Challenges And Dilemmas In Managing Health

Code of Conduct

Mr ‘John’ is a 45-year old male patient undergoing a long-term care in a care facility, and has been on tobacco abuse for the past 20 years. He has a history of other health complications such as chronic obstructive pulmonary disease and mental illness. John has also undergone an emergency hernia repair before. When he attempted to quit tobacco, his wound improved but it got worse every time got back to smoking. John had agreed to join a tobacco secession program and had even tried to follow the secession plan that was drawn for him. But worryingly, he slipped again back to smoking. As a result, Dr. X is becoming upset with the patient’s inability to stay committed to the secession plan and is becoming more worried about the possible health complications John is likely to face if he continues to smoke. He is in a dilemma of whether he should continue treating John or refer him to another doctor.

From this case, I feel that I am of value to all the other members of the society. Thus, many people rely on me for professional support and advice; especially when they feel vulnerable or disadvantaged either mentally or physically. Similarly, I realise that people are increasingly becoming concerned about smokers to the extent of sharing their opinion that physicians should deny smokers treatment services. According to Bikhchandani et al (2007), people who hold this opinion claim that smokers do not deserve treatment from physicians because they are morally responsible for their poor medical conditions. Based on the NMC (2008) code of conduct, this argument is not good at all because the code of conduct prohibits bias in the allocation of treatment for patients, and requires that all patients should be treated with equal urgency and in a manner that responds to their specific health needs.

To make sense of this situation, my opinion is that as a responsible nurse who adheres to my professional code of conduct (NMC, 2008), I should treat smokers the same way I would treat another person suffering from a different kind of addiction. Therefore, presented with the same case as John, I would take a personal responsibility, based on my professional code of conduct, to continue treating him and assisting him to quit smoking.

John’s case also reminds me that in future, I should be cognizant of the fact that allocating medical service based on moral responsibility is against my professional code of conduct because it undermines my relationship with the patient, yet this relationship is highly necessary for effective practice (NMC, 2008). Therefore, refusing to treat John on the grounds that he is morally responsible for his health condition is not acceptable and goes against the professional code of conduct in medicine (NMC, 2008).

Lastly, if I was presented with a similar case again, I would not abandon the patient, especially considering the fact that it is my legal duty to diligently provide care to the patient rather than abandon him. Ideally, this is based on the fact that patients may be unable to abide by all the physician’s prescriptions (Peters, 2007), but that does not mean that the physician is at liberty to abandon the patient. Hence, to solve the ethical dilemma presented in John’ case, I would continue treating John and assist him to quit smoking.

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References

• Bikhchandani J, Varma K., Henderson P, et al. (2007) Is it justified to refuse breast reduction to smokers? J Plast Reconstr Aesthet Surg.; 60:1050–4.
• Peters M. (2007). Should smokers be refused surgery? BMJ.; 334-420.
• The Code, NMC (2008). Standards of Conduct, Performance, and ethics for nurses and Midwives Retrieved from: