morality and ethics: could one patients’ right, overrule the other

Morality and ethics seems to be a broad topic, misunderstood by many, however is it really that difficult to understand, or do we just not want to. Morality is defined as the belief that some behavior is right and acceptable and that other behavior is wrong (“Morality definition and meaning | Collins English Dictionary” , 2019) and ethics defined as the principles of conduct governing an individual or a group. In the hospital setting, ethics and morality is expected to be highly raised and practiced, however from personal experience it is evident that it is not as greatly practiced as it is portrayed. The definition of morality and ethics takes me back to my 2nd week of clinical practice in my fourth year, when I encountered a patient who was homeless, and well beyond his 6 week stay, without any news from the shelters which have been applied for. The patient is expected to be discharged as of course the placement need beds, however he has nowhere to go, on the other hand a new patient needs full time rehabilitation but cannot receive it as the placement is full. Therefore the argument stands, whose rights are of more value. The South African Bill of rights Constituion states that every person has the right to access to basic HEALTH CARE, “South African History Online, 2019”. The rehabilitation placement is situated in Mitchells plain, where patients who require long term rehab as they are not fit to enter the community, they then receive therapy and are held for 6 weeks, if the patient needs more than 6 weeks the therapy staff along with the doctor have to motivate why the patient is not yet fit to leave, although these patients deserve to leave when they are ready to be reintegrated into the community, even if it takes more than 6 weeks, however, there are patients fresh out of hospital that need to be sent home directly to cope on their own, with only therapy which can be received at their local clinic, where they need to wait weeks or even months for a follow up. These patients await placement and can only get a bed when another patient leaves. Is it fair, or ethical to send a patient home, knowing that they are not ready to survive independently , simply because they need to empty a bed, but is it fair to the patient waiting at home for therapy when there is someone that no longer requires full time therapy, they just don’t have a place to go.

This situation in particular bothers me very much as the patient is not one of my patients, and I therefore am not asked my opinion on what should be done regarding discharge, it also bothers me how little the opinion of the student physiotherapist matters at this placement, the student is fighting for this patient to stay at the hospital until they find a permanent placement for him, however the doctors and nursing staff are arguing against it as he has had his fair share of therapy and is well beyond his 6 weeks of stay. On one hand, I am glad that it is not me that has to make the decision, but on the other hand I feel that as an almost qualified health professional, I need to stand up for my patients’ rights regardless of the consequences I might face, however, in this case which one is right and wrong, which patient deserves the bed, and who decides which rights overrule the other.

In South Africa we have a set constitution, where all the rights and ethical principles are clearly stipulated, and in a perfect world each and every right could be adhered to, but unfortunately, we cannot make decisions without overstepping ethical principles or patient rights in some way, it is therefore difficult to decide what the next step is and each choice could present with a complication or consequence of its own, we therefore have to take the decision and decide which rights we can adhere to , and which one overrules the other, should this situation just be treated as a first come first serve basis, or should the rights be adhered to that every member is entitled to access to proper healthcare.

We all have a set of rights, and somehow whether intentionally or not, they get violated, and sometimes we violate the rights of others. The decision to put one man on the street in order to accommodate another, could never be an easy decision, and although there are many brains working together to try and combat the situation, there will always be an unfair response or violation of somebody’s rights, and therefore it can be said that there is no absolute solution to this problem, or any problems similar to this.

Google.com. (2019). Morality definition and meaning | Collins English Dictionary. [online] Available at: https://www.google.com/amp/s/www.collinsdictionary.com/amp/english/morality [Accessed 20 Mar. 2019].

South African History Online. (2019). South African Constitution: The Bill of Rights. [online] Available at: https://www.sahistory.org.za/article/south-african-constitution-bill-rights [Accessed 20 Mar. 2019].

3 thoughts on “morality and ethics: could one patients’ right, overrule the other

  1. Hi Kayelene,
    Good topic and what you are taking about is relevent, i enjoyed reading it and it is a common question that a arises. The topic of a bed is always brought up and it is really distubing actually that our health sytem is failing their peope in this way.
    Make your arguement better and stronger by adding the basic right to the piece, find research on the states of the amount of beds avaliable and why it makes it so diffucult to keep pateinst to back your argument more and maybe add that this patient will later be a social issue because of him being homeless and not being intergrated into the community accordingly.
    your piece gave me alot of insight, i experience this on the daily where the bed is of more concerrn because the next patient needs it, where as the one that is already in it is just regarded as a formality. This is a uge problem in our country and ethically we are violating the patients right ro health care.

