Medical law, ethics, and professional practice are essential in the field of health and medicine as it manages, legislates, and control ethical behaviors in professional medical practice. “Medical law, ethics, and professional practice also enable patients, their families, the society and the doctor to have proper regard to health problems helping them arrive at important decisions” (Weed, 2002).
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In the case of a 68-year-old man admitted for surgery, we find that he became more vulnerable due to the unavailability of medical treatment and the sporadic nature of bleeding in his first residence. We can also say that he was responsible for his vulnerability as he did not realize how serious the situation would become and in the event seek medical attention early at whatever cost. More vulnerability was brought about by the medical practitioner and the specialist when they were unable to diagnose colorectal cancer through proper examination. These are some of the ethical issues in this case. Another ethical issue brought out in this particular case is beneficence, since the practitioner’s actions were not tuned towards the well-being of the patient. A non- maleficent issue is also noticed because the first two practitioners tried to propose treatments they thought could benefit the patient when they did not know the exact medical problem.
Professionally the practitioners violated some professional medical principles. Some of these principles included lack of competency, disclosure, inter-professional communication, and negligence (Pullman, 2005). Lack of professional standards of conduct and unaccountability was also evident. The two practitioners were required to effectively diagnose the ailment and propose proper medication, but this was not the case.
In the case synopsis, the legal aspects include the lack of inter-professionalism, lack of professional information sharing, negligence, and lack of legally acceptable secure outcomes. Therefore this paper is going to discuss the aspects of ethical, legal, and professional practice considerations based on a case synopsis of a 67-year-old man with colorectal cancer waiting for surgery. The paper will then conclude by analyzing the whole issue of ethical, legal, and professional practice.
In professional health practice, medical law refers to a branch of law that deals with the prerogatives and accountability of medical practitioners and the privileges of the patient. “The main branch of medical law is the law on confidentiality, negligence, and torts about medical treatment in the field of health, medical practice, and treatment” (McKeon, 2002).
In this case, the duty of care was not adequately executed leading to late diagnosis of the patient’s ailment. The patient’s doctor violated the medical board legislative act which states that a medical practitioner must ensure that, he/she saves a patient from harm by making certain healthcare or medication is administered in a professional, secure, and competent manner. Again this synopsis was an example of a breach of healthcare case with an instance of high negligence which is against the medical practitioner’s negligence law. Medical negligence law as explained by Mathews (2005) can occur in many different contexts and in this case synopsis they include; failure in diagnosing the patient’s condition, the delay caused by the two practitioners in making the correct diagnosis, and failure to carry out professional skills with competence. Other legal concerns in this synopsis are, “failure and delay in the provision of the appropriate treatment, failure to refer the patient to a competent specialist and the failure to carry out and report correctly on the test results” (Mathews, 2005).
In this case therefore the patient had the right to take legal measures against the practitioners and was entitled to compensation for negligence and unprofessional practice. On the other hand “the law recognizes that medical practitioners are forced to make difficult decisions under extreme pressures in situations where it is not always possible to make the correct decision. However, negligent medical treatment goes beyond being a simple reasonable mistake/error” (Mathews, 2005). When establishing a claim especially for negligence, it is essential to show that the treatment administered was below standards that are convincingly expected from a medical practitioner in a given circumstance. As a result, this case indeed displays professional negligence and unprofessional medical practice.
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“Because of their special knowledge and expertise, doctors have an ethical responsibility of improving and maintaining the health of their patients (Edwards 2002). This patient because of his vulnerable state put his trust in the practitioners in hope of a proper cure.
In this case, therefore, the code of ethics was not correctly executed taking into account the vulnerable condition the patient was left in. When referring to an article by the Australian Medical Association (2010) the medical general practitioner and the private surgeon did not carry out their ethical medical practice to the best of their ability. This is evidenced by their inability to successfully carry out the diagnosis of the patient’s illness.
Beneficence being one of the core values in medical ethics was also not executed in this synopsis case. In this case, the two medical practitioners did not act ethically to promote the patient well being. Additionally, all the actions they took did not serve the intended purposes that are in the interest of the patient.
Autonomy, in this case, was not valued as no actions were enhancing the patient’s autonomy. The practitioners and patients here were unable to make healthy decisions towards the wellbeing of the patient and professional practice. Consequently, this ethical principle was not practiced.
Non-malfeasance is another issue of concern brought out in this particular case. The practitioners did not execute this ethical issue properly as their professional practice did not place the patient out of danger. They violated this ethical principle because instead of their actions helping the patient they made him more vulnerable.
Since the patient was to some extend vulnerably, he put his trust in the practitioners for effective treatment. This was because they are the ones with the expertise in tackling such problems. In this example, though the practitioners were not in a position to help the patient and instead caused more vulnerability. Therefore the two practitioners did not act according to ethical principles.
