Delivering Ethical Health Care

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Introduction

From the moral and ethical perspectives, the healthcare industry is vital for sustaining lives. Without the presence of adequate structures of health care in any given society, the people in that society are bound to succumb to different ailments. This is to mean that healthcare is the central tenet of the welfare of any society.

The level of productivity of a given people is dependent on the state of healthcare in the society in which the people prevail. Therefore, the healthcare industry is paramount in any nation. This means that all the stakeholders in the healthcare industry must pay a lot of attention to the operations in the industry.

Operations in the healthcare industry have to be maintained at a level where the healthcare industry attains the potential to save as many lives as possible. However, research has denoted that the healthcare industry is one of the most complex industries in the world.

The complexity of the healthcare industry is based on the diversity in the number of healthcare conditions and the healthcare needs for these ailments, the moral dilemmas in the provision of healthcare, the modalities of delivering healthcare by the healthcare personnel, and the disposal of bio-hazards, which are the causative factors for a substantial number of ailments.

According to Mitchell (2013), delivery of health care mostly revolves around the relationship between the healthcare provider and the patient. The ability of the healthcare professional to deliver health care services to the patient is, in turn, dictated by a number of factors.

Among these factors are the regulatory policies in the healthcare industry in a given country, the physical and mental well being of the physician or nurse, the nature of ailment in question, and the working relationship between the physician and other healthcare providers in the given healthcare institution. These are just but a few of the factors from which the ethical questions arise.

Brown (2013) observed that the other critical concern in the healthcare industry is the level at which moral responsibility needs to be exercised by the healthcare professionals and the people who are ailing. The result is one question: How should the healthcare industry prepare to capture all these challenges and maintain a high level of ethical stance?

Lesser consideration of ethics by the stakeholders in the healthcare industry results in higher levels of vulnerability of the ailing and the healthy population in a given society. Responsibility, which is a key step in the pathway to the delivery of ethical healthcare, begins with the effort of all the stakeholders (Brown, 2013).

According to Bayer (n.d.), there is a need to embrace collective responsibility. In this sense, the main stakeholders have to engage the entire population for the sake of minimizing cases of diseases in the society. This observation is based on the fact that social and personal values play a critical role in promoting desirable health habits. This, in turn, secures the population from a number of ailments.

This paper explores the modalities of delivering ethical healthcare. The paper immensely focuses on the legal, social and ethical perspectives on the delivery of health care. These three aspects are important in the establishment of moral grounds in the delivery of desirable health care services in any given society. All these aspects are explored in relation to the delivery of ethical healthcare in the United Arab Emirates.

The paper seeks to answer a number of questions concerning the delivery of ethical healthcare. These are: What nature of a legal framework is critical in the establishment of a desirable environment in the healthcare industry? What are the ethical issues that confront the provision of ethical healthcare and how can they be dealt with by the stakeholders in the healthcare industry?

At what level are the different stakeholders in the healthcare industry required to exercise responsibility? Does the healthcare environment in the United Arab Emirates depict success in the provision of ethical healthcare? To what extent has individual responsibility been enhanced in the healthcare industry in the UAE?

The paper begins by giving an overview of the ethical stance in the provision of health care services. This is followed by the exploration of the three aspects of ethical healthcare. These aspects are elaborated through a search for the answers to the enlisted questions.

Understanding ethics in health care delivery

Ethics is a broad subject when it is applied in the healthcare industry. As observed earlier, healthcare services are critical for sustaining life. Therefore, the quality of health care services is something that ought to be given a lot of attention.

However, the provision of quality health care depends on not only the setup of infrastructure for the provision of health care, but also ensuring that there is a greater linkage between the society and the health care providers.

In this way, it becomes easy to capture the social, legal, ethical, moral, and the psychological parameters that play a vital role in improving the delivery of health care services to the population. The balance between these parameters is often ignored, yet it plays a central role in ensuring that the ultimate goal of health care delivery is attained (Brown, 2013).

According to Bærøe and Norheim (2011), the competence of healthcare services is determined by the set of decisions that are made and implemented by different players in the healthcare industry. The full support of health care entails the consideration of aspects of responsibility from all dimensions in the provision of health care, with the main goal of health care being put at the center.