    content is relevent to topics in class
    Referencing seems fine

    – “however is it really that difficult to understand, or do we just not want to.” if this is a question add the appropriate punctuation
    – and ethics “is” defined as
    – The patient is expected to be discharged as of course the placement need beds, read this sentence again i dont understand what you trying to say the of course doesnt fit in, maybe use a different sentence construction.
    -patients- patients’
    -“The rehabilitation placement is situated in Mitchells plain, where patients who require long term rehab as they are not fit to enter the community, they then receive therapy and are held for 6 weeks, if the patient needs more than 6 weeks the therapy staff along with the doctor have to motivate why the patient is not yet fit to leave, although these patients deserve to leave when they are ready to be reintegrated into the community, even if it takes more than 6 weeks, however, there are patients fresh out of hospital that need to be sent home directly to cope on their own, with only therapy which can be received at their local clinic, where they need to wait weeks or even months for a follow up.” – try and form new sentences but still with the howevers and counterarguments, your sentences are too long. This is one sentence you just added commas to break it up.
    – Is it fair, or ethical to send a patient home, knowing that they are not ready to survive independently , simply because they need to empty a bed, This is a question right? add appropriote punctuation please.
    -This situation in particular bothers me very much- maybe use words such as distrubing, more professional use of language.

  2. Hello Kayelene,

    Thank you for allowing me to read your piece on morality and ethics. I enjoyed reading your piece and gaining more insight to what these topics mean to you. Your writing piece reflects on the topic’s discus in the class. Therefore, I would rate your content as good. I like how you made the reader experience what a patient that requires rehabilitation must go through. Your writing piece made me think about my clinical practice experience, how I refer my patients to step down facilities such as your placement and I’m not even sure if there are any beds available.

    I like the argument that you made in the fourth paragraph. As you stated in South Africa, we do have a set constitution, where all the rights and ethical principles are clearly stipulated. It is sad to see that some rights get overruled and that we must chose to which rights we are going to adhere to. It would benefit our writing piece if you can state which rights of your patient was adhered to and which ones where denied. You can also reference these rights stated to make your writing more knowledgeable. Every patient has the right to health services and therefore it is terrible that they should wait for beds and some must give up their beds for others. Have you considered making this argument of the beds available stronger by adding reference to how many beds are there for people who require rehabilitation and how many people get discharge before they are ready to go home?

    Adding the definition of morality and ethics was a good idea as many people struggle to define these two terms. The reference added for these definitions is adequate, just delete the space in the in-test reference between the “ and the ,. It would benefit your writing by adding more references as I suggested in the previous paragraph. Remember to add your reference list at the bottom of your writing piece.

    I like how your paragraphs flow and how your piece tells a story. Maybe consider using shorter sentences and less commas to make it easier to read. Overall your writing piece was good and a nice to read. I found it very interesting that doctors and nurses will send patients home who still require rehabilitation. Thank you for not agreeing with this and wanting to fight for the patient and his rights. More people should have this attitude.

    Few grammar and spelling errors that I have noticed and changed:
    First paragraph
    – First sentence: Morality and ethics seem
    – First sentence: Comma needed after however,
    – Second sentence: add is after ethics
    – Second sentence: Comma needed after acceptable,
    – Second sentence: No space between “ and , in reference (“Morality definition and meaning | Collins English Dictionary”, 2019)
    – Fourth sentence: 6 weeks
    – Sixth sentence: Comma after Therefore,
    Second paragraph
    – Third sentence: Delete space after independently and before the ,
    – Third sentence: End with a ? not a .
    Fourth paragraph
    – First sentence: Delete space after to and before the ,

    Thank you and all the best
    Megan

  3. Hi Kaylene

    Thank you for your piece on morality and ethics. I like this topic and the questions you raise in this piece. The content in your piece reflects the class discussions we had and the questions of the availability of beds can be applied to different block placements. I am currently at Paarl Hospital and the turnover rate is really fast, because of the amount of patients that needs to be admitted to wards and the amount of beds available. Therefor I can relate to your piece.

    To make your argument stronger I suggest that you state which rights of the patient is being violated, the one that needs a bed and the one that is currently at your placement. You can also add your views on why the patient who is homeless should stay and why the other patient do not deserve the bed as you do not know his diagnosis and social background. As he can be homeless as well.

    Overall the piece is an easy read, however you can try and shorten your sentences. Do not forget to add your references at the end.

    All grammatical errors are covered by the previous to comments, therefor I will not repeat it.

    Thank you
    Robert

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