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Contents
1. Introduction:.................................................................................................................................... 3
2. Literature review: ............................................................................................................................ 3
3. Analysis: ......................................................................................................................................... 4
4. Discussion: ...................................................................................................................................... 5
5. Conclusion ...................................................................................................................................... 6
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A 70 years old male with the psychosis and COPD was having chest pain and chest tightness. The
health care professional was called for the treatment and then he was given first aid at home. The
HCP (health care professional) asked for hospitalization but the client’s family was not agreed and
they were not willing to take him to hospital.
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Bioethics and health care:

1. Introduction:
Ethical values are being described by the World Health Organization (WHO). According
to WHO (2010), “Ethical values refer to the way we ought to live our lives, including our
actions, intentions, and our habitual behavior. They can sometimes be the source of
disagreement and conflict”. Whereas, the human rights are explained by WHO as, “Human
rights are legal guarantees that protect individuals and groups against actions that interfere
with fundamental freedoms and human dignity” (p.5).These affect the patient and families by
destroying the autonomy, the rights of beneficence, autonomy, justice and maleficence. The
main issue which will be discussed in this piece of writing is the informed consents and its
use in health care. The aim of this writing is to show a relationship between the bio ethical
issues and how these are affecting the health care set ups. Moreover, this paper tries to focus
on all the 4 components of bioethics.
Informed consent is a paper which is signed by the person or patient who is being treated
or involved in research process. Informed consent shows that patients are aware about the
whole process and they know about their rights (beneficence, autonomy, justice and
maleficence). These principles are violated most of the time. In research, people or involved
patients are not given all the mentioned rights.

2. Literature review:
The concept of informed consent is becoming widespread around the world after
patient’s bill of rights (Kunac & Mosenthal, 2013). According to the Global Network of
WHO Collaborating Centers for Bioethics, & World Health Organization, (2015), health
ethics are very much involved and focused in the health care settings and community and
public health (p.10). Lachman, (2012) describes bioethics as, “Bioethics was understood to be
‘an area of interdisciplinary studies whose focus depends on the kinds of issues it examines
and the nature of ethical inquiry”. Furthermore, it also elucidated that bioethics doesn’t
include ethical issues but also social issues and animal plant life issues on which the
researches are being conducted (p. 66). Williamson (2014) explains, the efforts are being
made to involve the patients and families in citizens and decision making, in the field of
health care in hospital and public health (p.4).
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Alma Ata declaration tells that people have rights and duty to participate as individual
or in collective form for planning and implementation of their health care (WHO,
1978).Lachman (2012) strongly explains the care giving process in the light of ethics. There
are 4 phase; care about, taking care of, care giving and care receiving. Moreover, 4 elements
of care are also explained under the light of bioethics in health care; attentiveness,
responsibility, competence and response of the care receiver (p. 113).
Breslin, MacRae, Bell, & Singer (2005) explore that the clinical bioethics are working
in wide range in health care setups for adults, pediatrics, long term care and rehabilitation
center as well as in mental health departments. Furthermore, it has been explained with
research that there is a huge gap in informed consents in theory and informed consents in
practical life in health care systems and community hospital (p.4). In another literature the
factors which hinder the process of taking informed consents are explained. According to
Mamotte, Wassenaar, Koen, &Essack, poor health delivery system, poor community and
poverty, misconceptions and illiteracy are the main hurdles that hinders the process of
gaining true informed consents for surgical and medical procedures (2010, p. 2).
Hall, Prochazka& Fink, (2012) explains the importance of informed consents (IC) in the
medical field. It has become primary paradigm that helps the patients to protect their legal
rights. Moreover, it gives guidance to the practitioners in an ethical way (p.533).Leclercq,
Keulers, Scheltinga, Spauwen, & Van der Wilt (2010) had defined the informed
consents(IC) as a process that needs a competent doctor and it takes place when information
is transferred from doctor to the patients and families. According the author IC is not just
getting a sign on the peace of the paper (p.1406).Thus, the informed consents are the primary
hallmark that gives a chance to the patients and families as well as the health care providers.

