into a much wider focus.
“Our new report argues that ethical considerations need to be built in to the commissioning process.” (Bew, 2014) This won’t mean that there will be new procurement paperwork needed, however it will put into place the most important principles are then set down as a very clear expectation in contracts. Although this doesn’t happen as often as would be liked as commissioners and also providers report that they are aware …show more content…
of the ethical issues which are there, but they are rarely made explicit within procurement and also that of the contracting process.
Within Great Ormond Street Hospital the frequency of ethical dilemmas which they face is very common. Because of this they have established a clinical ethics service to help ensure that the patients within their care feel that they are being supported and also prepared to make decisions which they need to daily.
“Concerns about the frequency with which ethical dilemmas arise and the lack of an organised structure to provide analysis, support and training for those involved led to the establishment of a Working Party in 1995 to consider how these needs might be met.” (Great Ormond Street Hospital for Children , n.d.) This clinical ethic service serves an aim which is to create a culture within the hospital where each ethical issue which staff, families, and also the patients themselves face can be discussed openly and freely and be dealt with as swiftly as they possibly can.
This group is faced with new ethical dilemmas everyday whether that be regarding the treatment which patients decide to have or those which relate to the withdrawing of life saving care.
However this group which has been set up aim to help navigate with the increasingly complex and complicated areas which are being provided by a service, they do this by being able to support staff, parents, families, and also patients with dealing with the very delicate ethical aspects of their own
decisions.
The National Association for Healthcare Quality, have documents which are intended to help assist healthcare professionals in a professional manner and efforts to help improve the healthcare for every service user which uses them. “Healthcare Quality Professionals promote the dignity of the profession and are committed to practicing the profession with honesty, integrity, and accountability, respecting all laws and refusing to participate in or conceal any unethical, false, fraudulent, or deceptive activity.” (NAHQ, n.d.)
There primary concern and also commitment is to the health, wellbeing and also the safety of the patient’s which uses the service. When this is applicable they must always take appropriate actions which have to abide by the organisations policy when regarding any instant where incompetent, unethical, illegal or have impaired the practice, they need to be able to work to :-
- Practice the profession with honesty, integrity and also be able to be accountable.
- They need to maintain the level of competency which has been outlined within the standards of practice for healthcare quality professionals.
- They also need to support the standards pf practice for healthcare quality professionals.
These are to just name a few which they need to be able to abide by. Within the Ambulance service they are expected to be able to know and also recognise their own scope for their own practice. Within particular they are expected to know when they need to defer to someone who has the skill level/experience and also competency to be able to manage the patient who has that experience a lot better. Registered paramedics are also reminded of their own responsibilities which has been expressed under the new standards of conduct performance and ethics or SCPE, which is issued by the health and care professions council or it can be formerly known as HCPE.
“Primacy of care and standard of care is primarily dealt with by Standard 1 of the SCPE – You must act in the best interests of service users.” (London Ambulance Service NHS; London Ambulance Service NHS) Staff which are aspiring to be registered paramedics are reminded of the guidance which is issues by the HCPC within their publications guidance on conduct and ethics for students. The primacy of care and also the standard of care which is primarily dealt with this guidance. “You are responsible for the appropriateness of your decision to delegate a task. You must be able to justify your decisions if asked to.” (London Ambulance Service NHS )
To conclude, within each of the different roles within the NHS they all have a very different sent of ethical codes. Paramedics will have a set of ethical codes which are drastically different to that of a doctor who is working within Great Ormond Street hospital. Although they both need to know that a patient’s care and their decisions should be within the forefront of any decision which is made, with the best wishes of that of the patients considered. However when dealing with children, this can become blurred, as parents, paramedics and doctors will all have a different set of opinions and also ethical codes. However there is a large amount of policies which are set into place to make sure that every healthcare worker adheres to.