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As more and more people survive into old age, the burden of caring
for them becomes greater and greater. Although it is now possible
to alleviate many of the afflictions that beset mankind, no society
can afford to pay for all the healthcare that is now available or
technically possible. People working in healthcare increasingly
have to do more with less. Rationing takes many forms, mostly
covert, and the less privileged in most societies end up struggling
to get their proper share of the available healthcare resources.
All too often, those in the front-line have to deal with the
consequences of this 'rationing by default': healthcare
professionals find themselves rushed off their feet simply doing
the basic tasks and completing all the paperwork; placing frail,
sick people in ever lengthening queues, sometimes asking them to
wait for hours in the middle of the night under uncomfortable and
even unsafe conditions; and, worst of all, working under conditions
they would rather avoid in which the safety margin for those they
are caring for has been greatly diminished. We are all aware that
under these conditions the chance of making a mistake which can
seriously harm or even lead to the death of a patient is greatly
increased. But what can be done about this? How can you be sure
that you are doing the right thing when faced with having to
practise an uncertain science on vulnerable patients in a complex
system under ever-changing conditions? At what point could you
cross the invisible line from reasonable to irresponsible or
unethical behaviour by tolerating conditions or tacitly accepting
practices which may be regarded as unacceptable, even though you
may have little immediate control over them? This book is a guide
to getting it right for healthcare professionals. It is about doing
the right thing, in the right way, at the right time, for the right
people. These are the dimensions of quality in healthcare, and
although some are in conflict (equitable access and efficiency, for
example), adherence to ethical practice and professional behaviour
will help lead healthcare practitioners through the minefield of
responsibilities and priorities. Real-life situations are integral
to the book, with over 500 clinical examples referred to within the
text.
As more and more people survive into old age, the burden of caring
for them becomes greater and greater. Although it is now possible
to alleviate many of the afflictions that beset mankind, no society
can afford to pay for all the healthcare that is now available or
technically possible. People working in healthcare increasingly
have to do more with less. Rationing takes many forms, mostly
covert, and the less privileged in most societies end up struggling
to get their proper share of the available healthcare resources.
All too often, those in the front-line have to deal with the
consequences of this 'rationing by default': healthcare
professionals find themselves rushed off their feet simply doing
the basic tasks and completing all the paperwork; placing frail,
sick people in ever lengthening queues, sometimes asking them to
wait for hours in the middle of the night under uncomfortable and
even unsafe conditions; and, worst of all, working under conditions
they would rather avoid in which the safety margin for those they
are caring for has been greatly diminished. We are all aware that
under these conditions the chance of making a mistake which can
seriously harm or even lead to the death of a patient is greatly
increased. But what can be done about this? How can you be sure
that you are doing the right thing when faced with having to
practise an uncertain science on vulnerable patients in a complex
system under ever-changing conditions? At what point could you
cross the invisible line from reasonable to irresponsible or
unethical behaviour by tolerating conditions or tacitly accepting
practices which may be regarded as unacceptable, even though you
may have little immediate control over them? This book is a guide
to getting it right for healthcare professionals. It is about doing
the right thing, in the right way, at the right time, for the right
people. These are the dimensions of quality in healthcare, and
although some are in conflict (equitable access and efficiency, for
example), adherence to ethical practice and professional behaviour
will help lead healthcare practitioners through the minefield of
responsibilities and priorities. Real-life situations are integral
to the book, with over 500 clinical examples referred to within the
text.
There is an understandable tendency or desire to attribute blame
when patients are harmed by their own healthcare. However, many
cases of iatrogenic harm involve little or no moral culpability.
Even when blame is justified, an undue focus on one individual
often deflects attention from other important factors within the
inherent complexity of modern healthcare. This revised second
edition advocates a rethinking of accountability in healthcare
based on science, the principles of a just culture, and novel
therapeutic legal processes. Updated to include many recent
relevant events, including the Keystone Project in the USA and the
Mid Staffordshire scandal in the UK, this book considers how the
concepts of a just culture have been successfully implemented so
far, and makes recommendations for best practice. This book will be
of interest to anyone concerned with patient safety, medical law
and the regulation of healthcare.
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