TABLE OF CONTENTS Executive Summary.........................................................................................................................1 INTRODUCTION...........................................................................................................................1 MAIN BODY...................................................................................................................................1 CONCLUSION................................................................................................................................4 RECOMMENDATIONS.................................................................................................................5 REFERENCES................................................................................................................................7
Executive Summary It has summarised the ethic principles that can define as the moral valueof an individual to practice it in the behavioural approaches while performing task or work. It has combined with thedifferentelementsfromthebranchofknowledgesuchassystematizingandalso recommended to measure the concerns in terms of morally right in proper manner. This case study based on the“GOSPORT WAR MEMORIAL HOSPITAL” because there are lot of problem arise in the hospital and faced by the patients. It will cover the public relation media coverage in terms of awareness and helping the patients. It has recommended to implement multiple approach to improve the condition and situation of hospital management system. 1
INTRODUCTION Ethics is defined as the moral principles of an individual to practice it in the behavioural approaches while performing task or work. This is useful by combining elements from the branch of knowledge such as systematizing and recommending to measure the concerns in terms of morally right and wrongdoing (Cook and Pavlov, 2019). The case study is based on the infamous Gosport War Memorial Hospital which took place in the 1990s under the prescription of Dr. Jane Barton. This doctor gained monetary benefits by recommending the opioid drugs which took lives of 456 patients from the elderly unit. This medical malpractice brought questions on the integrity and work ethics of healthcare professionals like nurses, pharmacists who were silent throughout this episode and never interfered (Seitz, 2018). However, in 1991, senior nurses reported about it to the Royal College of Nursing (RCM) but got covered up. Later in the year 2009, Dr. Barton was never punished severely but received disciplinary action by the General Medical Council (Hayes and et.al.,2019). Although she retired soon and continued to live with this guilt, there were assumptions that few more comparative examples took place in the hospitals of National Health Services (NHS). This case is significant in understanding the damages that such malpractices has on the entire value and worth in the eyes of the service users, regulatory bodies and other healthcare institutions (Boseley, 2018). This case study highlighted the lack of ethical standards and mismanagement of the medications and treatments plan without any supervision which has tarnished the reputation and trust of this hospital among the public who run to hospital for any health issue. This report is based on understanding the bioethics and associated challenges that posed as threat to the service users and their families. It includes about the role of patients, industry, public relations and regulators to analyse the implications of such malpractice. MAIN BODY This case study has again come into limelight when Jeremy Hunt, the former Health Minister apologised to the public in the month of June 2018. This apology was towards those families who lost people due to the use of Diamorphine, a life-shortening opioid drug which was given to the elderly patients of the Gosport War Memorial Hospital (Hawkes2018). It has also emphasized on the lack of auditing and monitoring of the working practices working in the 2
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health and social care. There were several times when nurses came out but were forced to stay quiet in order to minimise the risks to the hospital's reputation and might also affect the economic aspects as well. Patients: It has been understandable that the patients are the most affected category of any malpractice. They are at the footsteps of any corruption or malpractice that might affect their well being and affect their perspectives in consuming services or products to live a comfortable living (Mannion and et.al., 2019). Thethesis statementis to impart education about the rights and policies before assessing the healthcare services. This is important because the patients has been ignored and were treated in an unprofessional manner. In context to the case study, the patients were completely at the hands of the professionals like doctors, nurses etc. who were given wrong dosage to relieve from pain but it turned out that it became a death sentence for those 256 elderly patients. These patients were given an opioid drug which was syringe driven and used to attach to the patient's body at constant levels. This medication is given to critically ill patients whose recovery chances are bleak and after spiking with this, the patient dies after a short span of time. Additionally, the