Course:DHYG400/Assignment 2 Dr. Laronde’s group (Ethical Issues in Work and Life)

DHYG 400/ assignment 2 Dr. Laronde’s group (Ethical Issues in Work and Life)

Arielle

Police Officer Interview: I interviewed a police officer that has been with the RCMP for 27 years. Many ethical dilemmas arise in law enforcement and it can be very challenging to determine what is morally right. Police corruption is an ethical area that has been most focused on (Donahue and Felts, 1993). Police misconduct has undoubtedly always been an problem, but it’s the magnitude and variability of the police deviance that is the main issue (Donahue and Felts, 1993). All of these examples put police officers in difficult positions and must make decisions based on what is morally right. These situations did not occur with the police officer I interviewed, but have occurred and continue to occur in this line of work many places. Bribery/Police Corruption: For example, let’s say a police officer handed out a speeding ticket or arrested someone for a certain crime. This person might try to pay-off the officer with a large amount of money to get out of being prosecuted. Here, the officer is faced with doing what is morally right (not accepting the money and give the ticket) and what he/she might be tempted to do (accept the money and discard the ticket). Abuse of power: For example, A police officer could be off-duty waiting in line at a club with his buddies. He could show his badge to the bouncer to skip the line. Use of excessive force: A police officer may use more force than necessary in a “dangerous” situation. For example, the taser incident of Robert Dziekański involved RCMP officers using excessive force with taser guns when it wasn’t exactly necessary. Conflict of interest: For example, a police officer’s best friend might be involved in a crime and may face prosecution, and may feel the need to let him off. Contraindications to professional standards: a rookie police officer’s senior partner is drinking on the job because he is an alcoholic. The rookie has to decide to tell someone to ensure the safety of him and the public or he can remain quiet and earn trust and respect from the other officer. As with any job, there are numerous parallels one can make between the ethics involved in policing and the ethical issues that arise in dental hygiene. Like in dental hygiene, police organizations have a code of ethics. For example, the RCMP’s ethical standards are based on core values including integrity, honesty, professionalism, compassion, respect and accountability. Whatever ethical dilemma it may be (in the police sector or in dental hygiene), these standards can be applied to ensure the best safety and care of the public.

Donahue ME, Felts AA. Police ethics: a critical perspective. Journal of Criminal Justice. 1993; 21: 339-52. http://www.rcmp-grc.gc.ca/eth/broch-eng.htm

Noemi

Anna

Family Doctor interview: This interview was conducted with a family doctor who practices in Richmond. As a health care professional, one would be confronted with various ethical issues. The family doctor I interviewed was not faced with any ethical issue however he shares issues that are currently present. He mentions that some of the doctors he knows of prescribe unnecessary medications when patients demands for them. Some doctors also prescribe and counsel the patient to take only a particular brand of drugs. As a result, the doctor would then receive benefits such as gifts or , in some cases, money from the drug company. Through further research,the money the doctor receives is referred as “consulting fee” ( Campbell E.G 2007). This violates the guideline set by the General Medical Council where it states “3. You should only prescribe drugs to meet identified needs of patients and never for your own convenience or simply because patients demand them. ” The person I interviewed did however encounter a ethical issue which I did not think was directly related to his practice at first. There was a friend and also patient of his who has been seeing him for less than two years. During one their appointments, the patient asked this family doctor to be his guarantor for the Canadian passport application. However, he declined because he had known the patient for less than two years and he felt it was wrong to be a false witness . Through researching, I found that it was also apart of a doctor’s practice guideline to “make sure that any documents you write or sign are not false or misleading. “

Campbell E.G. Doctors and Drug Companies — Scrutinizing Influential Relationships. N Engl J Med, 2007; 357, 1796-7. Wazana A. Physicians and the Pharmaceutical Industry—Is a Gift Ever Just a Gift? JAMA, 2000; 283, 373-80.

