Introduction
This essay aims to discuss certain aspects about the increasing trend of rapidly growing Sexually Transmitted Disease (STD) among the US’s major foreigner community Latino. The matter becomes serious when specifically we look at the population of this community in the Los Angeles (LA) county, of the California (CA) State. It has around 4.9 million Latino-based population. The Latino population includes 48.3 percent of total in LA and 38.4 of total in California. They also comprise of 21.6 percent of total firms in LA and 16.5 percent of total firms in the California. They are owned either by the Latino men or women.
It becomes evident from the latest research trends about the STD transmission and spread that, the Latino population is influenced with the potential attacks of this fatal disease in the Los Angeles county of CA. This paper outlines some of the important facts related to the general ethical and medical principles that are important to learn and apply in the context of HIV/ AIDS. They need to be related to the awareness and protection of the Latino Male community of this county. It also identifies and highlights some of the important inadequacies that are associated with their application with regards to the overall population, which further calls for the creation of a new healthcare program to spread more awareness amongst this targeted population.
The Health Issue or Problem
The excessive STD causes an uncertainty amongst the physicians during the diagnosis and prescription given to their potential STD patients. They prefer to prescribe defensive medication to their potential STD patients in fear of being getting sued due to any medical mistake. This defensive medication includes measures such as instructing potential STD patients to carry out costly medical tests out of fear of potential STD (Diaz, Ayala, & Bein, 2004). This practice lowers the chances of improvement of patient care because of diverting from its original purpose of offering quality medical care. The electronic and print media places numerous advertisements for STD diseases such as HIV/ AIDS against different health care professionals and providers frequently.
Law firms claim to offer specialized services related to health care related cases. As a result HIV/ Aids Control providers and facilities tend to terminate their services due to excessive financial pressure against STD. The excessive STD and subsequent tort system is subjected to providing approximately $10,000 for a family of four members (Gassert, 2008). This will obviously result in an increase of overall HIV/ Aids Control spending by approximately $124 billion. On an individual account, this results in an increase of medical liability premium. In addition, it is important to note that, we are targeting the Latino Males Community from the Los Angeles County of the California State. They are not from well-to-do families from economic and social perspective. The age range for these males will be around 25- 45 years.
Detailed Description of Heath Site: Impact of Excessive STD on the Historical Evolution of HIV/ AIDS Control
As per the statistics obtained from the healthcare website on HIV/ AIDS, it is found that, the average cost required to defend potential STD in the late 1990s amongst the Latino males was approximately $25,000 per case. This resulted in an increase of insurer’s spending on the HIV/ AIDS Control in order to adequately deal with the claims related to STD. In 1998, the total spending on the HIV/ AIDS was around $750,000 which reached to $800,000 by 1999. In 1994 to 1996, 34 percent of the Latino male claimants assessed amounts of around 1 million or more. By the year 1999, around 52 percent of the total patients suffering from STD diseases, were provided an assistance of around one million dollars.
This resulted in serious natured economic problems for the doctors and malpractice carriers and compelled them to exit from the HIV/ AIDS Control market completely. One such example was the case of St. Paul Companies, which was considered as a large malpractice carrier and it was covering many medical service providers. In 2001 it had to announce that it would no longer provide coverage to any medical practitioner. Between 2000 and 2003 around 60% increase was observed in average malpractice premiums and it was associated with the total Medicare cost (Carter & Hall, 2007). It was around $16.5 billion out of which $7.1 billion was spent with regards to the physician related services. President Bush had supported medical liability reforms during those times. The reform ensured explicitly that compensation or recoveries for non-economic damage should not exceed a reasonable amount.
However, today, we have Medicare – A national social insurance program in the United States, which is implemented since 1966 by the U.S. Federal government (Braithwaite & Arriola, 2003). It guarantees health insurance to all those people that are suffering from different disorders or diseases. This insurance program is also meant for the people that are physically or mentally disabled and are not able to work in any of the given system. This program has also covered the STD diseases so as to provide necessary medical assistance to the people of US.
Literature Review and Critique of Past Practices
We can consider the overall STD and tort system as the one that reflects ‘winning a lottery’ mindset (Beauchamp & Childress, 1983). It is a fact that money cannot become an alternative or replacement for a hurt or a wounded individual. STD is such a type of disorder, which is not only difficult to handle from the medical perspective, but also from the social and cultural perspective. Such patients find it extremely difficult to adjust them in a given societal environment. In addition, inappropriate monetary compensation and special focus issues makes the condition all the more worse. Further, several medical research studies have concluded that, due to lack of awareness amongst the Latino male population they are failed to address this medical issue. Hence, only curing the STD issue will not work; one needs to design special healthcare education programs and spread the awareness amongst this targeted population to avoid the future issues.
Innovation Practices and Interventions
In HIV/ AIDS Control it means an agreement in written or any other form between the patient and the physician and/ or medical service provider that shows patient’s consent to follow directions of medical service provider. Negligence or poor compliance with the ethical principles is considered as an important HIV/ AIDS Control problem as this can result in an inefficient or ineffective treatment. This inefficiency can cause serious negative implications and effects on the patient’s health (Brody, 1998).
