Summary of the Case with Critiques
The outbreak of the COVID-19, commonly known as the coronavirus disease, has created new challenges to healthcare institutions in the United States, especially those that offer care to the elderly. The case study shows that hospitals, skilled nursing centers, and personal care homes are no longer safe for senior citizens in the country. Traditionally, homes for the elderly provided care and support for the elderly, especially those who could not get proper support from their family members. However, recent studies have shown that these centers have become breeding grounds for the deadly virus. So many people have lost their lives in these institutions, and a section of the community believes that it is because of the negligence of the management and individual healthcare workers. Tomeo (2020) explains that most of these institutions and individual healthcare experts have taken various steps to contain the spread of the virus, such as fumigation, maintaining distancing, and restricting movement into and out of the facilities. However, these efforts have not been adequate in containing the virus. Although the case provided an accurate analysis and critique of these institutions, it is important to note that it failed to take into consideration the unique and unprecedented challenges that these institutions face during these trying times.
Ethical Ramifications
The case study presents ethical dilemmas to patients, their loved ones, healthcare institutions, and the government on how best senior citizens in the country can be protected. Patients and their loved ones no longer trust these institutions because recent statistics have shown that they have become major spreading grounds for the virus. A study by Yourish et al. (2020) showed that one-third of all coronavirus-related deaths in the United States have been in care homes. It means that the fear of patients and their loved ones are justified. Most of them often die in physical and emotional isolation, away from their loved ones. It is frustrating for one to lose a close friend or a relative in such a helpless manner. Some of these institutions have considered shutting down their operations for a period as they struggle to find ways of resuming operations when the safety of their clients is guaranteed. The government is also facing a major ethical dilemma. For instance, the Governor of Georgia directed the National Guard to help in fumigating care homes, but that did not stop the spread of the virus. Closing all the care homes in the state becomes the best option of protecting the elderly. The problem is that some of these people do not have alternative homes, and very few Americans may consider staying with strangers during this period.
The government, healthcare institutions, and the medical staff also face another dilemma over the basis upon which healthcare is to be delivered. As Figar and Đorđević (2016) pose, it is not clear whether it should be delivered on the basis of one’s ability to pay, which makes it a privilege, or on need, which makes it a right. There is a universal agreement in the United States that healthcare services are basic needs. However, enacting a universally acceptable law meant to make these services available has been a major challenge. The Affordable Care Act came close to making the services affordable to all Americans. However, the current regime has been opposed to its implementation, which creates a major challenge in terms of funding. Some of the healthcare institutions are unable to offer care to the elderly who cannot use the other alternative insurance covers to fund their medication. The medical staff faces a major challenge during this period of COVOD-19 when they are forced to reject patients unable to pay for their healthcare needs. The government and all the stakeholders involved are yet to come up with an appropriate approach to solving this problem.
Legal Ramifications
The analysis of the case study shows that there are issues that may have legal ramifications to care homes in the country. These institutions have been accused of gross negligence when caring for the elderly during this period of the COVID-19 outbreak. According to Glenza (2020), senior citizens can be safe if these institutions regulate the number of visitors. Anyone visiting these homes to deliver essential services such as food and medicine should wear protective gear. They also need to sanitize their hands as recommended by the World Health Organization. The massive outbreak of the virus in these facilities is a clear indication of gross negligence on the part of the management of these institutions. They have failed to take appropriate measures to protect their clients. It means that those who have lost their loved ones can sue these care homes. It is important to note that some of these institutions have made major steps in limiting the number of visitors, regularly fumigating the facilities, and limiting physical contacts as a way of protecting their clients. They have to do more to ensure that no one dies out of negligence in these care homes. In case of containment measures cannot be implemented, they should consider shutting down their operations.
