Response To Lorinda

Response to Lorinda

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Author Note

Response to Lorinda

Dear Lorinda, after reading your discussion post, I must say that you did a commendable job in explaining ethical dilemmas concerning the present situation of people's health and related disparities and the principles of social justice and human rights protection to reduce health inequalities. Moreover, the thoughts on cultural foundations regarding merits and demerits of the Affordable Care Act and healthcare reforms have also been shared.

As you shed light on an important issue faced these days in the healthcare industry regarding the healthcare of homeless patients. The problem is to choose between ethics and their duties, which is quite difficult for providers or nurses in certain situations. They may end up in distress affecting the quality of care they provide. However, this can be minimized the way you treat your patients, but a more realistic approach should be communicated in the provider office to deal with such dilemmas confidently. This can be done with the help of Moral case deliberation in which an organized communication exercise is conducted among a group of people. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"mvjO1Kvg","properties":{"formattedCitation":"(Spijkerboer, van der Stel, Widdershoven, & Molewijk, 2017)","plainCitation":"(Spijkerboer, van der Stel, Widdershoven, & Molewijk, 2017)","noteIndex":0},"citationItems":[{"id":95,"uris":["http://zotero.org/users/local/2y0xTiQs/items/WH99MXJR"],"uri":["http://zotero.org/users/local/2y0xTiQs/items/WH99MXJR"],"itemData":{"id":95,"type":"article-journal","abstract":"Health care professionals often face moral dilemmas. Not dealing constructively with moral dilemmas can cause moral distress and can negatively affect the quality of care. Little research has been documented with methodologies meant to support professionals in care for the homeless in dealing with their dilemmas. Moral case deliberation (MCD) is a method for systematic reflection on moral dilemmas and is increasingly being used as ethics support for professionals in various health-care domains. This study deals with the question: What is the contribution of MCD in helping professionals in an institution for care for the homeless to deal with their moral dilemmas? A mixed-methods responsive evaluation design was used to answer the research question. Five teams of professionals from a Dutch care institution for the homeless participated in MCD three times. Professionals in care for the homeless value MCD positively. They report that MCD helped them to identify the moral dilemma/question, and that they learned from other people’s perspectives while reflecting and deliberating on the values at stake in the dilemma or moral question. They became aware of the moral dimension of moral dilemmas, of related norms and values, of other perspectives, and learned to formulate a moral standpoint. Some experienced the influence of MCD in the way they dealt with moral dilemmas in daily practice. Half of the professionals expect MCD will influence the way they deal with moral dilemmas in the future. Most of them were in favour of further implementation of MCD in their organization.","container-title":"HEC Forum","DOI":"10.1007/s10730-016-9310-3","ISSN":"1572-8498","issue":"1","journalAbbreviation":"HEC Forum","language":"en","page":"21-41","source":"Springer Link","title":"Does Moral Case Deliberation Help Professionals in Care for the Homeless in Dealing with Their Dilemmas? A Mixed-Methods Responsive Study","title-short":"Does Moral Case Deliberation Help Professionals in Care for the Homeless in Dealing with Their Dilemmas?","volume":"29","author":[{"family":"Spijkerboer","given":"R. P."},{"family":"Stel","given":"J. C.","non-dropping-particle":"van der"},{"family":"Widdershoven","given":"G. A. M."},{"family":"Molewijk","given":"A. C."}],"issued":{"date-parts":[["2017",3,1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Spijkerboer, van der Stel, Widdershoven, & Molewijk, 2017).