“Professional public health practice helps the society by preventing disease and promoting health” (Beauchamp, 2001). The medical characteristic of professional practice in medical health is an essential constituent of the clinical activities of each medical practitioner. These characteristics comprise but are not restricted to “patient education, negligence, competency, the scope of practice and ethics” (Archer, 2003). In this synopsis case, these characteristics were flawed.
Here, there was no demonstration of professional medical practice or if there was it came later when the patient’s condition had already deteriorated. Professional medical practice according to Hoffman (2009) was not executed when the first two medical practitioners were unable to exercise professional standards supported by integrity and ability. Another unethical concern in this case supported by Hoffman is that the practitioners could not help the patient, “which means that they were somehow not up to date on relevant medical knowledge, codes of practice and legal responsibilities” (Hoffman, 2009). The professional guidance and accountability that should have been put under consideration were not executed. The reason for this may have been a lack of professional medical qualification in the first two practitioners. Professional practice should be executed by every medical practitioner as it is essential in making life-saving decisions. In this example, the professional practice was absent.
As a result of this, we can conclude that the way this patient was handled was not according to professional medical practice. In this case therefore the practitioners failed to follow guidelines of professional medical practice or any standards of care under these guidelines. The here professional practice was realized later.
In analyzing this case we realize that the two first practitioners did not follow the medical law, ethics, and professional practice guidelines. Although the patient did not seek medical attention for his symptoms for a relatively long time due to his remote locality and difficulty in accessing medical care, it was up to the practitioners to carry out medical care according to these three guidelines. If the proper diagnosis was done, maybe the patient’s vulnerability would have been reduced together with the costs he incurred. In the event, they would have then acted professionally and according to medical ethics.
Neither the GP nor the specialist followed the guidelines for the prevention, early detection, and management of colorectal cancer, as set out by the NHMRC (Australian National Health and Medical Research Council). This is regarded as an unprofessional medical practice. The issue of medical law came in when the practitioners were unable to act accountably leading to negligence, vulnerability, and delayed diagnosis which is against the medical law. Professionally there was a shortfall as:
All patients with symptoms of colorectal cancer (rectal bleeding, bowel or abdominal symptoms, and anemia) should have a thorough examination of the anus, rectum, and colon, including a digital rectal examination (DRE). In symptomatic patients over the age of 40, referral to a colonoscopy specialist is recommended (Leaper & Johnstons 2004)
Neither the GP nor the specialist did a DRE and given the position of the patient’s tumor, if it had been done they would have felt it. The Specialist “missed” seeing the tumor when banding the pts hemorrhoids; presumably, the photo scope was inserted beyond the position of the tumor and obscured it from view.
There was a breach of duty on care by both the GO and the specialist. The failure to properly investigate the patient’s symptoms and failure to diagnose cancer promptly meant the patient’s risks of morbidity and mortality increased. Consequently, medical law, ethics, and professional practice were not followed.
Therefore as shown in this paper, vulnerabilities such as this one brought about by unethical doctors and medical practitioners are supposed to be effectively eliminated by medical law, ethics, and professional practice. These guidelines also help create, “good medical practice and good doctors who enhance and promote the health and medical welfare of the people they serve in ways which fairly and justly respect their dignity, autonomy and rights” (Archer, 2003).
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Public expectations of medical practice need not be dented by unethical and unprofessional practitioners. Again there is a need for teamwork between the doctor, the patient, and other stakeholders to effectively iron out these differences in professional performance. When this is done and the GMC’s professional regulation reacts appropriately to professional medical mistakes, issues such as this one can be effectively controlled.
Archer, B. (2003) professional medical practice. Journal of professional medical practice, 9 (13), pp. 102-111.
Australian Medical Association. (2010) Medical Ethics. Australian Social Science Press.
Beauchamp, T. (2001) Public Health Practice. New York, NY. Oxford University Press.
Edwards, M. (2002) Medical Care, and Ethics. Journal of medical ethics 6(3), pp. 41-48.
Hoffman, T. 2009. Clinical professional guidelines. Web.
Leaper, M, & Johnstons, MJ. (2004) Reasons for failure to diagnose colorectal carcinoma at colonoscopy. Endoscopy 36(2), pp.499-503.
Mathews, B. (2005) Medical negligence. South Melbourne, VIC: Oxford University Press.
McKeon, L. (2002) Medical Law. Brisbane, QLD: John Wiley & Sons Australia Ltd.
Pullman, D. (2005) Ethics: Reframing the role of ‘principles’ in clinical ethics education and practice. Journal of Clinical Ethics 16(3): 223-229.
Weed, D. (2002) Ethics and professional health practice. Journal of professional health practice, 7(2), pp. 54-74.