case study demonstrated that the patients died which came as a shock for their families but could not do anything about it apart from griefing. However, the other practitioners could have come in front to tell the regulatory bodies like Royal College of Nursing or administrative section including board of directors but these also failed miserably. They closed their eyes and ears and moved ahead doing their allotted tasks which was clear violation of ethical code of conduct. According to Hippocrates, it comes under moral obligation of such professionals to safeguard and protect the lives of people and thus it was effective in minimising the reputational risks. Public relations (PR) or media coverage: This factor is useful in bringing awareness to the public and helping in overcoming the challenges and barriers that hinder the ongoing activities and operational practices at the organisational levels. This section is refereed as the biggest tool in reaching the public at the worldwide levels and with technological advancements, it has been proved as a blessing to make public including patients, professionals, non health related bodies and individuals vigilant and 3
give them updates regarding any malpractice or good practice (Shanahan, 2019). The thesis statement is to utilise the several platforms of information for welfare of society. In regard to the case study, it has been observed that during the time of the occurrence of this malpractice, it was hidden from the public eye and the people were misled and shown empathy. However, when the senior nurses complained against this malpractice and informed the authorities of Royal College of Nursing, they subsided this entire fiasco and compromised on their ethical code of conduct. This showed that lack of work ethics and moral values paved the path of this unfortunate incident that took lives of elderly patients. Moreover, the PR here showed lack of commitment and professionalism which put questions on the working practices of professionals at the organizational context. Later when this came into limelight, the agitated families were complaining and asking numerous enquiries regarding the policies and legislative frameworks of the healthcare institutions. Here, the media coverage assisted them in gaining momentum to give the affected families' justice and fair chance of punishing the culprits and protecting such mishappening in the near future. This would help in maintenance of organization or professionals reputation. The industry or sector: Any sector or industry in an all round aspects must deal with any situational crises under unity and collaborative approachability. Here, the health and social care sector is crucial since its presence is omnipresent in all the aspects of an individual. The sector has the ability to formulate policies, guidelines and instructions to be followed by all the attached organizations and companies working in the same industry. However, this requires constant supervision and reviewing methodology to sustain the challenges and bring ethical and moral based solutions to maintain effective patient centred care (Baker, Dargan and Smith2019). In regard to the case study, this industry lacked the basic management technique like reviewing process, quality management by supervising or monitoring etc. to regulate their professionals and working conditions. They failed in tackling the challenges that posed as serious issue in later time. The families were disappointed and deeply infuriated on the unethical behaviour of Dr. Jane Barton who did not care about the ill effects of the prescribed drug and led to deaths of so many elderly population. The nurses and pharmacists knew about it and yet they didnotinformanyone.Thisbehaviourclearlyshowedthattheprofessionalswerenot 4
compassionate and cheated not only the patients and the families but also put the lives of people in danger. Thus, it is important to understand that the industrial norms and frameworks act as driving forces to bring fair opportunity to the affected individuals and the concerned authorities. Moreover, the focus is to maintain the transparency and reliability of the contribution from professionals and other people working in the sector in maintaining the image or destroying the reputation among the competitors in the same sector. Regulators: Theseplayimportantrolesinunderstandingtheestablishment,identificationand procurement of the available resources to provide qualitative services for the patient centred care. Therearemanystatutorybodiesthatprovideassistanceandsupportinrecognisingthe drawbacks and other challenging components that act as hindrance between the patients and the professionals working in the sector. In order to maintain the decorum and dignity of the patients, these regulators must be strict and adhere to the guidelines properly to safeguard the people lives and help them by giving quality and delivery of services(Thorns and et.al., 2019). Their role is significant to channelise the flow of communication and following of policies in compliance order to maintain the patient centred care. When the senior nurses complained to the authorities at the Royal College of Nursing, they tried to cover it up ad asked them to stay under low levels and not to bring this incident again. However, with time, it came to light that the real cause behind