Further, in the given Los Angeles Latino Male Community, it has been noted that, people are affected with this disease, but there are no proper steps taken to help them or to cure their disease. There is a lack of proper healthcare framework, which fails to create the desired awareness on HIV/ AIDS amongst the people.
Even, the medical staff is failing to handle such responsibilities. They are the ones that will play an important role in addressing such negligence problems. Their effort to understand the patient’s case history in social contexts and living conditions will result in more effective treatment results (Butts & Rich, 2008). The general ethical principles about medical practice lay basic guidelines for the concerned individuals i.e. physicians, nurses, researchers and potential STD patients about a particular treatment program.
Thus, in order to address various issues, the four ethical principles provide a basis for important statements of human rights such as from the World Medical Association’s Declaration of Helsinki and United Nations organizations. These statements provide important framework for the Universal Declaration of Human Rights (UDHR) that is part of the international human rights commission (Nemoto et al., 2004).
The ‘Beneficence’ is considered as an important value associated with the health care ethics. It means physicians or treatment decision makers should take best decisions that do favor and benefit the patient. Hence, in the cases of the patients from this community, they should be provided with the state-of-art medical services, which will not only cure the STD disease, but will also, make them eligible to live in a given society.
The ‘Non-Maleficent’ principle encourages the practitioners and HIV/ AIDS Control staff to ‘avoid any sort harm’ for the potential STD patients. Some over enthusiastic physicians try to essentially prescribe a medicine to every patient before leaving their office. This over-prescription must be avoided as it can become a serious healthcare issue in negative terms for the patient. There are many possible side effects that can be associated to each such prescribed medicine (Kawachi, Subramanian, & Almeida-Filho, 2002).
It is believed that Aristotle had originated the basics of Justice theoretically and Abraham Lincoln held it in practical sense. This principle means that “all men (human-beings that include women as well) are equal and should be treated equally”. It’s implication in HIV/ AIDS Control ethics is a principle that talks of equality in providing treatment, facilities and services to the people without making any discrimination of any kind
The relationship between the HIV/ AIDS Control staff and a patient is important that should be built on the basis for mutual trust, respect and cooperation. They all must establish adherence to the ethical principles (‘autonomy, beneficence, non-maleficence and justice’). They all should remain honest in every matter. The physicians should not mislead potential STD patients about any false or unjustified expectations about positive results of treatment (Fryer, Dovey, & Green, 2000).
All the medical organizations in the Los Angeles Latino Male Community should follow the following requirements of the ethical principles:
- Safe and effective treatment should be provided to the patient in the form of well-resourced and well-managed programs.
- The HIV/ AIDS Control staff should strictly follow the guidelines of all the ethical principles provided by the government sources (Kawachi & Kennedy, 1997).
- The HIV/ AIDS Control and treatment programs should be equally accessible to the dependent persons.
This is important to be followed by all the medical institutions so as to encourage the health of such patients. In addition, they need to constantly update all the guidelines and procedures so as to better take care of the patients. In addition, the nursing staff should also take care of the families and provide them appropriate guidelines so that they can also take care of their family member in a better way. Since the income of these males is less, it will be necessary to provide them treatment at reasonable cost. And, if there is any serious issue, he will be immediately transferred to any of the biggest hospitals and submit the required documents to the management team. It will help to balance such issues from different perspectives.
I would like to highlight now one of the case studies of the Los Angeles Latino Male Community, wherein negligence can be observed both from the patient side, as well as from the medical staff perspective.
Luis Smith describes about the medical case and physical history of a 27 year old Latino Male suffering from HIV/ AIDS. According to his history and physical information noted down by HIV/ AIDS Control staff working at the Emergency Department, he often comes to hospital and presents him with his medical issue. He also has a history of orthostatic hypotension. He is very much careless in taking medicines on time and following the schedules provided to him by the medical staff. He stated during one of his visits to the hospital that he could not get out of his chair to take medicines as he was afraid of passing out from orthostatic hypertension. Further, each and everyone in the nearby nursing home facilities refused to admit him as a patient.
Luishad listened to the discussion between that patient and his doctor that several nursing home facilities had refused to admit him for providing necessary patient care because of his consistent and continuous non-compliance with the ethical and medical principles. He had terminated his relationships with most of the physicians that practiced in the surroundings of California, LA.
However, there is a fault of the patient since he has not been taking care of his health and also not following the medical guidelines instructed to him. In addition, despite suffering from the HIV/ AIDS disease, he has failed to take proper care of his health. But, during the same time, even the hospital and medical services have failed in treating and handling such a patient. They have provided medications and other necessary guidelines, but have failed to serve the patient, despite the fact that he has been suffering from HIV/ AIDS. Thus, under such situations, it is the responsibility of the medical staff to take control of him and explain the consequences clearly.
Deal with the negligence issues
Sometimes, potential STD patients do not follow the advice given to them by their health care practitioners. This mismatch in the action and behavior of patient is commonly known as Negligence.
