7-2 Final Project: Analytical Philosophy Paper
PHL-212-Q6135 Introduction to Ethics
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7-2 Final Project: Analytical Philosophy Paper
In the medical field, things are constantly evolving. From the types of procedures done for certain ailments to the rules that medical professionals have to follow on a daily basis, medical personnel must ensure they are at the top of their game at all times. This is why most medical facilities have a department that is solely dedicated to maintaining and enforcing these changes. The Compliance Department has been designed to prevent, detect, and correct employee violations of the Federal, State, or local laws, or institution policy and procedure violations. (Corporate Compliance, 2015) One of the most drastic changes that have come around is the implementation of HIPAA (Health Insurance Portability and Accountability Act of 1996). According to the U.S. Department of Health and Human Services, the HIPAA Privacy Rule provides protection for individually identifiable health information held by covered entities and their business associates and gives patient’s rights with respect to that information. The Privacy Rule also permits the disclosure of health information needed for patient care and other important purposes. (Health Information Privacy, 2015) All medical professionals understand the necessity of HIPAA and how this has helped protect the medical offices as well as their patients. However, the patients as a whole have showed many concerns due to the complex rules and regulations.
One of the rules, in particular, is the treatment of minors over the age of eleven. Within the HIPAA rules, there is a section that clearly states that if there is no law that specifies that a parent may or may not have access to the child’s information, the HIPAA regulations state the provider my decide to provide or deny access as long as it is consistent with state or local laws. (Carol Ford MD, 2015) This was put in place to protect the patient as well as the provider from unwillingly disclosing information to those who do not need it. In English, this means that the provider or medical facility has the choice to release medical information to the parent or guardian as long as it is in accordance with state or local laws. It does not matter that the parent is responsible for the insurance and is liable for all financial debts, they will not tell them what is going on with their child if it is not against any laws. The only exception to this rule is if the provider feels that the child is in danger of hurting themself or someone else. One question that still remains is exactly how ethical is it for a medical facility to withhold important medical information about a child from their parents?
There are certain categories of treatment that fall under this rule. COPIC Insurance Company conducted a survey of the Colorado Law concerning Minors and Risk. This survey states that the minor can get medical care and that medical information can be withheld from parents or guardians of minor childern concerning their medical treatment if the minor falls into one of the following catigories (Frequent Liability Concerns in the Health Care Setting, 2012):
· financial independence
· marriage
· prenatal, delivery, and post-delivery care
· minors who are parents
· birth control
· venereal disease
· addiction
· youthful offenders
As a parent, it is understandable that a minor who is married, has financial independence, has children of their or is considered a youthful offender would fall under this rule. However, the other items are up for debate.
Prenatal, delivery and post-delivery care as well as birth control and venereal disease are categories that are a very hot topic. These items alone undermine the traditional morality and family values. Allowing children to have pre-marital sex discourages the special and unique relationship of one man and one woman in a lifetime of marriage, and undermines marriage both as an institution and as family values. It also encourages sexual activities that are detached from true love and having children. (Thiroux & Krasemann, 2015) According to the Colorado Revised Statues, which regulates the laws for minors and birth control services rendered by physicians, birth control procedures, supplies and information can be furnished by providers to any minor who requests and is in need of birth control procedures, supplies or information. (CRS 13-22-105 Minors – birth control services rendered by physicians, 2008) If a provider is giving this service to a minor and is not informing the parent or guardian of the child’s sexual activities as well as providing birth control, then they are not only assisting in this act, they are disregarding it as well.
Another factor is the mental ability of a minor to make his or her own informed decisions. How can a minor of thirteen years old understand all of the medical terminology and make an informed and educated decision about their own health? According to our text, Informed Consent is a term that refers to procedures where the patients, or their family members if the patient cannot perform this duty, consent to some sort of medical treatment that could have detrimental side effects to include death. (Thiroux & Krasemann, 2015) For example, Mirena is a hormonal intrauterine device that is inserted into the uterus for long-term contraception. A T-shaped plastic frame that releases a type of progestin, Mirena thickens the cervical mucus to prevent sperm from reaching or fertilizing an egg. Mirena also thins the lining of the uterus and partially suppresses ovulation. (Staff, 2015) As an adult who works in the medical field, this is very easy to understand. As an adult that is not in the medical field, this explanation can be figured out quickly. As a child of thirteen, there are many words that are not in their vocabulary so understanding would be next to impossible without an adult explaining it to them. If they are unable to comprehend this definition, how can they make an informed decision about their own care?
Addiction is another subject that is very touchy in the healthcare community. According to the National Institute on Drug Abuse, 5.2% of seniors reported non-medical use of the opiate pain reliever OxyContin within the past year. In addition, nearly one in ten 12th graders abused the pain reliever Vicodin, second only to marijuana. In 2007, nearly 6% of 12th graders reported abusing over-the-counter cough and cold medicines at least once in the past year to get high. (Drug Facts Chat Day: Drug Abuse, 2015) These statistics are alarming to say the least. If a child is suffering from addiction, the parent has the right to know in order to take care of that child to the best of their abilities. It is the parent’s responsibility to ensure safety and the best treatment for their child, so shouldn’t they be informed of every medical issue they may be facing? To be able to treat a drug addicted minor without the parents’ consent is something that is hard for any parent to understand.
On the other hand, some say that the child would not seek medical treatment of some conditions if they had to tell their parents. According to the Alan Guttmacher Institute, most medical professionals believe that if minors who are sexually active had to inform a parent or have their parent’s consent to have medical treatment they would most likely not seek out care. (Boonstra & Nash, 2000) When these minors do not seek out medical care for issues concerned with being sexually active, many problems can arise, and some can be life threatening. Most teens that have a sexually transmitted infection (STI) show no symptoms and going untreated can cause chronic pain and infertility in the future and increase the risk of a life-threating tubal pregnancy. (Sexually Transmitted Infections (STIs), 2015) STI’s will not just go away without treatment. The symptoms may come and go, but the damage continues to get worse every day. The good thing is that almost all STI’s can be cured, the sooner they get attention the less chance of permanent damage to the child’s body and reproductive organs.
