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Advocacy is acting for others, advocacy research paper examples. Health professions have a long history of acting for advocacy research paper examples and an equally long history of ethical debate and discernment about such action and its scope and limits. This entry will outline historical trends in how health professionals have understood the balance of their responsibilities between the individual patient and the broader community.
There is also discussion of definitions and conceptions of advocacy and how advocacy has been incorporated into various ethical codes and charters of the different health professions. Lastly, there is a discussion of ethical tensions and conflicts that arise in performing advocacy and the changes in the modern era that have heightened calls for advocacy as a core professional responsibility. Advocacy is taking action on behalf of another individual. While acting for others is simple in conception, advocacy is far more complex in application.
Much of the rest of this encyclopedia is concerned with discerning right action. This discussion starts with the assertion that advocacy is the method of right action that follows a process of ethical discernment.
In witnessing an individual suffering harm or injustice, the expression of right action, advocacy research paper examples, the appropriate ethical behavior, is to advocate for the remediation of the unjust situation or for the removal of the source of harm. Many professions are concerned in some way with advocacy. Lawyers advocate for their clients. Clergy advocate for their parishioners, advocacy research paper examples. Physicians and other health professionals advocate for their patients.
In accepting payment, a fiduciary responsibility to another, a professional commits to act in the best interest of another. And yet, not all professionals under the same circumstances will discern the same right action or act in the same manner.
Uncertainty is thus one of the principal challenges of advocacy. Making a decision is one thing. Acting on that decision is another thing entirely. Action ventures from the hypothetical to the concrete. Action commits history to a new advocacy research paper examples. A decision carries no consequences; an action advocacy research paper examples in an outcome. In acting, an individual may serve advocacy research paper examples, but risks all the consequences that come from that action.
Acting — advocating — entails risks. Health professionals act daily in the face advocacy research paper examples uncertainty, advocacy research paper examples, yet advocacy may entail a call to action where they have no experience to even define the elements of their uncertainty.
Advocacy in the context of health unearths a number of tensions and challenges to be explored in this entry. Risks of advocacy include that vicarious action risks paternalism. Justice pits the interests and concerns of the many against the needs of an individual and vice versa. The boundaries that define these tensions have shifted greatly over the centuries and will continue to do so long into the future.
Health professions have defined their advocacy research paper examples most clearly in the context of a dyadic relationship between provider and patient, advocacy research paper examples.
Within that dyad, right action is most easily understood in the interest of a single individual. The duty to the individual is the bedrock of the moral authority of healthcare professions, and much of the historical ethical exegesis is concerned with the nature of this relationship and how best to honor it and its obligations. One of the earliest documents of the ethical requirement of professionals committing to healthcare is the Hippocratic Oath.
Many subsequent philosophers of medicine, across multiple religious traditions, upheld the importance of this commitment, from Galen to Maimonides and Avicenna. Galen begins to raise the tension of the duty to the patient and advocacy research paper examples to a wider community as he writes of his experience advocacy research paper examples caring for the gladiators of Rome and weighing the demands of the priests and generals against the individual Hafemeister and Gulbrandsen As Geraghty and Wynia have discussed, a system of physicians linked to communities arose in Europe in the fourteenth century, in response to the public health challenges brought by successive waves of the plague.
The understanding of communicable disease led physicians and communities to develop systems of quarantine to try to isolate sick individuals and protect larger communities. Communities hired physicians and contracted for health services for the local population in return for money and property, advocacy research paper examples.
The physician had a role to act or advocate for the health of both individuals and the community they lived within. Following the Renaissance, and the plague, were waves of famine and other illnesses. A shift of perception arose, and illness came to be associated with poverty. Criteria for worthiness included belonging to the community, being employed, or being old, advocacy research paper examples.
The determination of worthiness was a form of stewardship of community resources, and it was part of the relationship between the physician and patient. Those not deemed worthy were excluded from the possibility of medical treatment in that community. Often the ill and poor were institutionalized. In the seventeenth and eighteenth centuries, physicians came to reincorporate service to those advocacy research paper examples. Serving the institutionalized became a advocacy research paper examples of healing both health and social problems that were often seen as equivalent at this time Geraghty and Wynia In the eighteenth and nineteenth centuries, as epidemics abated and industrialization grew, the delivery of medical treatment became more regulated and centralized by governments in Austria, Germany, and France.
In contrast, a fee-for-service free-market system prevailed in the USA and the UK. Both consumers and physicians recognized a potential conflict of interest in this type of fee-for-service market.
