Ethics and Ethical Decisions in Designing Patient-Centered Health Interventions
Ethics and Ethical Decisions in Designing Patient-Centered Health Interventions
A care coordination plan for HBP and interventions for associated health issues needs to be designed around the needs and preferences of the patient and their families. Deciding on the interventions to include in the care coordination plan requires a consideration of the ethical guidelines. Ethically made care decisions for the interventions for severe anxiety, cognitive decline, and kidney damage associated with HBP consider each decision’s practical effects and ethical implications. There are potential ethical conflicts of concern in patient-centered such as in privacy, autonomous decision-making, and safeguarding medical quality (Hansson & Fröding, 2021). Considering these potential conflicts can help design care that aligns with the patient’s needs and interests.
Patient- and person-centered care is only possible if the patient fully participates in the care decision-making process and autonomously makes well-informed decisions (Yun & Choi, 2019). Therefore, a patient-centered health intervention requires the patient to be fully informed of the care interventions, including the benefits and risks and their decision regarding whether to take the treatment or not. Patients should also be allowed to make their decisions autonomously based on the provided and well-understood information provided by healthcare professionals. Additionally, assuring the privacy of the patient and confidentiality of the information shared can improve the design of the care coordination plan and make it more patient-centered. Furthermore, considering the ethical principle of beneficence ensures that the health interventions employed in managing health issues maximize benefits to the patient and reduce the risks of patient harm across the care continuum.
Each decision made during the design of health interventions affects the patient-centeredness of the care interventions and the entire care coordination plan. For instance, a decision to override the patient’s decision not to get involved in an intervention that requires being a part of a support group and pushing them to get involved in the support group can make the patient feel violated and affect their recovery process. In fact, patient autonomy has been found to improve self-management and care outcomes in patients with chronic conditions such as hypertension (Audthiya et al., 2021). Another example of a specific decision is to focus most therapy interventions on managing the blood pressure status rather than the associated health issues. These decisions lead to ethical questions and create uncertainty in the decisions made. They can lead to questions like, does pushing the patient to get involved in certain interventions for their own benefit create a conflict between beneficence and autonomy? Is wanting the best for the patient a personal interest or a benefit to the patient? Do the decisions made to prioritize certain interventions risk potential harm in the long term? Other ethical questions include whether the interventions actually align with the patient’s personal, cultural, and religious views.
Relevant Health Policy Implications for the Coordination and Continuum of Care
Health policy provisions have significant implications for the coordination and continuum of care in HBP patients. Care coordination must consider the various related health policy provisions to ensure compliance and avoid regulatory issues and consequences. The major health policies with significant implications on care coordination and the continuum of care include the Affordable Care Act (ACA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
The ACA has major specific policy provisions that have expanded access to care services for chronic conditions without charging a deductible, copayment, or coinsurance. The ACA significantly improves access to health services and reduces preventable hospitalizations (Myerson & Crawford, 2020). The ACA provisions on the coverage of chronic conditions will mean that the care coordination plan accommodates all HBP patients and helps manage the associated health issues regardless of their level of income. Therefore, the care coordination across the continuum of care is expected to be as affordable as possible.
On the other hand, HIPAA requires the protection of all personally identifiable patient information and the need for patient consent to share such information. Technologies for health, such as electronic health records (EHR) systems, have supported the efficient sharing of patient information, impacting care coordination even in hard-to-reach rural areas (Gill et al., 2020). Specific HIPAA provisions, such as the Privacy and Security Rules, have significant implications for care coordination. The care