PatientAdvocacy and Autonomy
PatientAdvocacy and Autonomy
Patient advocacy remains to be a fundamental aspect when it comes tohealthcare. Both nurses and physicians have the mandate to ensurethat they advocate for the needs of patients. The central objectiveof healthcare institutions is to ensure that patients get the bestservices. Such goals can only be achieved through concerted effortsto champion for patient advocacy and autonomy. Patient advocacy andautonomy are essential in ensuring quality service improvement thatleads to the best treatment outcomes.
Concept of Autonomy
Patient autonomy is the right an individual has to make a decisionregarding their medical care without the influence of the healthcareprovider (Agarwal & Murinson, 2012). However, patient autonomyallows the healthcare provider to create awareness through educationbut does not make the decision on their behalf. The concept ofautonomy is of fundamental significance for the empowerment it givespatients regarding the control of their medical care. An individualcan dictate how they would love to be attended to by the healthcarepractitioners. Information, however, determines the decision madethey will have received from the healthcare providers. Autonomy isvital because it enhances the quality of services that patients get.The approach of influencing decisions made by patients sets a wrongprecedence in the healthcare fraternity. The concept of autonomystrives to alleviate the aspect of imposing decisions to the patient.It is vital for healthcare institutions to uphold the concept ofautonomy because of the role it plays in ensuring improved qualityservice acquisition. Nevertheless, it is crucial to make sure thatthe aspect of autonomy does not affect service provision. Despite thefact that patients are empowered to make decisions, the choices theymake should not be an impediment to the achievement of qualityservices.
Patient advocacy is an area in healthcare that deals with theprovision of services to patients, carers, and survivors. Patientadvocacy focuses on issues such as rights, privacy, confidentiality,and representation, the creation of awareness, support, andeducation. The areas identified are of fundamental significance forthe impact it has on the quality of services received (Davoodvand,Abbaszadeh, & Ahmadi, 2016). The primary goal of advocacy is togive a voice to the patients, carers and survivors on issues relatedto healthcare. Patients get the opportunity to learn about the aspectof their rights through the creation of awareness. The approach isessential in ensuring that decisions made by patients are drawn froman informed perspective and not coercion.
Advocacy is essential since it enables the patient to make adifficult medical decision. The advocates educate the patients andallow them to understand how to deal with the various issues thatthey have to grapple with. Further, in cases where the patient isunable to comprehend the diagnosis made for a given disease, theadvocate serves to educate them on the same. Patient advocacy is acritical aspect of healthcare. Patients have the right to understandthe various treatment options that exist for them. The knowledge isparticularly essential because it acts to enable the patient tounderstand the entire process of service provision. Additionally,patients get the opportunity to present their concerns regarding themanner in which they are being served. If the nature of services theyreceive are not up to standard, the patient has the option to followup on the same through their advocates.
Informed consent can be portrayed as the permission that is grantedwith the understanding of consequences provided by a patient to thedoctor regarding treatment (Tam et al., 2015). It is a process thatentails getting permission from the patient before introducing anyhealthcare intervention. Healthcare providers have the mandate toensure that they ask the patient’s consent before introducingtherapy. The concept of informed consent dwells on the need to ensurethat there is understanding of facts, implications and theconsequences of a particular action executed by the healthcarepractitioner. The process of acquiring informed consent from thepatients is essential because it is a reflection of adherence topersonal dignity (Kass, Taylor, Ali, Hallez, & Chaisson, 2015).Service provision in the healthcare institution is about the focus onattainment of the best patient outcomes.
Patients have a vital role in ensuring that they get the bestservices. Similarly, it is the duty of healthcare providers toprovide all the information to patients regarding the treatment beingoffered. The information is instrumental in enabling the patient tomake a decision regarding whether or not they would be comfortablebeing treated. The informed consent will help in ensuring that thepatients have the information regarding what they should expect fromthe treatment. Ethically, it is vital for the healthcare provider toget informed consent before proceeding to administer treatment. Theapproach is integrative in the entire process of providing care tothe patients. The violation of the process of getting informedconsent can result in legal consequences. However, it is vital forthe healthcare provider to ensure that the patient providing theinformed consent is in their right state of mind.