Sharon In any profession, a healthcare career is commonly confronted with various ethical issues. Nurses also come across many common ethical dilemmas that they will face throughout their career. The person I interviewed was a pediatric nurse working at the Children’s Hospital. She has worked there for several years and within that time-frame, has come across many situations where she has had to exercise her ethical reasoning. The situation was that the child came in very sick with a condition, and after having diagnosed it, the parents were give several options as to what treatment they would like to choose. However the parents, who were inclined towards alternative modes of healing (eg. prayer circles, amulets etc) instead wanted to try their own methods of treatment through these means. Here, the nurse is presented with an ethical dilemma. After having done research on these alternative methods and finding no evidence based literature on these being successful; the nurse has to decide if the parents feel so strongly about these ways of healing, does she respect their decision? Or does she attempt to get authorities involved. If she does nothing, the child is not being treated and his condition will continue to worsen. If she tries to force her choice of treatment on the parents, she risks them possibly taking the child away from the care of the hospital and bringing him somewhere else. Ultimately, the nurse resolved the dilemma by trying to reason with the parents, patiently explaining the available treatment options the hospital staff are able to provide and literature that revealed the success rates of these methods. It is important for a nurse to understand the emotions and thoughts of their patients, developing the quality of empathy. This will help the nurse to be more tactful when dealing with sensitive ethical issues and incline the patients to be more receptive to listen. The article that related to this research also stated that conflicts between the guardian and nurse are common and dealing with these issues require understanding and the tactful persuasion on the nurse’s part in convincing the parents that the treatment offered is in fact in the child’s best interest.

Redman BK, Fry ST. Nurses’ ethical conflicts: What is really know about them?. Nursing Ethics. 2000; 7(4): 360-6.

Jaclyn In any healthcare profession there are always going to be ethical issues that arise. Like dental hygienists, pharmacists also have to face ethical dilemmas with their clients. The person I interviewed was a Pharmacist at a local drug store. She has worked there for 25 years and although there might not be big ethical issues, there are some that come along. There are many times when a client comes in asking to refill a prescription without a doctors note but in order to fill it, they must call the physician first or the client must go back to the doctor to get it renewed. No matter how much the client may need the prescription or want it, there is protocol to be followed. Another situation that often occurs is alcoholics come in wanting to buy Listerine. Although it is great to make the sale for the store, it is unethical to allow them to purchase the item. The situation that happened to the pharmacist I interviewed was a 16 year old girl came into the pharmacy for Plan B and some information. The next day the girl’s mother came in and asked the Pharmacist about her daughter’s information and what had happened the day before. Although her daughter is only 16 and still a minor, there is still a confidentially clause that the pharmacist must abide by. There are strict rules for client confidentially and even though the mother is her legal guardian that information cannot be given out and is between the pharmacist and the client. There have been a lot of ethical issues with this because some pharmacists don’t treat clients the same depending on what age they are. They look at a 16 year old as a kid and will give away personal information to other people. It is important for pharmacists to understand the emotions and thoughts of their clients so that they can develop a trusting relationship. Most of the people that come into the pharmacy have been there for many years also and are returning clients. By remaining respectful, professional and fair it helps the client trust the pharmacist and when giving information to clients they will be more likely to listen.

>Reem ESL teacher interview: This interview was conducted with an adult ESL teacher that works with people older than 18 who want to learn English. She teaches level one ESL which includes very basic vocabulary and concepts. She did mention being faced with little ethical issues and dilemmas frequently.The first challenging issue comes to her mind is the language barrier these people face and how hard it is for them to communicate with her and each other when a common language does not exist. These people find it hard to express themselves and present their ideas to the class. It is, therefore, a challenge for them to work in groups and collaborate with each other which also makes it hard for her to be understood. Also, these new immigrants have different beliefs, values, and attitudes that might different than hers. Some behaviours might be acceptable and sound normal in their culture but may not be accepted in hers and vice versa. This means right and wrong have different meanings to these individuals and that needs to be respected by the teacher and other classmates. Further, another issue that has caught her attention is the importance of time to different people. In some cultures, time is worth a lot and people manage their time effectively which means using a planner to mark down appointments, being on time, and assigning a specific time period for tasks such as using time lines. To others, time may not mean the same. They maybe late in attending class and appointments, coming back to class from coffee breaks ( which means disturbing the class after it had started) and handing in their homework. This usually puts her in a tough spot since she wants to tell them about the importance of being on time but in some cultures it is considered rude to speak to an elderly person about that kind of issue especially since the teacher is younger. Does she tell them or leave it as it is to prevent an ethical dilemma? Another issue that rises sometimes in her class is some people may say something racist unintentionally which may not be insulting in their own culture but is unacceptable in our society; this is when she needs to step in and explain it to them to help the adapt to what is/isn’t acceptable. She finds herself faced with an ethical dilemma again if she is talking to an elderly student. Furthermore, in some societies it may be normal to use some specific non verbals such as shaking one's hand which at the same time may not be acceptable to others due to different reasons such as religion. Hence, she needs to be sensitive to all the different cultures and control the effect of her personal beliefs on her communications when dealing with ethical dilemmas (Weinstein et al. 2004). As can be seen from the above information the teacher has to not only teach English as a second language but also train everyone in the class to respect others for their unique cultures and beliefs and also to make sure that the classroom rules are followed and applied by all. This is very similar to the ethical dilemmas we face sometimes in DH practice. We need to be aware of our clients’ different values and believes, respect them for who they are and be aware of our own biases to minimize their effects when we are providing care ( Majumdar et al. 2004). Dental hygienists, especially younger ones, may also be facing similar ethical issues when, for example, talking to an elderly patient and teaching them or giving them OHI and the patient might feel spoken down to by the hygienist. Also, when the patient refuses to be treated and touched by a specific gender of hygienists for religious reasons what should the hygienist do?