The main goal of healthcare is to ensure that as many lives as possible are prevented from either the acquisition of diseases or succumbing to the ailments. Also, an environment that is highly ethical cannot be attained when there is no sensitivity to the moral considerations among all the stakeholders in the healthcare industry.

All stakeholders in the healthcare industry must be ready and willing to read from the same script to strike a balance in roles and responsibilities in the delivery of ethical healthcare to the population. It should be noted here that the population is part of the stakeholders since it is considered to be the target of health care services.

According to Guedert and Suely (2011), the delivery of healthcare in the contemporary society is confronted by different factors, among them the resource factor and the demand for desirable attitudes by the professionals in the healthcare industry. The healthcare industry is faced with a number of ethical problems.

These problems include: the conduct of health professionals, health policies and the socioeconomic issues, relational patterns between the patients and the physicians, complex moral cases in the healthcare industry like the end –of-life care, and healthcare education. These problems are broadly grouped, meaning that an exploration of each problem presents a number of other ethical dilemmas (Guedert & Suely 2011).

According to Mitchell (2013), the provision of health care services at times goes far beyond the skills and competencies of the health care providers. For example, a nurse may choose to work way behind the time that is stipulated in the employment Act only to ensure that the safety of patients under his or her care is guaranteed.

In such a case, it can be argued that morality is depicted in the choices that are made by the person and not the aspect of adherence to the law. If the nurse chooses to adhere to the law, then he might as well leave the vulnerable patient to succumb to the injuries as his action at this point is still justified.

The aspect of contact between the healthcare professionals and the patients presents a moral situation whereby a moral relationship has to be developed for the well-being of the patient to be attained. However, a number of socioeconomic conditions often prevail in the larger health care industry. These often result in difficulties in embracing moral relationships in the healthcare industry (Mitchell, 2013).

Another dimension of ethics in health care is the individual lifestyles as determinants of the state of healthcare for each individual. Moving away from the philosophical view that life is sacred and ought to be protected at all costs, it is argued that the moral responsibility of healthy living lies with individuals.

In a similar sense, it is argued that it is within the moral right of individuals to make choices, some of which may pose health risks to their lives. However, in such cases the healthcare professionals can still make choices both from their personal initiatives or from responsibility to safeguard the lives of people who make decisions that pose a threat to their health (Brown, 2013).

According to Jallinoja et al. (2007), the perception of healthcare professionals on patients is a factor that has gained significance in nursing ethics. This comes from a considerable rise in the number of health care conditions that are coming from the nature of lifestyles that are embraced by patients. Ethical concerns arise over the habits of people and the scale at which such habits can be reshaped into healthy habits.

Legal, ethical and social aspects of healthcare delivery in the United Arab Emirates

Health care delivery is a critical component in the UAE as one of the countries in the world that is experiencing economic transformation that seeks to place the country among the middle income economies in the world. A research by Margolis, et al. (2003) indicated that most people in the United Arab Emirates are satisfied with the primary health care services that are provided by healthcare institutions in the country.

This can be taken as an indicator of the consideration of quality standards in the discharge of health care services in the country. However, it cannot be taken as an indicator of ethical considerations in the discharge of health care services across the healthcare industry in the country.

Quality assurance programs have not been improved in the country to enhance the quality of health care outcomes in the country (Margolis et al., 2003). Gaps are still eminent in the delivery of ethical healthcare in the United Arab Emirates as far as quality and ethical consideration are concerned.

Several policies have already been developed in the UAE to help in fostering an inclusive environment in the delivery of health care services in the country. One of the policies that catch the attention of many people is the policy on cultural awareness and sensitivity in health care service delivery. This policy was informed by the fact that the country has a culturally diverse population.

The diversity ranges from ethnicity to race, religion, and language among others. This policy, which has a legal force, was developed to help address the problem of cultural diversity and its effects on the delivery of quality health care to all people in the UAE.

All healthcare institutions in Abu Dhabi are required to enforce the policy to address the legal and ethical conflicts that exist in the health care delivery in the country (Health Authority – Abu Dhabi, 2007).

