ABSTRACT
This research was done to ascertain how aware radiographers are about the ethical code of patient rights and to access the reasons; if any for the abuse of ethical code of patient right by practicing radiographers. Result shows that there is good ethical conduct among practicing radiographers and all the practicing radiographers are aware of ethical code of patient rights. Most of the radiographers that abuse ethical code of patient’s rights are those who have never had any course in medical ethics and those who do not agree that RRBN enforces profession ethics.
LIST OF TABLES AND FIGURES
Table 1: Age and sex distribution of practicing radiographers
Table 2:Radiographers response on educational level.
Table 3:Radiographers response on whether they know that patients have right in radiology department.
Table 4: Radiographers response on explanation to patients the nature and the procedures of exam before doing it.
Table 5:Radiographers response on patients objection to exam as a result of fear or any other reason.
Table 6: Radiographers response on seeking for patient consent before carrying out radiological exams on them
Table 7:Radiographers response on how they manage patients information.
Table 8:Radiographers response on colleagues’ abuse of ethical code of patient’s right.
Table 9: Radiographers response on ensuring patients privacy during exam
Table 10:Radiographers response on following patients request card sequentially in calling them in for radiological exams.
Table 11:Test of Chi-square distribution of indices
Table 12:Chi-square value of indices
LIST OF FIGURES
Fig 1:Bar chart showing radiographers response on having had a course on medical ethics
Fig 2:Bar chart showing radiographers response on whether RRBN enforces the practice of professional ethics
TABLE OF CONTENT
Title page – – – – – – – – – i
Approval Page – – – – – – – – ii
Dedication – – – – – – – – – iii
Certification – – – – – – – – iv
Acknowledgement – – – – – – – v
Abstract – – – – – – – – – vi
List of tables and figures – – – – – – -vii
Table of content – – – – – – – – viii
CHAPTER ONE: INTRODUCTION
- Background of the study
- Statement of the problem
- Objective of the study
- Significance of the study
- Scope of the study
- Hypothesis
- Literature review
CHAPTER TWO: THEORETIC BACKGROUND
2.1 Professional ethics
2.2 Ethical code of patient right
2.3 Ethical responsibilities of radiographers
2.4 Medicologal implication of radiographers and health professionals to the patient
CHAPTER THREE: RESEARCH METHODOLOGY
3.1 Research Design
3.2 Target population
3.3 Sampling Size
3.4 Instrument for data collection
3.5 Procedure for data collection
CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS
4.1 Data presentation and analysis
4.2 Test of Hypothesis
CHAPTER FIVE:DISCUSSION, SUMMARY OF FINDINGS RECOMMENDATION, CONCLUSION AND LIMITATION
5.1 Discussion of data
5.2 Summary of finding
5.3 Recommendation
5.4 Conclusion
5.5 Limitation of study
REFERENCES
CHAPTER ONE
INTRODUCTION
1.1 BACKGROUND OF STUDY
In the rapidly changing atmosphere of health care, many factors have affected how health care is practiced. The rights of the patient have also been affected. Patient rights have recently become the center of national attention in the practice of medicine. The push for legislation of a patients’ bill of rights is to provide laws that would prevent health maintenance organizations (HMOs) and other managed health plans from refusing to pay for appropriate care. A patient’s rights occur at many different levels, and in all specialties.
According to J. fletche28 the phrase ethics means merely a body of rules to govern the social behavior and graces of professional. He further stated that failure to comply with the ethical provisions of a profession culminates in malpractice which is punishable by the board or body.
The science of ethics, therefore aims to define the grounds and validity of the various system of principles and secondary rules governing conduct and duty. The radiographers are expected to explain the nature and procedures of the examination to the patient and also give him instruction on what to do before the examination commences. The patient has the right to object to certain examination based on the risk, religion, or belief before the examination is done. It is usually taken for granted that competent adult has the right to decide for themselves what will be done to their bodies.
According to the American Registry of Radiologic Technologists1, radiographers agree to abide by the Code of Ethics of The American Registry of Radiologic Technologists and have an obligation to apply those principles to ensure that the patients entrusted to them receive the best possible care. This is similar to what the radiographers in Nigeria agree to abide by. This is usually taken on the day of induction. Whenever an issue arises that may compromise that care, radiographer must know how to advocate for the patient. In order to do so effectively, they must be well-acquainted with the principles, rules, and policies governing their profession as well as understand that continuing education is vital to fulfill the duties and responsibilities appointed to them.
