Ethical Issues in Geriatric Service Organizations

• LINA DIAZ

Common ethical issues and conflicts experienced by managers and practitioners of geriatric service organizations and recommend alternative measures to remove or minimise such ethical dilemmas and conflicts experienced by managers and practitioners of geriatric organizations.

Actual and potential conflict of interest between family members, professional

There are common ethical issues and conflicts experienced by health professionals and managers of geriatric service organizations. Ethical consideration rendering for elderly patients, no matter what the age, if they are able to make health decision for themselves, then they should receive the right to do without being pressured. If they are incapable of doing it then the relatives will make such decision. In the world of the elderly, ethical issues are greatly important because they are very vulnerable. In such, that elderly are taken advantage of their rights as patients. The ethical issue, dilemmas involve the elderly and those healthcare provider or family members. The team of caregiver needs to form a group to provide a better care, to enhance the quality of care, and quality of life. Ethics and morality are not equivalents. Although ethics is frequently study of morals, for the elderly and their healthcare providers, ethics means two different things. For the elderly, ethics is about how they want to be treated and allowed to make their own decisions. For family members as caregivers, ethics is about doing what is right even when no one is looking. For professionals providing eldercare, ethics is about adherence to established canons of ethics promulgated by organizations. There are common Ethical issues in the eldercare providers. The Actual Conflicts of Interest, several conflicts of interest may arise when family members and professional caregivers assist or represent the elderly. Conflicts involving spouses and their wishes versus the elder’s wishes and interest; conflicts involving family members from different generations and their wishes versus the elders interest; conflicts involving a fiduciary (such as a guardian, conservator or agent under a power of attorney) who may have interest different than elder; and conflicts involving the care provider’s business interest versus the elder interest, wellbeing and quality of life. The Potential, Future or Perceived Conflicts of Interest, are those which are not actual conflicts when rendering assistance to the elder’s. For instance, a power of attorney is prepared by the elder’s attorney and signed by the elder to give his son the power to manage all his business affairs when the elder could not. At this point there is a potential conflict of interest. Later, after the elder is actually incapacitated, the son as agent seeks legal counsel concerning strategy that could impoverish the elder by transferring the assets to the son. The potential conflict has now become a conflict of interest. Social workers should be alert and avoid conflicts of interest that inhibit the exercise of professional discretion and impartial judgment. Clients should be inform in potential conflicts arises and assist to resolve the issue that protect the client interest.

Ethical Issues and the Elderly www.ensingnlaw.com

Confidentiality

Confidentiality issues is one the hardest things to learn by many healthcare providers and how to maintain patient confidentiality. Privacy maybe invaded and confidentiality violated by revealing information that can be used to expose a client to unwanted response from healthcare provider. Issues form the client cannot discuss with our family, friends or spouse. Yet, in reality it happen, even it is illegal unless it is done with great discretion to protect the client’s identity. Under the law, we need to ask permission from the client about discussing clients care even with his own family. There are some other privacy issues that caused health care institution to rearrange offices, designate waiting areas and sign in sheets to protect the privacy and identity of the patients. Trust is very essential part in establishing relationship between caregiver and clients. Patients need to know that they can discuss sensitive information with their health provider in a safe condition. However, there are some issues such as public health issues like Acquired Immune Deficiency Syndrome, sexually transmitted disease and communicable disease which require reporting. Being a health care provider, confidentiality is very important to practice, discussing with colleague, we need to make sure that others cannot hear the conversation or identify a patient. The records and charts of the patients must be kept confidential in legal terms. It should protect the information and responsibly share the information to trusted one. Yet there are rare circumstances, such as when a court order has been issued, wherein a physician may be legally obligated to disclose information without the patient’s signature. Similarly, a physician might have a duty to warn, if it is believed that a patient poses an obvious threat to other individuals. The health care provider should avoid disclose any personal and medical information that has been entrusted to them by the patients. When a patient’s private information is shared, there is the expectation that health care providers will keep the information in confidence. This may include patient’s diagnosis, history of illness, drug use, and family history. The importance of confidentiality to elderly patients should not be overlooked. Although health care team, family and friends might assume that these concepts are unimportant to an elderly patient, the patient might not agree. A competent patient should expect that information share with the health care provider will kept confidential.

Confidentiality Issues www.netplaces.com

Ethics Programs www.miami.edu

Decision-making capacity of the elderly

Decision making capacity and competency in the elderly, the number of older adults with cognitive impairment has increased. There is growing need for assessments to identify their decision making capacity and competence. The importance of assessing decision making capacity is respecting the values and interests of older adults. It is necessary to ensure that intervention improve care for all older adults. However, issues related to capacity to consent raise many difficult questions that must address. Assessing the decision making abilities of understanding, appreciation, reasoning, and expressing a choice is very important. Assessing competency becomes increasingly critical when the patients wish id to forego a life-saving procedure. Supporting patient’s choice regardless of the outcome of that decision is an important part of patient advocacy and therefore an important component of patient care.

Decision Making Capacity www.ncbi.nlm.nib.gov