According to EL-Amouri and O’Neill (2011), sensitivity to the culture is a social perspective of dealing with the challenges and concerns that are mostly raised by the people in the country.

Among the provisions in the policy is that all institutions that provide direct health care services to the population must offer interpretation services. This is meant to enhance these institutions’ ability to offer medical services to everybody in the country through the elimination of the language barrier.

The dignity and worth of people in the healthcare industry are determined by the ability of the people to communicate and foster moral relationships with the physicians and nurses.

As a matter of precedence, the policy also touches on the issue of value, which ascertains the desire to establish a healthcare environment that is responsive to issues of humane treatment and dignity of all the patients (Health Authority – Abu Dhabi, 2007).

Picturing this from Guedert and Suely (2011) observation about the ethical challenges that face healthcare professionals in the fair discharge of health care services, it can be argued that there is a sense of responsibility by the stakeholders in the UAE healthcare industry.

The policy on culture depicts a high level of consideration of the differences in the social environment. These variations form part of the complexities in embracing ethics in the delivery of medical services to the population. The right of every individual to access health care services is in most cases impeded by social barriers.

Ethical codes of professional behavior for the healthcare professionals are clearly enlisted in the legal framework that guides the discharge of medical services across the UAE cities. The laws do not only stipulate the roles of the healthcare professionals, but they also bring out the expected behavioral attributes of the health care practitioners to attain quality health care.

This kind of healthcare is characterized by the provision of ethical and patient-driven care for all the people within the areas where the law applies. This helps in improving the competency of health care providers as depicted by the indicators.

Among the provisions in the laws that have been developed by the Dubai Health Authority is the need for medical professionals in the country to pay attention to high moral standards when discharging their duties.

These moral standards focus on issues like consent, truthfulness, conflict of interest, confidentiality, allocation of health care resources, and the interaction of healthcare professionals with the pharmaceutical industry (Dubai Health Authority, n.d.).

Healthcare providers are exposed to certain ailments from the patients in the course of discharging their duties. According to Zaidi, Griffiths and Levack (2012), this is not only a sociological concern, but also a factor that informs policy in the healthcare industry in the UAE. There are dangerous strains of viruses and bacteria that can be passed from the patient to the health care providers.

Examples are Hepatitis C and the HIV virus. Exposure and real contact with these strains of viruses by the healthcare professionals often results in unprecedented levels of stress and stigma among the health care providers. This, in turn, jeopardizes the ability of healthcare providers to effectively discharge health care services to the population (Zaidi, Griffiths & Levack, 2012).

Most of the healthcare providers who are exposed to dangerous strains of viruses often fear to report these cases because of what they term as hostile policies. One of the fears is that health care providers who are non-citizens are at risk of being deported back to their countries of origin if they are detected with HIV and Hepatitis C, even when these diseases are acquired in the line of duty (Zaidi, Griffiths & Levack, 2012).

With the high number of health care professionals fearing to report such cases, the lives of the patients are further put at risk. This means that the United Arab Emirates, just like other countries like New Zealand, needs to implement policies that will see the development of healthcare schemes for the healthcare professionals who are infected with diseases when attempting to save lives.

This is a moral responsibility of the government and other institutions that are charged with the responsibility of ensuring that there is quality and ethical health care delivery in the UAE.

As observed earlier, the healthcare industry is quite complex. Raven (2002) observed that the separation of business from organizational ethical responsibility is one of the most challenging issues in delivering ethical healthcare in the UAE. This issue invigorated a debate in the early years of the first decade of the 20^th century.

Companies that are engaged in the delivery of healthcare products need to embrace social responsibility. Social responsibility is aimed at eliminating conflicts of interest in the delivery of healthcare products and services across the United Arab Emirates. This means that the government of the UAE ought to have established a ground that favors fair and open procurement procedures.

Through sound procurement procedures, it is easy to lock out unethical practices in the industry like the delivery of drugs that have been pirated. An example of the commitment of the United Arab Emirates to embrace the ethical delivery of healthcare is the 2001 cancellation of a $500,000 contract that entailed pirated drugs.

The main weakness in the enforcement of copyright laws in the UAE health sector is that the country lacks a law to protect patents and copyrights in the healthcare sector.