Although the radiographer understands the definition of the word “patient,” when the definitions of the noun and adjective forms of the word are combined, a more thoughtful description is achieved: a person under medical care (noun) demonstrating uncomplaining endurance under stress (adjective). Of course, radiographer frequently encounters the complaining patient as well, but it is important to remember those last 3 words-endurance under stress. The majority of patients are not members of the medical profession, they have little or no medical knowledge, and for them, simply coming to the radiology department or the hospital can be a stressful experience. Radiographer have the education and experience, hence patients trust radiographer to do what is best for them. When one considers that the word trust means to have confidence or faith in, the patient-radiographer relationship takes on a whole new perspective. It is an awesome responsibility we have for our patients, and we must do everything we can to see that the care provided to them is of the highest quality. If the value of that care is degraded, then we have an ethical obligation to”advocate” (writing or speaking in favor of or supporting) on behalf of that patient. Ethics means moral code, rules of conduct, principles, sense of duty, and conscience. When considering all of the above, one sees that radiographer are bound by rules of conduct to honor the faith and confidence placed in them and must serve as advocates in order to protect the patients entrusted to their care.
Similar work has been done on the awareness of ethical rights among radiology patients. This research project goes a step further by intending to demonstrate the awareness of Ethical code of patient rights among practicing radiographers, which will help them know the ethical code of patient rights in the radiology department.
1.2 STATEMENT OF PROBLEM
- The researcher on his course of clinical posting in several occasions witnessed abuse of ethical code of patient rights by radiographers.
- There is perceived doubt if patient’s individual rights is still protected by practicing radiographers.
1.3 OBJECTIVE OF STUDY
- To ascertain how aware radiographers are about the ethical code of patient rights.
- To access the reason if any; for the abuse of ethical code of patient rights by practicing radiographers.
1.4 SIGNIFICANCE OF STUDY
- It will enlighten practicing radiographers on the ethical code of patient rights.
- It will help to reduce the incidence of abusing ethical code of patient rights by practicing radiographers.
- It will improve patient’s corporation during radiological diagnosis.
- It will be of help to other researchers in the related field.
1.5 SCOPE OF STUDY
This work will be limited to practicing radiographers in x-ray department in the following hospitals in Enugu metropolis.
- University of Nigeria Teaching Hospital.
- Park lane General Hospital.
- National Orthopedic Hospital.
1.6 LIMITATION OF STUDY
The research has small numbers of targetpopulations
- HYPOTHESIS.
H0 –There is good ethical conduct among practicing radiographers
H1-There is poor ethical conduct among practicing radiographers
1.8 LITERATURE REVIEW
Ethics, as a whole is an important component of any business or profession and on indicator of standards that the profession will follow. In health professions codes of ethics are used as the standard to be upheld by practitioners. In any medical system, there are bound to be complaints about the conduct of practitioner ranging from very serious allegations such as assault or molestation to more minor incidences such as rudeness or mis-information.
Aristotle2 believe that virtue becomes an important part of one’s life because the person who practices virtue will be better off, not financially, but in overall living. Ethical reasoning contributes to functioning as an ethical person and requires a blending of cognitive and effective processes, as well as integration of moral judgment, sensitively motivation and character.
James A.E3 states that the radiographer’s respects confidents entrusted in the course of professional practices, respects the patient’s right to privacy and reveals confidential information only as required by law or to protect the welfare of the individual.
According to Samuel et al24 “patients has right to know the name of radiographer that is diagnosing him or her.
Umerah B.C4 patients has right to receive an explanation concerning the nature and the procedures of the radiology exam before you continue the exam. The patient should be duly informed about possible risks related with the procedure. If there are several alternatives and if the patient requires information on alternative treatment, he or she has right to know them as well as the name of persons involved in them.
Gillhearm A5, “patient has a right to refuse the examination to an extent permitted by law as well as to be informed about health consequences of the decision made.
Smith R et al6, In the course of outpatient and inpatient examination and treatment, a patient has a right to maximum privacy in correction with the treatment programme. Analysis of his or her case, consultations and treatment are confidential issues and must be performed discreetly. Presences of persons who are not directly involved in the examination have to be agreed with the patient, which is valid also for university facilities, when these persons have not been selected by the patient.