In the second part, you discussed the merits and demerits of ACA, which, although helps the US patients to afford health care at low costs at the same time, it has some anomalies based on cultural biases ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"bWvDKXNc","properties":{"formattedCitation":"(Harris, 2014)","plainCitation":"(Harris, 2014)","noteIndex":0},"citationItems":[{"id":107,"uris":["http://zotero.org/users/local/2y0xTiQs/items/BRB9LAK6"],"uri":["http://zotero.org/users/local/2y0xTiQs/items/BRB9LAK6"],"itemData":{"id":107,"type":"article-journal","container-title":"Social Policy","language":"en","page":"64","source":"Zotero","title":"Cultural Collisions and the Limits of the Affordable Care Act","volume":"22","author":[{"family":"Harris","given":"Jasmine E"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Harris, 2014). However, according to Andrew and Boyle, the introduction of transcultural concepts has transformed the thought process of nurses in nursing care. The nurses are now more socially knowledgeable about the health care of patients belonging to different communities ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"rLCges52","properties":{"formattedCitation":"(Andrews & Boyle, 2016)","plainCitation":"(Andrews & Boyle, 2016)","noteIndex":0},"citationItems":[{"id":99,"uris":["http://zotero.org/users/local/2y0xTiQs/items/X8CIWKYK"],"uri":["http://zotero.org/users/local/2y0xTiQs/items/X8CIWKYK"],"itemData":{"id":99,"type":"book","abstract":"Transcultural Concepts in Nursing Care helps nursing students transform their thinking so they develop into culturally competent nurses capable of safe, thoughtful, and ethical care of individuals, families, groups, and communities of diverse backgrounds. Transcultural Concepts in Nursing Care takes a life span approach to describe cultural variations in lifestyle, habits, beliefs, and life process; and in doing so, provides a framework that will improve health and nursing care to minority, underrepresented, disenfranchised, and marginalized populations. Rather than just covering specific cultures and expected behaviors/beliefs of that culture, the authors provide students the tools they will need as nurses to effectively perform cultural assessments and incorporate their findings into their interventions. With more culture specific examples in this edition, the text offers the knowledge needed to provide culturally competent and contextually meaningful care for all clients. Fully updated in its seventh edition, this unique resource creates an interdisciplinary knowledge foundation reflecting the cultural changes in the clinical nursing environment.","ISBN":"978-1-4511-9397-8","language":"en","note":"Google-Books-ID: MlLhoQEACAAJ","number-of-pages":"446","publisher":"Wolters Kluwer","source":"Google Books","title":"Transcultural Concepts in Nursing Care","author":[{"family":"Andrews","given":"Margaret M."},{"family":"Boyle","given":"Joyceen S."}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Andrews & Boyle, 2016).

Thirdly, the author talks about the application of social justice and protection of human rights in minimizing discrimination in healthcare provision. Though the culturally competent nurses can cater to such disparities, the practice of socially responsible behavior, along with the accountable parties monitoring societal equality, can help protect human rights ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"rMnWcxAq","properties":{"formattedCitation":"(Joshi, 2017)","plainCitation":"(Joshi, 2017)","noteIndex":0},"citationItems":[{"id":101,"uris":["http://zotero.org/users/local/2y0xTiQs/items/Y9AXJRB5"],"uri":["http://zotero.org/users/local/2y0xTiQs/items/Y9AXJRB5"],"itemData":{"id":101,"type":"article-journal","abstract":"Citizen-based accountability strategies to improve the lives of the poor and marginalized groups are increasingly being used in efforts to improve basic public services. The latest thinking suggests that broader, multi-pronged, multi-level, strategic approaches that may overcome the limitations of narrow, localized successes, hold more promise. This paper examines the challenges and opportunities, in theory and practice, posed by the integration of two such citizen-based accountability strategies—social accountability and legal empowerment. It traces the foundations of each of these approaches to highlight the potential benefits of integration. Consequently it examines whether these benefits have been realized in practice, by drawing upon five cases of organizations pursuing integration of social accountability and legal empowerment for health accountability in Macedonia, Guatemala, Uganda, and India. The cases highlight that while integration offers some promise in advancing the cause of social change, it also poses challenges for organizations in terms of strategies they pursue.","container-title":"World Development","DOI":"10.1016/j.worlddev.2017.07.008","ISSN":"0305-750X","journalAbbreviation":"World Development","language":"en","page":"160-172","source":"ScienceDirect","title":"Legal Empowerment and Social Accountability: Complementary Strategies Toward Rights-based Development in Health?","title-short":"Legal Empowerment and Social Accountability","volume":"99","author":[{"family":"Joshi","given":"Anuradha"}],"issued":{"date-parts":[["2017",11,1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Joshi, 2017).

While concluding your viewpoints, I consider every ethical dilemma is different and thus demands decision making through discussions rather than relying on ethical principles. Moreover, nursing students need to be aware of diverse cultures to facilitate their patients without any disparity. This can be accomplished by conforming to diverse cultural reforms and inspection by the regulatory bodies to maintain equality among patients who need to be practiced.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Andrews, M. M., & Boyle, J. S. (2016). Transcultural Concepts in Nursing Care. Wolters Kluwer.

Harris, J. E. (2014). Cultural Collisions and the Limits of the Affordable Care Act. Social Policy, 22, 64.

Joshi, A. (2017). Legal Empowerment and Social Accountability: Complementary Strategies Toward Rights-based Development in Health? World Development, 99, 160–172. https://doi.org/10.1016/j.worlddev.2017.07.008

Spijkerboer, R. P., van der Stel, J. C., Widdershoven, G. A. M., & Molewijk, A. C. (2017). Does Moral Case Deliberation Help Professionals in Care for the Homeless in Dealing with Their Dilemmas? A Mixed-Methods Responsive Study. HEC Forum, 29(1), 21–41. https://doi.org/10.1007/s10730-016-9310-3