Scenario 1
Impacts of EMTALA to Patients Seeking Emergency Treatment for other Reasons Other than Emergency
Healthcare reforms continue to bring to the fore several significant ethical issues. The Emergency Medical Treatment and Active Labor Act enacted in 1986 has fueled ethical discussions over numerous controversial topics (Moffat, 2016). The law aims at ensuring that patients receive medical attention during emergencies despite their insurance status or their ability to cater for the medical services. EMTALA outlines instances where a patient can be transferred to another hospital or when he or she can be refused treatment.
Although the law was enacted to reduce cases of ‘dumping’ or ‘wallet biopsy’ many patients continue to seek emergency medical attention even when they are not suffering from emergency health conditions. However, the law and the set code of ethics impact these individuals in various ways and among them is refused treatment. When a patient reports to the emergency department and requests care, he or she undergoes a thorough medical screening examination to determine whether he or she is suffering from an emergency health condition. If the condition is proved an emergency, the patient is treated until he or she is in a stable condition. However, if there is no emergency, the health center is not obliged to treat the patient.
Moreover, the law and the set code of ethics can also impact a penalty to those patients violating the EMTALA. The fine for those who negligently infringe the statute ranges from $10,000 to $50,000. This penalty is paid after the body involved with physicians and patients malpractice polices completes the investigation and finds the individual guilty of violating the act. The same scenario applies to hospitals that violate this law.
Scenario 2
Ways of Honoring a Patient’s Autonomy
As nurses perform their duties, they are obliged to respect their patients’ autonomy where they give them freedom to choose the type of treatment to undergo. In cases where the patient lacks the ability to make the decision, the nurses should include his or her attorney in their decisions (Lindberg, Fagerström, Sivberg, & Willman, 2014). However, there are cases where nurses find themselves in a dilemma of making their professional decision or respecting their patients’ autonomy. In such a case, I believe that use of systematic approach during decision-making is the best method of honoring a patient’s autonomy. This involves informing the patient of his or her medical condition and analyzing the interests of all the involved party before taking any action. This is because despite honoring the patient’s autonomy, nurses also have the duty of caring for other people such as the patient’s family.
This can be done through dissecting the problems where the nurse analyzes the consequences of honoring the patient’s autonomy. If the consequences deem to be wrong, the nurse should explain these effects to help the patient in making a prudent decision. Besides, the nurses should also take a consideration of their duties and obligations in healthcare. This involves considering the person they owe the duty as well as what is best for the patient.
How to Handle the Different Opinions
Various opinions are provided in situations of deciding whether to safeguard or ignore a patient’s autonomy. In such a situation, there should be a joint discussion where all opinions from the nurses are considered to come up with a collective answer in regard to patient’s autonomy. As a leader of the group, I will encourage the development of moral courage and acknowledge all the opinions of the group members. I will also engage the members in group discussions where the different individuals will try to understand each other’s opinion to make the right decision.
References
Lindberg, C., Fagerström, C., Sivberg, B., & Willman, A. (2014). Concept analysis: patient autonomy in a caring context. Journal of Advanced Nursing, 70(10), 2208-2221. doi:10.1111/jan.12412
Moffat, J. C. (2016). Appendices: Appendix I: Implementation of Emergency and Disaster-Related Policies and Procedures Relating to EMTALA: With and Without a Section 1135 Waiver. EMTALA Answer Book, 1-71.
