Controversial issues related to technology
- Availability
- Cost
- Self determination
- Quality of life
- Prolonging death
- Cloning
- Stem cell research
- Transplants
Medicine in Hippocrates
Elements
- BlackBile
- Yellow bile
- Phlegm
- Blood
Death is natural
Do not prolong death
Modern medicine
Holistic
Preserve and cure
Challenge death and prolong life
Earth ethics
- Our health depends on earths health
What can nurses do for the earth?
- Respect and care for earths bounty
- Ecological integrity
- Social and economic justice
- Promote democracy, nonviolence and peace
Health insurance in the past
1920s healthcare industry grew
1930s developed health insurance plans
1940-1960s health insurance cost increased rapidly (passed medicare)
Health insurance currently
Limited access to health care because of cost
2010 Patient protection and affordable care act
High cost can be contributed to the medicare passed in the 1960s. It removed the incentive for institutions and physician to keep cost down
Administrative branch
*Rules and regulations
EX: prescriptive authority for advance practice nurses, implement mandatory standards of care, CDC new Ebola policies
Judicial branch
*Influences health care professions through common law
. Ex: Roe vs. Wade
Legislative branch
*Issues decided by federal or state laws
Ex: Medicare/Medicaid revisions; health insurance reform; issues r/t advance practice nursing
Nurses influence on the health policy
- Nurses are interested in politics
- Nurses are voting population
- Nurses can be bridges between clinicians and policy makers
- Nurses can support candidates
- Nurses can be involved in policy formulation
Utilitarian
“Greatest good for greatest number”
Libertarian
“Each individual has right to protect their property”
-disagrees with obamacare
Communitarian
“Places community at center of value system”
Children in poverty
- poor nutrition
- disease
- chronic illness
- drugs
- mental illness
Poverty and health care intricately related
How health disparities exist in the elderly:
- Higher socioeconomic groups live up to 20 years longer
- Minorities live without pensions and on incomes below poverty level
- Elder abuse is on the rise worldwide (4-6%)
Impediments to intervening with vulnerable groups
- Victim blaming
* Language of violence
Caring for LGBT patients
i. More likely to receive substandard health care
ii. Reluctant to inform about orientation for fear of hostility or prejudice (resulting in deficiencies of care)
iii. Solution: use gender-neutral language (“partner”), assure confidentiality, and ask specific questions about sex practices. Be sensitive to creating an environment that encourages open dialogue
Barriers to empowerment
- anxiety
- mistrust
- apathy
- resources
- economic
- political factors
- fear of change
Fostering empowerment
- Role-model self-empowerment
- Identify what patient perceives as empowering
- Offer opportunities for choice
- Assist in setting and reaching goals
- Help patient acquire knowledge and skills
- Design strategies within sociocultural context
Whistle blowing
-publicly speaking out about questionable practices
- last resort
Legal protection for whistle blower