In the AMA Journal of Ethics Clinical Cases, Dr. Nelson had a situation with one of her fifteen-year-old patients and her father while in the emergency room after an Intrauterine Contraceptive Device (IUD) was implanted and the child ended up with a Pelvic Inflammatory Disease (PID):
“After her father left the room, Andrea pleaded with Dr. Nelson not to tell him that she was sexually active. She said that his threat was real—he had forced her older sister to leave home when she got pregnant at age 18. Andrea said that things at home were fine and that she and her father had always gotten along well, but that he had made it clear that he believed his daughters should wait to have sex until they were married. “Even if you don’t say anything, he’s going to think this is because I’m having sex,” Andrea insisted. “Can’t you just make up another reason why I’m sick?” (Xiomara M. Santos, 2012)
This case is as real as it gets. I would venture to say that most people in the United States either have heard of or personally know a family that has kicked out one of their children for doing something that they do not believe in or is against their religious beliefs. There are millions of teens that become homeless due to one factor or another each year. The National Association for the Education of Homeless Children and Youth claim that an estimated 1.6 to 1.7 million youth experience homelessness on their own each year, and 20-40% of unaccompanied homeless youth have been thrown out of their homes because they are gay, lesbian, bisexual, transgender, or pregnant. (Unaccompanied Homeless Youth, 2015) With these children “on the street”, the percentage of sexually transmitted disease and drug addiction are staggering. The other problem with this situation is that once the child is on the street, having them come in for any type of medical care is almost impossible. The adult community has tossed them out, so it is easy to see why they would not trust them now.
When I first started working in the medical field, as a parent I was alarmed at the thought of this rule actually existing. I could not understand what provider or medical facility, in their right mind, would not inform the parent of their child’s medical information. As I moved up the responsibility ladder, I started to look into the reasoning behind this rule, and why it was important to do business in this manner. After conducting much research, I can see and feel the concern of both sides of this issue. I do believe that parents have the right to know everything about their children, including their medical care. Adversely, I understand that most children will not get the care they need if a parent or guardian is informed of some of the situations listed above. This dilemma comes down to the morality of the child’s overall health. Act Utilitarianism states that everyone should perform that act which will bring about the greatest amount of good over bad for everyone affected by the act. (Thiroux & Krasemann, 2015). With this in mind, it is easy to see that getting the best care for the child to ensure a healthy life is the greatest amount of good over bad.
In conclusion, the overall wellness of the teen is what needs to be considered, and nothing more. I feel that it is morally right and ethically correct for a provider to withhold certain medical information from the parent or guardian to ensure that the patient, in this case the adolescent child, gets the medical care that they need in order to maintain a healthy life. As much as the parent or guardian and some medical professionals may disagree, the child’s care is what needs to be thought of. Beyond all of the information above, not providing this information to the parent is the law, and following the law is always ethically correct.
Works Cited Boonstra, H., & Nash, E. (2000, August). The Guttmacher Report on Public Policy. Retrieved from The Guttmacher Institute: http://www.guttmacher.org/pubs/tgr/03/4/gr030404.html Carol Ford MD, A. E. (2015, July 17). Colorado Departemnt of Education Documents. Understanding Minor Consent and Confidentiality in Colorado, 5. Retrieved from Colorado Departemnt of Education: https://www.cde.state.co.us/sites/default/files/documents/healthandwellness/download/school%20nurse/understanding%20minor%20consent%20and%20confidentiality%20in%20colorado.pdf Corporate Compliance. (2015, August 26). Retrieved from Johns Hopkins Medicine: http://www.hopkinsmedicine.org/compliance/ CRS 13-22-105 Minors – birth control services rendered by physicians. (2008, January). Retrieved from Prenatal Plus Provider Manual: http://cospl.coalliance.org/fedora/repository/co%3A12509/he192178p862008internet.pdf/he192178p862008internet.pdf Drug Facts Chat Day: Drug Abuse. (2015, August 19). Retrieved from NIDA for Teens: https://teens.drugabuse.gov/national-drug-facts-week/drug-facts-chat-day-drug-abuse Frequent Liability Concerns in the Health Care Setting. (2012, July). Minors and Risk. Denver, Colorado: COPIC Insurance Company. Health Information Privacy. (2015, August 24). Retrieved from U.S. Department of Health & Human Services: http://www.hhs.gov/ocr/privacy/hipaa/understanding/index.html Sexually Transmitted Infections (STIs). (2015, August 14). Retrieved from Cincinnati Childrens: http://www.cincinnatichildrens.org/health/s/std/ Staff, M. C. (2015, January 15). Mirena (hormonal IUD). Retrieved from Mayo Clinic: http://www.mayoclinic.org/tests-procedures/mirena/basics/definition/prc-20012867 Thiroux, J. P., & Krasemann, K. W. (2015). Consequentialist (Teleological) Theries of Morality. In J. P. Thiroux, & K. W. Krasemann, Ethics Theory and Practice (p. 37, 265, 291). Pearson. Unaccompanied Homeless Youth. (2015, August 25). Retrieved from National Association for the Education of Homeless Children and Youth: http://www.naehcy.org/educational-resources/youth Xiomara M. Santos, M. (2012, February). Protecting the Confidentiality of Sexually Active Adolescents. Retrieved from AMA Journal of Ethics: http://journalofethics.ama-assn.org/2012/02/ccas2-1202.html
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