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Universal screening programs have a specific capability to enhance universal health coverage and improve the general public’s health. They can prevent illness, minimize disability, and lower mortality when they are structured correctly. The fact that such universal screening programs may not be appropriate and may cause more harm than good leads to various ethical concerns (Elliott et al., 2018). Universal screening programs shouldn’t be advocated for doctors and medical students because they can lead to stigmatization, coercion, discrimination, lack of autonomy and partenalism.
Stigma
Labeling, stereotyping, and exclusion are all components of the robust social process known as stigma, leading to status loss and discrimination. When universal screening is recommended, and a doctor is later found to have a disease, this typically results in atrocious stigma in medical facilities, which adversely affects people who are seeking medical care when they are most vulnerable and undermines correct diagnosis, appropriate treatment, and favorable health outcomes (Ortmann et al., 2016). Since stigma has been identified as a barrier to universal screening in many medical school settings, similar circumstances occur when medical students undertake a versatile program that prevents them from participating in activities that the other medical students are allowed to do. This leads to stigmatization and discrimination.
Coercion
Coercion is prevalent, disputed, and associated with complex ethical quandaries. The choice of participating in screening may be difficult for medical students and doctors, especially if they feel pressured by adults and their superiors. It is considered that Universal Screening is excessively intrusive. Medical professionals or students might be afraid of seeming indiscreet or vulnerable, uncertain about what details to disclose and what to keep private (Briesch et al., 2021). When risky information about a doctor is uncovered, their superiors may force them to quit or leave their posts. When the school department gives medical students the choice of abandoning their studies or altering their course after the universal screening detects something irregular, they also experience coercion.
Autonomy
The universal screening policy is vital to the ethical ideals of promoting autonomy, but more focus needs to be paid to putting them into practice. Universal screening may deliver excessive harm due to low-value or outdated screening programs and poorly communicated screening options that leave doctors and medical students with heavy decision-making burdens (Davidson & McGinn, 2019). Due to the limited incentives for health facilities and schools to comprehend the adverse effects of universal screening and institutional and societal influences in favor of screening, autonomy is not sufficiently supported.
Paternalism
Paternalism arises when a doctor makes a choice for a patient without the patient’s explicit consent and thinks the recommendations are best for the patient. Doctors will overwhelm patients with information when universal screening is recommended, information for which they have no context and which might adversely affect rational decision-making and information processing. In the traditional paternalism model, it was acceptable for the doctor to choose what information to share with the patient concerning the diagnosis (Dodge, 2019). In cases of a fatal disease, the patient is occasionally not informed of the true nature of the illness, but this will not be the case for physicians who have implemented the universal screening program. Paternalism in school systems doesn’t work if all it incorporates is monitoring and supervision; it only thrives when there is a culture of connection, and med students feel that their instructors fully grasp their needs. This will not be the case if medical students make universal screening mandatory. The stated ethical concerns should be addressed concerning universal health screening and should not be recommended to all doctors and medical students.
References
Briesch, A. M., Chafouleas, S. M., Dineen, J. N., McCoach, D. B., & Donaldson, A. (2021). School building administrator reports of screening practices across academic, behavioral, and health domains. Journal of Positive Behavior Interventions, 24(4), 266–277.
Davidson, K. W., & McGinn, T. (2019). Screening for social determinants of health. JAMA, 322(11), 1037.
Dodge, K. A. (2019). Annual research review: Universal and targeted strategies for assigning interventions to achieve population impact. Journal of Child Psychology and Psychiatry, 61(3), 255–267.
Elliott, S. N., Davies, M. D., Frey, J. R., Gresham, F., & Cooper, G. (2018). Development and initial validation of a social emotional learning assessment for Universal Screening. Journal of Applied Developmental Psychology, 55, 39–51.
Ortmann, L. W., Barrett, D. H., Saenz, C., Bernheim, R. G., Dawson, A., Valentine, J. A., & Reis, A. (2016). Public health ethics: Global cases, practice, and context. Public Health Ethics Analysis, 3–35.
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