Individual healthcare practitioners may also be held responsible for any form of negligence that may lead to an outbreak of COVID-19 within a healthcare facility. As Torres-Villarreal and Bernal-Camargo (2019) observe, these people are on the frontline in the fight against the pandemic and they have done a commendable job, some losing their lives in the process. However, they should remain committed to protecting their patients from the virus at all times. The World Health Organization has recommended the use of protective clothing every time a medical doctor or nurse is handling a COVID-19 positive patient. The practitioner is then expected to remove the protective gear, properly sanitize, and wear a face mask before attending to another patient that does not have the virus. Deliberately failing to follow this procedure may be considered gross negligence, especially if it results in the spread of the virus. They can be held individually responsible and can face prosecution. Baron and Corbin (2019) note that doctors and nurses are doing everything within their powers to protect themselves, their patients, and their loved ones from infection. They have maintained the use of protective gear every time they are handling patients with the virus.
Assessing Both Sides of the Argument in the Case
It is necessary to assess both sides of the argument in the case to understand how similar institutions in the country can deal with the problem. The main idea that comes out from the case study is that homecare institutions in the United States are not doing enough to protect the elderly from coronavirus. The study suggests that these institutions have failed to take measures that would have protected the vulnerable population from the disease. This claim is supported by medical reports and statistics, which indicate that one-third of those who have lost their lives of the disease were in care homes (Yourish et al., 2020). Their failure led to an unprecedented spread of the disease within a relatively short period. Individual healthcare experts have also failed in their role to control the spread of the virus within these organizations. Reports indicate that there have been cases where the outbreak of the virus was caused by medical practitioners who failed to sanitize properly after handling a patient already diagnosed to be positive (Tomeo, 2020). In cases where it is proven that institutions or individuals were negligent in their actions, it may be necessary to take appropriate punitive actions against them, especially when people lose their lives
It is always easy to criticize individuals and institutions without understanding the unique challenge that they face. According to Tomeo (2020), COVID-19 has proven to be an elusive virus that medical practitioners are struggling to understand. In the United States, many healthcare workers have lost their lives trying to fight the disease. Their selfless actions are often shadowed by claims of negligence by individuals who have been safely quarantined in their homes. It is possible that sometimes one may make a mistake in the process because this is a new normal for almost everyone around the world. Such a mistake should not be used to attack these healthcare providers who have never given up on people. Homecare institutions that have remained open should also be lauded because some of their clients have nowhere to go during such a period. They are risking the lives of their employees to ensure that senior citizens in the country have a home. Society should do better than to attack healthcare workers verbally or even threaten them with a legal suit. Such actions may create fear among doctors and nurses who may consider withdrawing their services from some institutions. Such a move may worsen an already bad situation.
Recommendations for Change
The case study shows that a section of society, especially those who have lost their loved ones to COVID-19, believes that medical practitioners are not doing enough to combat the spread of the disease. They have been blamed for gross negligence (Glenza, 2020). Although it may be true that a few medical staff have been irresponsible in their action, the vast majority have remained committed to fighting the disease. One of the recommendations that these practitioners should embrace is the need to follow guidelines provided by WHO on how to dress when handling a patient who is positive of the virus. They need to learn how to wear, use, remove, and dispose of the gear after use. Doing so will not only protect them but also their patients and their loved ones. Doctors and nurses should inform the management of institutions they work for about the needed supply for the protective equipment. Early communication of projected demand for these items would ensure that they are availed at the right time. It will also eliminate cases where protective gear has to be reused. These healthcare workers should also be keen on gaining more knowledge about this new disease.
Hospitals, rehabilitation centers, skilled nursing centers, and personal care homes have a responsibility of ensuring that they protect senior citizens who are more vulnerable to COVID-19. One of the areas that they should give top priority is equipping their medical experts. Doctors and nurses who are constantly in contact with patients should have appropriate protective gear to ensure that they are protected from the virus. The equipment also helps in ensuring that they do not spread the virus to their patients (Baron & Corbin, 2019). The institutions should limit visitation by friends and family members who are admitted. In cases where such visitation is unavoidable, visitors should have the right protective gear that will ensure that they do not spread the virus to the patient, and neither should they acquire the virus during such processes. Visitors should purchase their own protective gear to lower the cost of operation. Strict supervision will be necessary to ensure that patients do not have physical interaction with visitors delivering supplies to the facility. It may also be necessary to limit physical interaction among the elderly within the care facility.