3. Analysis:

Bioethical issues are affecting the health care professionals and health care settings in
different way. Heiskell (2010) has defined the principals of ethics which should be followed
in the health care settings. These principals are; patient’s autonomy (autonomy is self-
governance, it is often reduced in health care facilities due to number of conflicts and
problems), Beneficence (helping and contributing to the welfare of the patient),
Nonmaleficence (this is the right not to harm the others), Justice (fairness or equal
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distribution of good and bad, that is important in quality of healthcare) (p.5). These all
principles are necessary for health care providers to follow.
In a research which was conducted at national level by a health care professional all
the rules and principals of ethics were violated. Firstly, when we talk about the Beneficence,
it means prevention of harm and removing the conditions that will harm the others
(Occupational Therapy Code of Ethics, 2015). However, this right was violated and
medications were used or trials. Even the health status of the patient is known by the
researchers. Secondly, Nonmaleficence means the people should be kept away from the harm
even the patient is good by health and all the practices should be done under the care
(Kunac&Mosenthal, 2013). On the other hand, this right is also violated in research process,
medicines are tested but proper precautions that will prevent from the harms are not taken.
Thirdly, the autonomy of the patient is also violated in different ways. According to
Occupational Therapy Code of Ethics (2015) patient have rights of thought, intention and
actions and will when they make decisions (p.376). Contrary to this, autonomy of the patient
is also violated. Patients are paid for taking part in the research and they are not allowed to
leave by their own will. Fourthly, the justice is referred as the respect of the people’s right
more than the law (Punjani, Bhanji, Megani, & Shah, 2014). On the other hand, the respect
and justice is not given to the patients.

4. Discussion:
Hall, Prochazka& Fink, (2012) give information about the factors that affect the
physicians in taking informed consents. These factors include; patient’s comprehension
(patient know a little and remember about the information given to the patient), patient’s use
of disclosed information (patient may disclose the information given to him/her by the
physician to others, patient’s autonomy (patient think about their autonomy; when they were
asked about the most interesting thing about the informed consents they focused more on
building the trust and less on decision making) and
lastly the demands on providers ( a thorough informed
consent process is not easy and it takes time from the
busy schedule from clinical side) (p.534).
(Figure 1: Venn diagram showing the multiple
overlapping purposes of informed consent)
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Guinand, Gapany, Simon, Wasserfallen& Joseph (2015) gave information that in 20th
century During the 20th century, the issue of patient involvement in treatment and care and decision
process has become gradually become important and necessary in adults and pediatrics. It is
also important that the patients and families in hospitals and people in community should be
informed about the diagnosis, prognosis, advantages and disadvantages, all the possible
alternative treatments.
Furthermore, possible treatment, intra operative risks and postoperative risks should be
informed to the patient prior to surgery (Pp.1-2). From the above mentioned data it is clear
that the physicians and health care providers must involve the patients and families in clinical
decision making and treatment process. There are a number of ethical issues which are
involved in the health care systems and these are related to the health care providers as
well.Williamson (2014) explains ethical issues as theethical issues are vital in the progress
and development of healthy behaviors, practices (clinical, community based) and the policies
that help in the promotion and health sustain (p.4).

5. Conclusion
In nut shell, it can be said that more and more work is needed in this field to
ensure patient safety and treatment process. Moreover, faithful efforts are needed to make the
patient and family partnership in treatment process. Those should be involved in decision
making process and this should be done to the extent to which they are able to involve. When
the patients and families are involved in the care then it is termed as participation. Bioethics
is also named as applied ethics. These have the same rules and values that we used to apply in
ordinary circumstances. In today’s medical and health care field, a lot of issues are being
faced by the physician, nurses and other health care providers indeed. More studies and work
is needed to meet the health care needs and finding the ways to meet the quality care in health
care settings.

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