Conflicting Legal and Ethical Requirements in Clinical Practice

The diversity of the American people is striking. This comes with a variety of beliefs and tastes. Clients and medical practitioners both have competing needs and preferences, which are likely to jeopardize the effectiveness of the medical process and patient results. Counsellors must align their practice within the bounds provided by their level of education, experience, professional credentials set by regulators, and legal discretion, according to Section C.2.a of the ACA code of ethics. Dr. Lewis continued to practice outside of his professional boundaries, as outlined by the ACA code of ethics mentioned above.  This is not appropriate because it places the wellbeing of the patient at stake.

It is the role of all medics to ensure that they understand the standard care (Moffett & Moore, 2011). Neglecting the standard care for any situation can make a person liable for any resulting fatalities as in Chase v. Sabin (1994). In this case study, Dr. Lewis understands the standard care. He understands that the most appropriate action is to explain to the patient that psychopharmacological intervention was the standard practice and deviating from the treatment was likely to compromise her chances of recovery.

Dr. Lewis resorted to the adaptive approach without properly examining the factors that could necessitate the shift. One of the key aspects of evidence-based practice is that every step should be backed by clear and verifiable data. Dr. Lewis went against the provisions of evidence-based practice. This means that there was not only violation of the legal provisions but also the professional standards.

Patient autonomy has been significantly enhanced in the US healthcare system. Physicians who afraid of losing patients easily wield to the clients’ wishes. When medics decline giving in to the patient’s demands, the latter can threaten that they will move to another facility. Therefore, Dr. Lewis may have acted out of fear of losing the particular patient to another provider.

Unlike the patient, Dr. Lewis understands the necessity of following the standard practice and the dangers posed by deviation from this practice. Many Americans respect medics and would be willing to listen and follow their advice. In the case study, Dr. Lewis indicates that the only other option was telling the patient that medicine is the standard care and there was nothing else. The clinician would have chosen to be open with the patient and explain to her the necessity of following the standard treatment procedure.

The adaptive approach aims at gratifying the patient but compromises the credibility of the profession (Elwyn et al., 2012). One of the key qualities that a medic should possess is empathy. However, this empathy should not prevent the medic from adhering to the legal and professional standards. Dr. Lewis understands that medicine is not her expertise. Designing a protocol to be enjoined into the patient’s psychopharmacological treatment is a show of empathy to the patient. However, this is what could have led to the patient’s laxity and withdrawal from the process.

There are many times where legal provisions, professional standards and personality of clinicians may conflict. However, re-examination of these three aspects will reveal that they are meant to promote the wellbeing of the clinician and the patient. It is upon the medical practitioner to determine what is best for their patients. They should implore the latter to follow the standard practice. The standard care procedures and practices are usually formulated basing on experimentation and experience. Therefore, clinicians should try to ensure that they implement this standard care.

References

American Counselling Association. (2005). ACA Code of Ethics. Retrieved from http://www.counseling.org/docs/default-source/library-archives/archived-code-of-ethics/codeethics05.pdf?sfvrsn=4

Chase v. Sabin, 516 N.W.2d 60, 445 Mich. 190 (1994).

Elwyn, G., Frosch, D., Thomson, R., Joseph-Williams, N., Lloyd, A., Kinnersley, P., ... & Edwards, A. (2012). Shared decision making: a model for clinical practice. Journal of general internal medicine, 27(10), 1361-1367.

Moffett, P., & Moore, G. (2011). The Standard of Care: Legal History and Definitions: the Bad and Good News. Western Journal of Emergency Medicine, 12(1), 109–112.