The federal and state governments have major roles to play in facilitating healthcare institutions during this period of the COVID-19 outbreak. The primary role of the government is to provide funding to these institutions. Every medical practitioner, especially a doctor and a nurse, is expected to wear a set of protective gear for every patient they handle. It means that a nurse can use over ten protective clothing in a day. Hospitals and home care institutions may not afford to avail such a huge number of the suppliers needed by these practitioners. Funding from the government can help overcome the problem. Another major role is to ensure that doctors, nurses, clinicians, cleaners, and any other person working within a healthcare facility are adequately trained on issues relating to the new disease (Torres-Villarreal & Bernal-Camargo, 2019). Empowering the staff makes them more responsible and aware of the challenges that they have to address. When new scientific discoveries about the disease are made, the information should be made available to the medical staff within the shortest time possible. The state government has the responsibility of inspecting and supervising healthcare facilities to ensure that they are following the set guidelines on how to manage the spread of the disease.
Evaluating How to Use This Information in the Future
The case has had a major impact on my understanding of the responsibility that one should have when undertaking their responsibility. It is clear that doctors, nurses, clinicians, and every other person who is working in the healthcare sector are risking their lives because they are at the highest risk of contracting the coronavirus. However, the slight omission by some of these practitioners has led to mass loss of lives. It indicates that slight negligence may have major implications. The concepts learned in this course warn against any form of negligence when one is attending to a given role assigned to them. The grim situation in many home care facilities in the country was caused by such negligence. I have also learned that the success of an institution directly depends on the output of every employee. A failure of one nurse to observe the set guidelines may lead to a massive outbreak of the disease even if other staff members are responsible. The case will significantly affect my future practice. I have learned about the significance of being responsible when undertaking a given assignment. The case has enabled me to understand and appreciate the value of employees working as a team.
It is clear from the course that ethics, professional duties, and legal factors are intertwined. When undertaking a given professional duty, one must strive to be ethical. They need to ensure that they do the right thing at all times and in the right manner (Figar & Đorđević 2016). Some people may be tempted to engage in unethical practices when they have the opportunity to do so, especially when it involves gaining some benefits or when it is the easier way of addressing a given task. However, it is necessary to understand the fact that failing to be ethical may have some legal consequences. If the unethical behavior directly or indirectly leads to death or any form of harm to another person, then it may result in legal action. The information from this course has enhanced my interest in further study of ethics and law. I need to gain more knowledge about the relationship between ethics and law. Of great interest to me is to understand when unethical behavior may lead to legal consequences. I intend to use the information from the case and the course to define my career path. I intend to practice law and become a legal scholar, especially in the field of medical law.
References
Baron, P., & Corbin, L. (2019). Lawyers, mental illness, admission and misconduct. Legal Ethics, 22(1), 28-48.
Figar, N., & Đorđević, B. (2016). Managing an ethical dilemma. Economic Themes, 54(3), 345-362.
Glenza, J. (2020). Covid-19: Nursing homes account for staggering share of US deaths, data show. The Guardian.
Tomeo, T. (2020). Conquering coronavirus: How faith can put your fears to rest. Sophia Institute Press.
Torres-Villarreal, M. L., & Bernal-Camargo, D. R. (2019). Learning legal ethics in the law clinics: One hundred thousand housing law for offences against minors. Legal Ethics, 22(1), 103-108.
Yourish, K., Lai, R. K., Ivory, D., & Smith, M. (2020). One-third of all U.S. coronavirus deaths are nursing home residents or workers. The New York Times.