There are several sensible ways to deal with such patient non-compliance to the medical instructions. The physician needs to perform valuable assessments and try to find the reasons for patient’s non-compliance. The relationship that exists between a patient and his physician is very crucial and the relevant HIV/ AIDS Control staff should intelligently get knowledge about patient’s way of living. The method of questioning can be adopted to find out trouble spots so that those can be identified without causing an embarrassment (Altman, 2003).
For instance, the physician can encourage the patient to suggest an understandable and acceptable treatment schedule. The physician and concerned HIV/ AIDS Control staff should perform a thorough assessment of the patient’s life style, problem areas and other difficulties in following the schedule. They thereby, can suggest him with the necessary recommendations that are feasible and practical to fit to his needs, requirements and personal priorities (Fisher & Fisher, 1992).
Reflection
Patient negligence with the treatment in accordance with the principles laid down under ethical principles is an important problem that needs to be addressed. A patient-centered model needs to be followed in which communication between a patient and nurse should be made in such a way that patient’s point of view is given a greater importance.
There is some literature available related to the nursing standards that argues that the dominant view of negligence failure is subjected to the social aspects of potential STD patients’ lives. Therefore another argument evolves that it should not be assumed that negligence is only due to the fact that potential STD patients do not follow advice of physician or HIV/ AIDS Control staff.
Instead, the possible reason of negligence may be the problematic social circumstances or any other severe living conditions in which potential these patients live. For example, consider a woman patient who is advised to walk around the block everyday, but the locality resembles to a violent neighborhood.
Obviously the ground reality and her living conditions do not allow her to follow the directions of physician or HIV/ AIDS Control staff. But, in papers and according to the records she would be marked as a non-compliant patient. Hence, HIV/ AIDS Control staff should recognize and mediate with the social context of potential STD patients. There is also an opportunity for the HIV/ AIDS Control staff to take a role of leadership and advocacy by learning the effects of treatment on a patient’s life, along with their effects on his health.
Assignment as Health Control Coordinator in the LA County
This assignment as a Health Control Coordinator discusses some of the important facts related to a serious crisis existing in Los Angeles HIV/ AIDS Control system. It is a fact that the national HIV/ AIDS Control system is considered as one of best HIV/ AIDS Control system globally and it is followed by other countries as a role model. But, the rapid increase in HIV/ AIDS Control costs makes it important to critically look into the system and identify some of the important reforms associated with it. The newly proposed HIV/ AIDS Control reforms will be meant to provide relief to the US citizens in general and specifically Latino ethnicity.
In addition, I have also found issues on awareness and lack of proper healthcare facilities due to which, many patients fail to get the desired treatment. Even, the local government is failing to meet these medical requirements of the people. Hence, being a healthcare coordinator, I would like to include two basic things in my program: (i) creating a campaign and canvassing it into those areas, where sexual literacy will be less. Even, the children will be taught lessons on Sex Education and they will be provided proper guidance. In addition, there will be special focused groups created with a view to make people educate about the disorder, how it occurs, and how it can be cured. This will make the task a lot easier for the physicians and the patients to handle such issues.
In the Los Angeles County, the medically insured citizens spend highest in terms of per person cost for the STD treatment. Hence, as a coordinator of the Health specific programs it is one of the biggest challenges that I have to deal with. This factor needs us to introduce specific facility based training programs for the healthcare staff that can drive the physicians to prescribe defensive medication to their potential STD patients (Ash et al., 2003).
This will result in increasing the quality of HIV/ AIDS Control services to the citizens and the probability of unavailability of provider or doctor when a patient needs its services will increase. This research intends to provide a detailed and comprehensive insight into the relationship to HIV/ AIDS Control changes subjected to the STD and the investigation about its impact on the historical evolution of HIV/ AIDS Control system.
I would like to add a program that will note down some specific medical issues, for which the case either goes for the top-level authority, and only then he will be able to prescribe the medicines. I would like to pick at least one or two days from the week and will include several people from that respective city to join for this movement.
Further, a careful analysis about the significance of this event based upon our beliefs and values needs to be submitted in the form of a detailed survey report. As a Coordinator to Heath specific Programs the main focus will remain on the implementation of HIV specific educational and awareness programs targeting the Latino community. The healthcare staff will be indulged in taking all the necessary steps and protection measures about education of the safe sex to the potential patients.
Conclusion
The study provides a solid basis to investigate several important aspects about the STD cases found amongst the Latino community. This significant event affects the overall HIV/ AIDS Control system and puts a barrier in the way of offering affordable services to the Latino community of Los Angeles. There were some efforts made on the governmental level to deal with this problem but still a lot of things need to be done.
One of the important things that should be done in order to adequately deal with the STD is to make an attempt to develop a culture of taking bold professional decisions. The actual problem is not a mistake made by a HIV/ AIDS Control professional but, might be of the management personnel (Bates et al., 2003).
The potential STD patients’ negligence to the proscribed medical medications and ethical principles can cause serious implications that may affect their lives. A large quantity of literature related to nursing standards and guidelines considers patient negligence as the problem of patient and it needs to be resolved by intelligent interventions of physicians and/or HIV/ AIDS Control staff. This paper concludes by proposing some of the recommendations to better deal with the problem of patient negligence in the cases of HIV/ AIDS.
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