McLaughlin considered values as preferences, needs, motivators, concepts and situational needs; these values influence the world view and choices of policy decision makers and followers alike. Values affect and shape policy making with respect to both organizations and individuals. Hence decision-making is a highly value-laden process (as cited by Shams et al, 2016, p 3)
As healthcare professionals, the quality of policy decisions made must be to high ethical standards and beyond reproach, making the presence of value and ethics relevant in the various policies that affect the industry.
Going by one of the basic principles arrived at when defining “Health” in a seating of the World Health Organization, “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, or economic or social condition” (as cited by McLaughlin & McLaughlin, 2015, p 193).
In reality sometimes there are distinctions, patients at times refuse care based on their religious values which in turn impact the treatment they allow themselves receive. On the other side of the divide, what if the distinction of religion is based on healthcare professionals’ individual values. The focus here being how religious values dictate the actions of those giving care. There have been cases of providers refusing certain duties “expected” of their role(s). For example, some healthcare professionals, based on their belief system, will not perform: blood transfusions, abortions, prescribe certain medication, administer a rape kit -that is the “morning after pill”, treat patients of the opposite gender, etcetera.
The Hippocratic oath states to do no harm but the strength of this has been diluted over the centuries, with other standards gaining prominence. The argument is ongoing, as givers of care, the physical plus emotional well-being and totality of quality experience is part of the expectations of patients and this expectation should ordinarily not be denied care. Still, increasingly providers voice out on how they should not have to compromise even when there is a value of life -above all else (ethics and personal or organizational beliefs inclusive).
The American Medical Association’s Code of Ethics, which are not "laws" per say, has some guidelines for healthcare professionals to follow in this scenario.
Section 1.1.7: Physician Exercise of Conscience: “Physicians are expected to uphold the ethical norms of their profession, including fidelity to patients and respect for patient self-determination. Yet physicians are not defined solely by their profession. They are moral agents in their own right and, like their patients, are informed by and committed to diverse cultural, religious, and philosophical traditions and beliefs” (McDonnell, 2017).
There are also statutory protections afforded such conduct under state legislation containing “conscience clauses” and the First Amendment, which protects actions guided by sincerely-held religious beliefs under federal constitution (Patsner, 2008). And more recently, the creation of the office of Conscience and Religious Freedom Division at the Department of Health and Human Services was made to hear complaints from medical professionals, who feel they are being pressured into providing medical services that conflict with their religious beliefs, ethics and values as individuals. The office has recourse in the case of a violation, they could issue a corrective action (Khazan, 2018).
“The issues of ethics and values are not just limited to professional decisions, but also play an important role in all analyses of policy alternatives” (McLaughlin & McLaughlin)
As long as there are people involved in policy making there will always be debate with regards to the right route to take to ensure the highest quality and ethical standards possible for patients. The onus is on healthcare professionals to keep north as the AMA Code of Ethics also states, “The relationship between a patient and a physician is based on trust, which gives rise to physicians’ ethical responsibility to place patients’ welfare above the physician’s own self-interest” (McDonnell, 2017).
Reference
Khazan, O. (2018, January 23rd). When the Religious Doctor Refuses to Treat You. The Atlantic. Retrieved from https://www.theatlantic.com/health/archive/2018/01/when-the-religious-doctor-refuses-to-treat-you/551231/
McDonnell, J. (2017, January 8th). Doctors Can Now Refuse Treatment Out Of "Religious Freedom" Retrieved from https://www.theodysseyonline.com/doctors-refuse-treatment-religious-freedom.amp
McLaughlin, C.P.& McLaughlin, C.D. (2015). Health Policy Analysis: An Interdisciplinary Approach. Jones and Bartlett. 2nd ed. Pp 193
Patsner, B. (2008). Refusing to Treat: Are There Limits to Physician "Conscience" Claims? Retrieved from https://www.law.uh.edu/healthlaw/perspectives/2008/(BP)%20conscience.pdf
Shams, L., Sari, A. A. & Yazdani, S. (2016). Values in Health Policy: A Concept Analysis. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5088722/
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