the deaths of those patients was due to usage of unwarranted drug. This came under the violation of oath of duty and broke the legal rights which gave the families a chance to sue the involved doctor. Moreover, the doctor was not punished and her licence was also working. This was not acceptable because the punishmentshouldhavebeenmoresevereandthiscouldhavebeenalessontoother professionals to work under the framework of ethical code of practices (Dyer, 2018). It would prove beneficial in maintaining the reputation and minimise such malpractices. CONCLUSION Ithasbeensummarizedthatthiscasestudyhashighlightedthedarkersideof professionals behaviour in gaining additional amount of money through illegal and unethical techniques. The role of professionals here has demonstrated that they also behave in normal human manner and sometimes face dilemma whether to follow moral principles or continue with 5
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the safety of the given job. The analysis clearly showed that the role of regulators and media coverage are crucial in formulating the policies and adherence to rules under ethical order. Moreover, the patients are the receivers in this sector and must be given complete attention to meet their requirements in wholesome manner. Here, the sector must be in sync with all aspects of performing the tasks at hand under the legislative framework to maintain the dignity, respect and reputation. Moreover, the patients must be given proper treatment plans and should be also educated regarding the dosage, medication and other vital signs to maintain the patient centred care. RECOMMENDATIONS Need of ethical code of practises at organisational levels It has been recommended to implement the ethical code of practices in the organization that require for independently maintain the organizational culture. It has required to give a proper auditing and provide the equal duties to their patients. Ethics are important principle which needed to apply in their moral duties to take right decision regarding the patient healthcare. It forms when individual with carried out the equal interest towards their goals and achievements. Code of ethics must be set the specific criteria when employee were follows the regular auditing and manage or strong the legal system in terms of healthcare. Proper ethics within the organization can offer many benefits to the patients and improve the corporate culture among the people(Baker, Dargan and Smith2019). It has a social responsibility to improve the better culture through the internal communication or legal practices. Establishment of strong management systems It has recommended in implementing the strong management system that help for organization to maintain their policies and procedures in proper manner. It has needed to handle every task in appropriate manner. The employees are mainly coordinates with other staff members to manage their internal communication which help for hospital staff. They also record the patient's information which necessary to easily identified at any time. It has used the system module where every staff record all type of examination and test results of patient (Dyer, 2018). It has possible when they will develop or establish strong management system to manage and control all type of facilitates and services in proper manner. 6
Training sessions for professionals The professionals must be given induction and orientation sessions initially to make them realise the significance of fulfilling the duties in professional and ethical manner(Dyer, 2018). This would help in bridging the communication gaps between the professionals and the patients with their families. 7
REFERENCES Books and Journals Baker, H., Dargan, S. and Smith, C., 2019. 46 Improving the prescription of anticipatory medications for adults recognised as dying in a district general hospital. Cook, G. and Pavlov, A., 2019.Disease in the Merchant Navy: a history of the Seamen's Hospital Society. CRC Press. Dyer, C., 2018. Deaths from medicines: lessons from coroners’ reports are too easily lost, review finds. Hawkes, N., 2018. Gosport: will justice ever be served?.BMJ: British Medical Journal (Online). 362. Hayes, P.W. and et.al.,2019. European naval diets in the sixteenth century: A quantitative method for comparative and nutritional analysis.Historical Methods: A Journal of Quantitative and Interdisciplinary History.pp.1-18. Mannion, R. and et.al., 2019. Healthcare scandals and the failings of doctors: Do official inquiriesholdtheprofessiontoaccount?.JournalofHealthOrganizationand Management. Seitz, D.W., 2018.World War I, Mass Death, and the Birth of the Modern US Soldier: A Rhetorical History. Rowman & Littlefield. Shanahan, D., 2019. A concept analysis of poor care using Rodgers’ evolutionary cycle.The Journal of Adult Protection. Thorns, A. and et.al., 2019. 47 Demonstrating safe prescribing at the end of life after the gosport war memorial hospital report: a regional survey of inpatient hospice practice. 8
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Online Boseley,S., 2018.Gosport hospital: more than 450 patients died due to opioid drugs policy. [Online].Availablethrough<https://www.theguardian.com/society/2018/jun/20/gosport-war- memorial-hospital-opioid-drugs-policy-inquiry>. 9
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