Licensure and regulation were also less centralized, and consumers were distrustful of the capacity of the physicians they engaged. Physicians recognized that the direct remuneration from individuals could challenge their broader obligations to the community and to public health. In the USA, most physicians practiced in small communities, and their relationship to those communities and self-interest in preserving a patient base led to some internal control on how much their attention could be deflected away by pure financial gain and a singular focus on the individual.
At the start of the twenty-first century, healthcare providers again are faced with new crises in which to reconsider their roles. From novel epidemics to global climate change and to the exponential and unsustainable growth in the cost of medical therapies, providers are currently asking themselves about the boundaries of the provider-patient relationship and the duty a health professional has to the broader community.
In the face of these pressures, healthcare professionals are being called on to speak as technical advocates. Given the modern global dynamics of health, advocacy in this context moves beyond the local distribution of community resources or addressing social justice, to action for security, health, and wellness of a global community. In caring for a patient, a provider might define her duty as an advocate by providing care and working to ensure access to the treatments and resources that an individual requires to treat illness and disease.
However, such a perspective takes a very narrow view of her duty to prevention. In the face of such facts, the provision of care alone is an inadequate response if prevention of harm remains an ethical obligation. Some health professional organizations have acknowledged this changing ethical landscape by broadening the scope of professional purview to include a call for advocacy.
The American Board of Internal Medicine ABIM advocacy research paper examples, for example, in its charter on medical professionalism ABIM Foundationp. and should advocate for changes in policy and legislation to improve social conditions. In each of these cases, the responsibility is clearly labeled as one shared by every individual.
In other cases, the responsibility is defined collectively, for the profession as a whole. In these activities, health is understood as. Other health professional organizations including the American Association of Physician Assistants and the American Association of Medical Assistants also encourage members to participate activities aimed toward improving the health and wellbeing of the community. This definition addresses the intention of health advocacy to improve health and well-being and reduce suffering, but intentionally leaves out clinical advocacy research paper examples as a form of advocacy.
In accordance with the previously discussed professional oaths and ethical practice statements, clinical action is an expected expression of routine ethical practice. Healthcare advocacy assumes action beyond the clinical realm, to improve health and well-being through action for ethical principles in the wider context of the individual patient and the community they live within. For most of the recorded history of medicine, the most common dilemma of justice was one of distributive justice.
How does an ethical professional earn a living and still provide care for those in need? In other words, advocacy research paper examples for justice was the task of an individual and was meted out in face-to-face interaction. Individual providers, most often physicians, provided care for those in need and balanced their work for individuals against their need to earn a living.
The evolution of healthcare over the last century has altered this landscape and with it the challenge of advocacy for justice in the modern era. Consider medicine as an example. For most of its history, medicine behaved as a professional guild. The guild established criteria for entry, established standards of performance and conduct, and trained the next generation.
The state of the art evolved through the ingenuity and effort of individual members of the guild who shared the fruits of their creativity and discovery within the guild. While elements of the guild remain in health provider professional organizations, the ingenuity and effort of individuals have been privatized to for-profit medical device and pharmaceutical manufacturers worldwide and for-profit insurance companies, advocacy research paper examples, hospitals, and physician groups in select advocacy research paper examples. The subsequent cost to individuals and communities has the potential to destabilize entire economies, advocacy research paper examples.
The juggernaut of healthcare industry, while benefiting many people with more effective medical treatments, is undermining other engines of health within society, through its terrific cost. Access to healthcare is in many economies China, India, the USA limited only to those who can afford it. In response, healthcare is increasingly seen as a public good.
Health of citizens is an asset that benefits all of society, in the form of more able workers, advocacy research paper examples participative students, and more revenue to the state, and decreased state and private expenditures for illness.
Additionally, the public finances medical progress through research while heavily subsidizing the education and training of health professionals. In most developed countries, the public funds the majority of medical services. Even in the USA, where private financing has been jealously preserved, the government funds a majority of all medical care. In the past, a single provider or a small group of providers might constitute the entire healthcare system for a community.
That individual or group was the sole means of addressing inequities in the distribution of healthcare resources. Under those circumstances, offering free care to the poor was an act of justice. Today, in most instances, providers can care for their patients with the expectation of being paid. Providing care for free is no longer an act of justice, it is an act of charity, advocacy research paper examples. This is a critical distinction to make. Charity is a gift given at the caprice of the giver.
Justice is a structural response that, if perfectly applied, would eliminate the need for charity.
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