Health professionals have an ethical duty

The British Medical Association (BMA) recently published guidance from its medical ethics committee on decision making concerning the withholding and withdrawing of life-prolonging medical treatment. It is a very thoughtful and thought-provoking document, the ramifications of which go far beyond the immediate situation it is addressing. The authors are clearly well aware of this.When considering a doctor’s ethical response to “contemporaneous requests for life-prolonging treatment” made by competent patients, the committee observes: “Although patients’ wishes should always be discussed with them, the fact that a patient has requested a particular treatment does not mean that it must always be provided.” They advance four propositions in support of this conclusion, namely: “(a) Health professionals are not obliged to provide any treatment which cannot produce the desired benefit”. “(b) There is no obligation to provide any treatment which is clearly contrary to an individual’s health interests. A life-prolonging treatment may, for example, prolong life but result in severe pain or loss of function so that overall it produces severe harm to the patient”. “(c) Except in an emergency situation, doctors are not obliged to treat contrary to their conscience (though they may be obliged to make an appropriate referral)”. “(d) Where resources are limited, it is inevitable that some patients will not receive all of the treatment they request even though such treatment could be potentially beneficial to them”. Towards the end of their commentary on the last of these propositions, they observe: “Health professionals have an ethical duty to make the best use of the available resources and this means that hard decisions must be made. Whilst this is a much broader issue than can be discussed thoroughly in this document, it is clear that doctors are not obliged to comply with patients’ requests for treatment when they make inequitable demands on scarce resources”. Later they come back to this issue in the context of patients who have lost or never attained competence. In that connection they observe: “Existing guidelines and court judgments have insisted that non-treatment decisions for people who lack the ability to make or communicate decisions should be based on considerations of benefit to the patient and not cost. It is obvious, however, that money spent caring for irreversibly and severely brain-damaged patients is money which cannot be used to treat other patients. This is an issue which needs to be acknowledged and addressed on a national scale as part of the debate on rationing and prioritising resources”

Communication and support from health-care professionals to families, with dependent children, following the diagnosis of parental life-limiting illness : a systematic review

Background: Communication between parents and their children about parental life-limiting illness is stressful. Parents want support from health-care professionals; however, the extent of this support is not known. Awareness of family’s needs would help ensure appropriate support. Aim: To find the current literature exploring (1) how parents with a life-limiting illness, who have dependent children, perceive health-care professionals’ communication with them about the illness, diagnosis and treatments, including how social, practical and emotional support is offered to them and (2) how this contributes to the parents’ feelings of supporting their children. Design: A systematic literature review and narrative synthesis. Data sources: Embase, MEDLINE, PsycINFO, CINAHL and ASSIA ProQuest were searched in November 2015 for studies assessing communication between health-care professionals and parents about how to talk with their children about the parent’s illness. Results: There were 1342 records identified, five qualitative studies met the inclusion criteria (55 ill parents, 11 spouses/carers, 26 children and 16 health-care professionals). Parents wanted information from health-care professionals about how to talk to their children about the illness; this was not routinely offered. Children also want to talk with a health-care professional about their parents’ illness. Health-care professionals are concerned that conversations with parents and their children will be too difficult and time-consuming. Conclusion: Parents with a life-limiting illness want support from their health-care professionals about how to communicate with their children about the illness. Their children look to health-care professionals for information about their parent’s illness. Health-care professionals, have an important role but appear reluctant to address these concerns because of fears of insufficient time and expertise

Exploring registered health professionals' assessment of older adults in care facilities : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy at Massey University, Turitea Campus, Palmerston North, New Zealand /

Older adults in care facilities are increasingly frail, with a number of co-existing conditions and complex health care needs. Before entry into a care facility, and while they are residing in a care facility, older adults are assessed by health professionals from different disciplines. The aim of this research is to gain insight into registered health professionals' 1 Registered health professionals: For this research, the term 'Registered health professionals' includes Dietitians, Diversional Therapists, General Practitioners, Occupational Therapists, Pharmacists, Physiotherapists, Registered Nurses and Social Workers, who are employed or contracted by a care facility. understanding of assessment of older adults in care facilities and how these assessments are utilised by Registered Nurses to create a plan for care. Assessment is an integral part of clinical practice for health professionals. Health professionals assess older adults to plan and deliver care, to instruct others about the care to be provided to the older adult, and to meet contract and audit requirements. For this pilot project, fourteen health professionals who perform assessments of older adults in care facilities participated in this research. Participants were approached via their place of employment. Data were gathered through semi-structured interviews and analysed by Thematic Content Analysis. The following theme was clearly identified in this research: ▪ Fragmentation of the assessment and care planning process, with sub-themes related to ▪ human resource issues ▪ the focus on physical aspects by contracted health professionals ▪ the single-discipline approach to care planning ▪ the lack of formal information sharin

Electronically Assisting Communication for Health Professionals

New information and computing technologies offer cost efficient and effective learning opportunities for health care professionals. The Assisted Electronic Communication project is prototyping, administering and evaluating a digital discourse system for health care professionals within an acute Hospital. Health care staff participating in the study are able to access and contribute to threaded, asynchronous discussions and themed information in the context of critical work documents. Early indications are that the system is viewed very positively, and seen as a way of critically engaging with new material that is getting closer to an idealized learning in the workplace

Bilingual Proficiency Among California's Health Care Professionals

Explores the policy options for encouraging and measuring second-language competence among healthcare providers in California

“Raining” in Your Emotions as a Student Affairs Professional

As younger generations of student affairs professionals become more involved in the field and aware of their mental health identity, there appears to be a disconnect between young professionals and those who are older and keep the state of their mental health hidden. The author questions whether young professionals’ openness about their mental health identity lines up with the institutional/general professional expectations for dealing with emotional trauma in their field. In this narrative, I discuss my understanding of how student affairs professionals encounter tragedy while holding their own mental health wellness. I will further delve into how professionals can feel restricted in their ability to voice their concerns about mental health, especially because of the fear of judgement. I will be exploring this experience through the story of my life as a live on professional in residence life between Fall 2018 and Spring 2019

The Update, February 13, 2012

The Update is a bi-weekly web newsletter published by the Iowa Department of Public Health's Bureau of Family Health. It is posted the second and fourth week of every month, and provides useful job resource information for departmental health care professionals, information on training opportunities, interdepartmental reports and meetings, and additional information pertinent to health care professionals

The Update, May 2013

The Update is a bi-weekly web newsletter published by the Iowa Department of Public Health's Bureau of Family Health. It is posted the second and fourth week of every month, and provides useful job resource information for departmental health care professionals, information on training opportunities, interdepartmental reports and meetings, and additional information pertinent to health care professionals. NOTE: The last issue before this October 29, 2012