>Weinstein, C.S., Tomlinson-Clarke, S., Curran, M. Toward a Conception of Culturally Responsive Classroom Management. Journal of Teacher Education, 2004; 55:1, 25-35. >Majumdar, b., Browne, G., Roberts, J., Carpio, B. Effecs of Cultural Sensitivity Training on Health Care Provider Attitudes and Patient Outcomes. Journal of Nursing Scholarship, 2004; 36:2, 161-6.

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Tammie

Registered Nurse Interview:

Similar to dental hygienists, registered nurses also follow a code of ethics that guide their practice and provide guidelines of how they should handle ethical situations. The Code of Ethics for Registered Nurses was developed by the Canadian Nurses Association and serves as a foundation for nurses’ ethical practice. Part I of the code consists of “Nursing Values and Ethical Responsibilities”. This section outlines seven primary values including: providing safe, compassionate, competent and ethical care, promoting health and well-being, promoting and respecting informed decision-making, preserving dignity, maintaining privacy and confidentiality, promoting justice and being accountable. In the interview done with a registered nurse, the R.N. told me about a patient that she was assigned one day on her shift. This patient has been in and out of the hospital since birth and was hospitalized 2-3 times annually for respiratory problems. Doctors have seen this patient so many times that they go straight to giving her the medications that she needs. However, during this hospital stay, doctors realized that the patient has developed drug resistance to the antibiotics used in her treatment. There were so many other disciplines involved in the treatment of this patient, with each discipline concerned with different things. The teams of doctors would tell the patient’s father a number of different things. They would also come and tell the patient things that were often misinterpreted. In the end, the father and the patient were extremely overwhelmed with all the information they were given and were very stressed out and worried. The ethical dilemma arises where the R.N. realizes that someone needed to advocate for the patient and her father. It was clear that the different disciplines involved needed to come together to figure out what was going on in the patient’s case. The R.N. was faced with a problem of how to justify calling together all the different teams involved to figure things out for the patient. Does doing this cause harm or good? She knew that a meeting was needed, but at the same time, she should be trusting in the other professionals she was working with. The R.N. herself was also overwhelmed as she was not familiar with the patient’s condition either. As a result, the R.N. decided not to take any immediate action in calling a meeting but continued to play a supportive role to the patient and her father. When nurses are faced with ethical dilemmas, they tend to use conventions as their predominant decision-guiding criteria rather than patients’ personal needs and well-being(Dierckx de Casterle et al., 2008). In the end, doctors came and clarified the situation for the patient and her father. The R.N. acted in support of the patient and her father and was able to keep them calm until more information was available. Nurses are constantly working with other health professionals in providing care for a patient. It is important for a nurse to respect the decisions of other health professionals as well as realize when their knowledge and feedback is needed.

1) Dierckx de Casterle B, Izumi S, Godfrey NS, Denhaerynck K. Nurses’ responses to ethical dilemmas in nursing practice: meta-analysis. Journal of Advanced Nursing. 2008; 63(6):540-9. Retrieved from "http://wiki.ubc.ca/Help:Starting_a_new_page" Views