However, a ministerial decree that was issued by the Ministry of Health has been helpful as far as the protection of rights for the investors in the industry is concerned. The decree has aided in improving the healthcare environment in the country by attracting external investors in the industry (Stier, 2013).

Ethical and standard healthcare begins with quality practices in other industries like the food industry. If ethical standards are not embraced by the food industry, then the citizens are bound to be exposed to a lot of ailments that come from the consumption of non-standard foods.

One critical thing to note about the delivery of food in the United Arab Emirates is the 2005 law that was passed and saw the establishment of a Food Control Authority in Abu Dhabi. The mandate of this authority is to ensure that the food that is delivered to the population adheres to international safety and health standards.

Consumers need to be protected because they do not have the power to determine the quality of the products that they consume. Most of these products are bound to have a direct effect on the health of the consumer. Most food companies, which are often profit oriented, take advantage of the fact that consumers have no ability to determine the contents of what they consume.

This implies a lack of morality and responsibility. Having such an authority in place is likely to restore sanity in the food industry and cushion the consumers from the likelihood of consuming unsafe food (General Secretariat of the Executive Council, n.d.).

Analysis of issues

According to Bean (2011), most of the ethical issues in the healthcare industry revolve around three areas. These are: clinical practices, organizational practices, and specific issues that occur within the practices in the clinical operations or the organizational operations. The most resounding question as far as the delivery of ethical healthcare is concerned has been how to separate organizational from clinical ethics.

However, this is a difficult question to answer considering the fact that clinical practices are founded on organizational practices. The clinical environment is largely determined by the precedents that are set at the organizational level. This implies that the actions and behaviors of individual health care providers are largely shaped by the policies that exist in the healthcare industry.

What has come out in the paper is that the embrace of ethics begins with the establishment of a legal framework that governs the behavior and conduct of the stakeholders in the healthcare industry. Ethical standards are highly embraced when there is a legal force. A legal force helps in controlling the behavior of the players in the healthcare industry.

The other thing is that legislation in the healthcare industry should be diverse; not only focusing on the conduct of the healthcare professionals as noted in the case of the UAE. For the legislation to be effective and result in an ethically oriented environment in the healthcare sector, it has to be accompanied by social policies.

Social policies play a greater role in responding to the personal and psychological issues that emerge in the healthcare industry. Such issues are eminent in the discharge of patient centered services by the healthcare professionals.

Conclusion

The contemporary healthcare industry is confronted with a lot of challenges. These challenges range from legal, socioeconomic, technical, to ethical concerns. Research has denoted that the needs in the healthcare industry are extraneous, a factor that most often slows down the efforts of the healthcare providers in meeting the healthcare needs of the population.

Delivery of ethical healthcare in a country starts with the development of an environment that highly values life. This means that every course in the healthcare industry should be aligned with the main objective of healthcare delivery, which is safeguarding lives at all costs.

Therefore, health care stakeholders need to approach health care from a broader perspective to capture the ethical considerations in the delivery of health care. This implies that there should be a focus on the systems of delivery, beginning with the suppliers.

The government of the United Arab Emirates needs to ensure that there are adequate policies to govern the supply of medical products to ensure that the suppliers meet the desirable standards. This is critical in the delivery of quality health care.

The ability of healthcare providers and professionals to meet the needs of the patients and safeguard their lives begins with the ability of the professionals to meet their needs. The needs in this case include physical, socioeconomic, and psychological needs. This is based on the nature of work that is done by the health care providers.

Several policies have been developed to help improve the ethical stance in the delivery of health care in the United Arab Emirate. However, most of the policies seem to be one sided. They mostly favor the patient and leave out the health care professionals, yet they are critical in sustaining the lives of patients through the delivery of health care services.

The government of the United Arab Emirates, especially the Ministry of Health, needs to come up with polices and pieces of legislation that capture the needs and concerns of patients and healthcare providers.

Most important, there is the need to develop policies and laws that safeguard the needs of the healthcare professionals. This is an enabling factor in the development of a highly ethical environment in health care. This will, in turn, enable the embrace of high moral standards in the healthcare industry.

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