NurembergCode and the Declaration of Helsinki
The Nuremberg Code was developed in response to doctors who decidedto perform clinical trials in an unethical experimentation during theSecond World War. The code is essential since it set precedence onhow to conduct research ethically. Notably, voluntary consent wasmade a requirement in any clinical research study. The focus of thecode is the minimization of risks and harm brought to those takingpart in the study and must be understood by healthcare professionals(Adhikari, 2016). The introduction of the Nuremberg Code is essentialbecause it upholds ethical conduct in research. Despite the quest toget answers to various scientific problems, researchers must striveto ensure that they do so in an ethical manner making sure that therisks don’t outweigh the expected benefits.
The Declaration of Helsinki is a description of the adoption oftwelve principles that sought to guide the physicians on ethicalconsiderations as relates to biomedical research. The Declarationreiterates the need to distinguish medical care that benefitspatients and research that may or may not has benefit (Adhikari,2016). The Declaration of Helsinki (DoH) guides human researchethics. Those engaged in research have the mandate to ensure thatthey execute their activity in a manner that takes consideration tothe ethical framework.
of the events leading to development of Ethical Guidelines
Before the passage of Pure Food and Drug Act, there were noregulations that guided the use of human subjects in research. Thelack of regulations saw unethical practices when it came toconducting human research. The Institutional Review Board werenon-existent. The unethical practices witnessed in places such asNuremberg regarding human clinical trials saw the introduction ofethical guidelines.
TheBelmont Report: Ethical Principles and Guidelines for the Protectionof Human Subjects of Research
The Belmont Report seeks to summarize ethical principles ("TheBelmont Report", 2017). The Belmont Report is essential for therole it plays in the protection of minority groups such as theminors, prisoners and persons with mental illness. The establishmentof the report is vital because it helps in the protection of specialpopulations in different ways.
First, the report helps in ensuring that the autonomy of the minoritypeople is maintained. The report identifies an autonomous person asthe individual who is capable of deliberating on various issues ("TheBelmont Report", 2017). Autonomy ensures that the person’sopinion is taken into consideration. Minority groups have opinionsregarding different issues. Researchers aiming to conduct clinicaltrials on the minority groups have to factor in the opinion of theirhuman subjects. The approach would be instrumental in ensuring thatthe minority people are protected. For example, in dealing withpersons with mental illnesses, the report puts it upon theresearchers to uphold ethics and not take advantage of humansubjects.
Secondly, the Belmont report ensures that informed consent is sortbefore any study is conducted. For example, in the case of minors,the report reminds the researchers to seek consent from parents orguardians. Through the same, human clinical trials that are conductedwill be guided and founded on informed consent which is based on thenature of the information the subjects have. Finally, the reportindicates the need to ensure that researchers aim at realizing thehighest benefits. For example, if the study was to involve prisoners,the result should be beneficial to them.
Overall, ethical principles should guide any human clinical trialbeing conducted. However, the patient or participants informedconsent must be provided. The approach is instrumental since itfocuses on the realization of maximum benefits while at the same timeminimizing harm to the patients.
Agarwal, A. K., & Murinson, B. B. (2012). New Dimensions inPatient–Physician Interaction: Values, Autonomy, and MedicalInformation in the Patient-Centered Clinical Encounter. RambamMaimonides Medical Journal, 3(3), e0017.http://doi.org/10.5041/RMMJ.10085
Adhikari, S., Paudel, K., Aro, A. R., Adhikari, T. B., Adhikari, B.,& Mishra, S. R. (2016). Knowledge, attitude and practice ofhealthcare ethics among resident doctors and ward nurses from aresource poor setting, Nepal. BMC Medical Ethics, 17,68. http://doi.org/10.1186/s12910-016-0154-9
Davoodvand, S., Abbaszadeh, A., & Ahmadi, F. (2016). Patientadvocacy from the clinical nurses’ viewpoint: a qualitative study.Journal of Medical Ethics and History of Medicine, 9,5.
Kass, N., Taylor, H., Ali, J., Hallez, K., & Chaisson, L. (2015).A Pilot Study of Simple Interventions to Improve Informed Consent inClinical Research: Feasibility, Approach, and Results. ClinicalTrials (London, England), 12(1), 54–66.http://doi.org/10.1177/1740774514560831
Tam, N. T., Huy, N. T., Thoa, L. T. B., Long, N. P., Trang, N. T. H.,Hirayama, K., & Karbwang, J. (2015). Participants’understanding of informed consent in clinical trials over threedecades: systematic review and meta-analysis. Bulletin of theWorld Health Organization, 93(3), 186–198H.http://doi.org/10.2471/BLT.14.141390
The Belmont Report. (2017). HHS.gov. Retrieved 17January 2017, fromhttps://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/index.html#xrespect