Patient has right to expect that all reports and records concerning their diagnosis are treated as confidential. Safely of this information must be also secured while processing it electronically.7
According to Goddard PR8 “A patient has a right to expect the hospital to comply as much as possible and reasonable with the patient’s request todegree corresponding to the nature of disease. If necessary, the patient may be transferred to another health care facility, nevertheless full justification and information on necessity of this transfer should be provided together with information on all other existing alternatives. The facility, where the patient is to be transferred, also has to approve the transfer first.
Morality J9. “A patient has a right to a detailed and understandable explanation even if a radiographer has decided to follow a non-standard procedure.
Holm S et al10. State that “a patient with terminal illness has a right to sensitive care from all health personnel which include radiographers who must respect his or her wishes provided they do not violate the law.
Patient has a right to know and follow the rules of the health care facility where he is diagnosing and the right to check his account and ask for explanation of its items regardless of who pays the account11.
According to Christian Herold, chairman Department of Radiology Vienna’s General Hospital12 ethically patients have right to be protected by unnecessary radiation which base on the principle of “as law as reasonable achievable” in delivering diagnostic services, with the 3 key aspects of radiation protection being time, shielding, and distance. State rules regarding radiation protection to the patient very, but Oregon has clear administrative rules about general shielding, holding patients during exposures, and tracking the use of fluoroscopy dosage. 10 medical facilities track radiation exposure to ensure compliance with these laws.
The Community Hospital’s Radiation Safely Committee asks for a quarterly report of the flouro usage and technologists receive a quarterly report on the percentage of their patients who were properly shielded all of these practices work toward protecting the patient from excessive radiation, as well as protecting medical imaging personnel13.
Richardson ml14 state that all patients regardless of age or any other factor deserve the best imaging examinations with the least possible radiation dose. He further state that “because younger patients are more radiosensitive, it is natural and appreciate that the debate on the relative risks and benefits of imaging modalities begin with our pediatric patients.
Keown15 defined negligence to ethical code of patient rights as “carelessnesness where is duty to take are and where failure in that duty causes damage” it may occur as an act of either omission or commission and liability to negligence may be either person or vicarious.
Den Haag16, in his study carried out to find the attitude of radiographers toward ethic code of patient rights in some district hospitals which showed that most of radiographers do not take these responsibilities seriously while dealing with patient irrespective of their knowledge of professional ethics. The work noted that the group monitoring the radiographers does not have enough regulatory control and that professional incompetency was not a ground for disciplining a radiographer by the state medical board in many states.
Radiographers and other health care professionals in Nigeria and developing African states have been on their great fortunes of unheard action against them for reckless misadventure.
Sharger JD17 in a research to determine the relationship between ethical right of patients and radiology. He identified seven elements that constitute the ethical responsibilities of radiologist. These includes protecting patient interest, communicating effectively with radiographers and patients, providing excellent image interpretations, seeking continued learning and continuous improving quality.
Rendtorff18 states that the principles of autonomy and integrity are seen in the framework of human rights law. The principles manifest the concern for protection of human rights in biomedicine.
Emmanuel Le’Vinas19 described vulnerability as the “foundation for understanding human condition” the human being is vulnerable and must be protected when confronted with possible intervention by others.
According to Armstrong J20 “when a radiologist receives an order for a test, the first step is to consider whether the test is truly necessary. Radiologists are ethically responsible to expose the patient to as little potentially harmful testing as possible.
A study by Douglas21 revealed that relatively rare incidence of medicolegal actions in Nigeria. A pertinent observation was made that this is now increasing and is expected to increase the more as the life style approximation is that of western countries and patients know their rights. The profession must be aware of the laws and statutes governing medical practices and the code of conduct written or implied pertaining to his duty and relationship with the patient, it is only then that he can avoid the pitfalls which Lurk around the practice.
Buddhism22, in India over 2,540 years ago, emphasized that the root cause of suffering lies within one’s mind. To obtain freedom from suffering, one must develop the right view and practice the right action. The Buddhist aim of eliminating suffering in a compassionate way coincides with the objectives of medicine, and Buddhist clergy have been involved in care of the sick for over 2,000years.
Sharger JD23 Health profession and their ethic are vary important, the interest in medical ethics have captured the contemporary mind because they represent major conflict in the area of technology and basic human value, those dealing with life, death and health.
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