Amber Shaikh
Ethics Reflection Essay
In this essay I will explore the reasons I chose to enter the Physician Assistant profession, and how the ethical frameworks of Beneficence, Nonmaleficence, and Autonomy will guide me in the clinical practice aspects I look forward to as a future medical Provider.
The reasons I have chosen to become a Physician Assistant lies in the values of the career itself. PAs hold to utmost importance the dignity, health and safety of their patients while working in collaboration with Physicians practicing patient care approach. I always wanted to work in a career in which I can help people, both physically and mentally. Since I was little I have always loved meeting new and different people and listening to their stories. I am also intrigued by medicine and how the human body handles diseases and how treatments work with the body to heal it. One of my favorite things about this profession is also the fluidity of the field and how you are not bound to one aspect of medicine. I also like how PAs have a close relationship with their patients and other members of the team. They value a team based approach to patient care, for a overall well rounded patient encounter.
Moving into clinical practice I believe the following things will be most important to me; actively working to heal and treat people, effectively and passionately communicating with patients using patient centered care approach, and learning and staying up to date with proper medical and surgical techniques. Working to heal patients is the root of medical practice, it will allow me to put into practice all the medical knowledge I have gained through the didactic years along with my passion to help people. Communicating with patients effectively is important because it is the core value of medicine, it means to have an encounter that builds patient trust and rapport, while being informative, empathetic and finally educational for the patient. Medicine is fluid and every changing along with the practices, procedures and equipment. The Physician Assistant profession prides itself of continuing medical education and having “forever learning” approach. With this, PAs stay up to date on the latest practices to best treat your patients. I feel that medicine is a well rounded career one that benefits from a provider that is open to learning and growing.
I believe that the ethical principles of Beneficence, Nonmaleficence, and Autonomy will play a key role in my ethical decision making in clinical practice. Beneficence is the principle of performing actions that best benefit the patient, involving both the intention to do good, and acting on it (class discussion 12/11/19). It means to promote patients’ health and welfare, in all aspects; physically, mentally and emotionally (Yeo et all 1996). In the medical setting this usually goes hand in hand with treating and healing patients. This is also involved with keeping yourself well updated in order to learn practices that will best benefit the patient. This often is tied to the ethical principle of nonmaleficence, which means to do no harm. It means to not perform any acts that can be disadvantageous or harmful to the patient (Yeo et all 1996). Many treatments in medicine involve some level of harm or pain, however the concept of nonmaleficence means to ensure that the harm is not disproportionate to the benefit of the treatment (Alziehmer-Europe 2009). Autonomy is the principle of self determination and self rule, and that everyone has the right to decide for themselves. It consists of four aspects, all which show reasons for the patient’s autonomy to be respected; Autonomy as free action- one is able to do what they want to do and is not being forced or coerced, Autonomy as effective deliberation-a persons ability to rationally come to a decision, Autonomy as authenticity- does the choice embody the character and values of the person, and Autonomy as moral reflection-being aware of one’s choices (Yeo et all 1996).
The principles mentioned above will best support the aspects of medicine that are important to me because they each highlight how to effectivity and ethically perform as a future medical care providers. Beneficence is the act of doing something that benefits others; something that is synonymous with the term “Provider” which means one who gives and helps the people. My constant desire to give back to the community and work to help people has been deep rooted in the values of me and my family. Several years ago, my grandfather opened a school in the rural village of Tundojam, Pakistan, where I was born. Here he had a mission of educating and motivating children to become their own person and be driven. Since it opened 9 years ago, it has now had over thousands of students; all of whom have now gained a valuable educational background due to the passion of my grandfather. Being inspired, I went on to work in medical brigades in Honduras and Nicaragua, knowing that a life spent helping people would make me most content. I believe the values of beneficence are deep rooted in this aspect of clinical medicine because to be a good provider you must uphold the welfare and dignity of the patient first.
The principle of Autonomy is tied with the aspects of patient communication using patient centered care and working with a team for the overall benefit of the patient. Autonomy is the concept of respecting the individual and practicing self rule (AAPA 2017). When using patient centered care approach, it opens a pathway of communication that is not exclusive to what the provider is asking. It allows the patient to control the narrative and tell their story in a manner that they believe is most important. Autonomy is that of allowing patients to make their own decisions, to do this however, patients need all the information to make those choices. This is supported by the autonomy aspects of moral reflection and effective deliberation. By effectively talking to patients, listening to their story and giving them all the information they need, patients can rationally make informed decisions. With this, the choices they make will also be reflective of their own moral character (Entwistle et all 2010).
Finally, I believe that the ethical principle of nonmaleficence is tied to the clinical aspect of continuously learning and staying up to date on proper medical practices and procedures. This not only means learning new surgical techniques, but also staying up to date with policies and protocols, including team interaction. With an overwhelming list of responsibilities Providers already have, it can seem daunting to ensure you are constantly caught up, however there are some easy ways to achieve that; reading medical journals (JAAPA, uptodate, etc), attending Continuing Medical Education (CME) conferences, and preparing for the PANRE (Chin et all. 2016). All of these are not only encouraged in our field, but are required, giving us more motivation to stay up to date. By staying current, we will embody nonmaleficence as we will actively strive to learn the best procedures and protocols to do the least harm to our patients. This will allow us to learn proper technique and strategy so we can strive for a higher benefits vs risk ratio in our future clinical practice.
Moving forward, I believe the ethical principles mentioned above will guide me in my future clinical practices of patient centered care, patient healing, and continuing medical education in order to make ethical and moral medical decisions to best benefit my patients.
References:
“Guideline for the Ethical Conduct for the PA Profession.” AAPA, American Academy of PAs, 16 Feb. 2017, www.aapa.org/wp-content/uploads/2017/02/16-EthicalConduct.pdf.
Yeo, Michael, Anne Moorehouse and Jean Dalziel. “Autonomy.” Concepts and Cases in Nursing Ethics, 2nd ed., Broadview Press, 1996, pp. 91–135.
Yeo, Michael, Anne Moorehouse and Jean Dalziel. “Beneficence.” Concepts and Cases in Nursing Ethics, 3rd ed., Broadview Press, 1996, pp. 103-139.
Chin, Lynda, and Greg Satell. “How Physicians Can Keep Up with the Knowledge Explosion in Medicine.” Harvard Business Review, HBR, 9 Mar. 2018, hbr.org/2016/12/how-physicians-can-keep-up-with-the-knowledge-explosion-in-medicine.
“Ethics – Definitions and Approaches – The Four Common Bioethical Principles – Beneficence and Non-Maleficence.” Alzheimer Europe, 9 Oct. 2009, www.alzheimer-europe.org/Ethics/Definitions-and-approaches/The-four-common-bioethical-principles/Beneficence-and-non-maleficence.
Entwistle, Vikki A, et al. “Supporting Patient Autonomy: the Importance of Clinician-Patient Relationships.” Journal of General Internal Medicine, Springer-Verlag, 6 Mar. 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC2881979/.
