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ethics - Coggle Diagram

- - - - mental health services
      - reduced 1/2ry, fewer GP consults and higher prevalence of poorly managed chronic disease.
        
        higher hospitalisations, often from conditions which are preventable.
        
        exacerbated by costly medical transport services
      - rural as a barrier
  - - - Higher rates of death from machinery and agriculture.
        
        Mental health issues from crop failures, debt, environmental weather stresses impacting crops.
  - - - Tight knit community. Addressing gaps. Supporting local business owners, benefiting economy.
        
        healthcare: Increase access to primary and secondary care. Continuity of care which strengths pt outcomes and dr-pt relationship,
        
        role model effect, inspire more young children to pursue teaching or healthcare roles, then return to rural areas.
        
        concerns around maintaining confidentiality and avoiding treating personal relationships.
    - - accommodation/schooling
        
        limited training opportunities and further studies
        
        infrastructure of hospitals: lacking facilities thus may not see as many cases in metro area.
        
        separated from families
        
        job opp for partners, schooling for children. creating community, joining sporting teams.
        
        Dr will still manage a wider scope of practice due to lack of facilites, eg giving birth must happen there due to distance
        
        hospital temporary accoms, gov subsidised
      - solution
        
        telehealth (remote monitoring), rural training hubs. community based care (co-design programs with local coms). incentives and retention (prof dev, career progression, housing support). integrated services (better collaboration btw hospitals, GPs)
  - - - advocacy: for resources, services, systemic improvements on behalf of your patients.
        
        practical outcomes: impr rural health impr the whole system (better preventative care reduces hospital strain)
  - - - lang barrier
        
        poorer health literacy - lack of edu and access to rpimary healthcare
      - if not given culturally safe, understandable healthcare, their ability to make informed decisions is comporimsed
      - training more dr to be culturally competent, or hiring more indig aus
    - - harder to afford transport, healthy foods.
      - sedentary lifestyle correlated with lower socioecono
    - - raise awareness: grass roots, teaching kids habits. fundraising events to make barriers more accessible. hosting fun runs, creating community while exercising.
- - - - Withholding information WITHOUT their consent is unacceptable.
        
        Encourage pt to specify their desired extent of knowledge regarding their medical information. May also convey to a proxy instead.
        
        Dr can assess amount of information a pt is ready to receive at a given time. This maximises beneficence and ensures right info given at right time.
        
        even if they consented to something before, may have changed their mind - so important to obtain consent each time
  - - - Choice goes to potential advanced care directive, proxy, next of kin, IF no one available, Dr (+ colleagues)
      - In emergency situations, treatment can be provided without consent.
  - - - Dr can override parental wishes if parents decision puts child at significant risk or harm, or life saving treatment, Dr has a duty of care of the child. By involving ethical and legal teams, apply to court to authorise treatment.
        
        Dr can refuse treatments as pts do not have the right to order treatments, only refuse it. However, Dr must refer pt to another dr who can provide the service. Dr should fulfil their role until additional support is available.
  - - - If pt declines, respect decisions. However, follow up in future, continue to look for alternatives.
- - - - equivocal treatment by dr to all patients.
  - - - Organ transplant
        
        age: younger pt would generally live longer meaning more quality adjusted life years.
        
        not just about age tho
        
        Biological match: are pt matches for liver, size appropriate?
        
        Alcoholism status? if so, will there eventually be a need for another liver if they revert?
        
        dont be judgemental that bc it was self-inflicted, they don't deserve it.
        
        urgency
        
        DISCUSS WITH FELLOW COMMITTEE MEMBERS
  - - - accesibility, inclusivity, respect
- - - - Roles:
        
        Challenges:
        
        Learnt:
        
        Med:
        
        Drs ultimately guide the care plan, coordinate the team and make critical decisions under pressure. Advocate for patients, take accountability. I enjoy the challenge of being a leader.
        
        Managing conflicts
        
        Obstacles were managing conflict and strategies around conflict resolution. I learnt the importance of firstly giving individuals space to reflect on their own and cool down. So not trying to solve an issue the moment it happened, eg mid game, as people would be overly emotional. Also gathering more information from all parties to understand both sides, then having effective communication to propose a solution or mediate a meeting where a compromise can be found. Furthermore, taking accountability for why this issue happened, and changing guidelines or team expectations to be proactive and prevent future reoccurrence.
        
        In medicine, conflicts may arise with patients or team members, so being able to take the appropriate steps, actively listen, weigh multiple perspectives and gain second opinions to formulate solutions is of utmost importance.
        
        establishing authority and balancing approachability
        
        Obstacles I encountered were establishing my role as a leader amongst a team of friends. As my teammates were close friends, they often didn't take me seriously, while I enjoyed the humour and friendship, I needed to establish a level of maturity and authority. I did this by balancing being approachable with clear expectations, also leading with example by being punctual and putting in extra effort. I also made it clear when it was ' serious ' time.
        
        As a doctor, there needs to be a strong balance between professionalism and approachability. Pt need to feel comfortable and listened to, but also confident in your authority and clinical judgement. Similarly, while dr work withing multidisciplines, they ultimately guide the team and make those final decisions, so having the ability to balance authority with collaboration is essential.
        
        include everyone
        
        Obstacles I encountered were trying to account for everyones wishes on the team. Some players wanted highly competitive drills, others preferred a more casual approach. If I tried to satisfy everyone, training lost structure. To overcome this, I communicated with players individually, listened to their perspectives and adapted sessions in rotations to balance these needs.
        This taught me the importance of clear communicaton, and creating an environment where everyone feels comfortable sharing their concerns, such that we can all collaborate for the best team outcomes.
        
        In medicine, the same applies, Dr need to bring together pt, families and multidisciplinary teams with different perspectives. Requiring active listening, strong communication and putting the patient at the centre of the plan.
        
        My role involved organising training sessions and drills, while making sure I incorporated input and feedback from team members. After games, I gave specific feedback to individuals, with consideration to timing, setting, privacy and specific goals. Also encouraging and motivating my team,
  - - - asking questions
    - - leadership skills
- - - - Positives: comfort (emotional support), cultural alignment and pt engagement. MORE AFFORDABLE.
        
        By incorporating pt's preferences, I build trust, develop rapport and strengthen communication, which enhances pt outcomes. Respecting ones culture and beliefs.
        
        Eg, I grew up with my grandmother providing indian traditional methods, and they have a special place in my heart.
      - Negatives: Lack of evidence on efficacy, safety risks of misuse and worsening effects, delays in evidence based treatment.
        
        Recent years there is a decline in trust towards doctors, hence people are relying on these alternative means which can impact their health outcomes.
        
        Avoid disrespecting because it may give the impression of western med> all, and this is harmful ideologies in a Multicultural Australia.
        
        Can spread to communities, ruining individual dr reputation, clinic and representation of all drs.
  - - - placebo surgeries: Increased risk of surgery, emotional impact, risk of infections, scarring, pain, anaesthesia risk. post surgery recovery (economic stressor).