Health Care & Ethical Issues Introduction

This research paper will focus on ethical issues of privacy, terminal illness, human rights, living wills, making living wills mandatory for medicare, social worker's involvement, autonomy, the family role, termination of life support, and the right to die.

There exists an ethical and legal requirement to protect patient information and home care records, and home healthcare nurses have this responsibility along with health care institutions. Privacy and confidentiality are separate entities, and the protection of one does not necessarily mean the protection of the other. The right to privacy is embodied in the law. The First and Fourteenth Amendments to the Constitution prevent state and federal agencies from invading an individual's privacy:

As the right continued to develop, the right to be left alone became defined as an individual's protection from unreasonable intrusions into his or her private affairs: in other words, the right to keep personal information from others (Brent, 1997, 256).

Home health care concerns with regard to privacy include the use of a patient's likeness or name for economic advantage without patient consent (for example, taking a photograph of the patient for use in a promotional brochure), and public disclosure of private facts about the patient (such as disclosure of a diagnosis), each without the patient's consent (Brent, 1997, 256).

Privacy is a right covering each individual, while confidentiality is more limited and cover

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million Medicare patients who die each year. In a study of five hospitals, the last-minute medical care costs for patients with near-death diagnoses who died in the hospital averaged about $10,400 per patient. It is estimated that in the final month of a patient's life the intensive care costs can surpass $100,000; total costs to Medicare for medical care to these patients in their last 30 days was approximately $20 billion in the fiscal year 1995 (Lindblom, 1995, 10-11). Congress could require all Medicare patients to have a living will that sets forth the kinds of treatments wanted when near death and unable to communicate clear instructions personally. Instead of being coerced into foregoing care, patients would have the option of demanding or rejecting treatments such as cardiac resuscitation, mechanical respiration, artificial nutrition, and antibiotics in the event that they became permanently unconscious or irreversibly brain damaged during a terminal condition. Steps to reduce pain and suffering could also be anticipated and defined in a living will (Lindblom, 1995, 9). "The Patient Self-Determination Act of 1990 requires health providers working with Medicare or Medicaid to ask patients whether they have living

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