Monica Benjamin

Ethics Reflection Essay

12/4/18

I will be using beneficence and dignity to support my goals as a PA of helping patients with difficulty speaking English and low health literacy.

Besides for the self-serving reasons of having a career I enjoy and good pay, I have chosen to be a PA, as many others have, in order to help people. A normal community member can make a difference and volunteer in various ways, however being a PA gives you a specific skill set to help people in a specific way. Many people are living with illnesses and conditions that medicine can alleviate or treat entirely, but do not seek care for financial or accessibility reasons and I hope to contribute to the effort to address these issues.

Along with the use of medicine to diagnose and treat patients, my focus in clinical practice would be to help those with language barriers and lower health literacy understand their condition and what measures they must take to achieve better health. During my undergraduate years, I majored in Spanish and volunteered as a Spanish medical interpreter. I repeatedly saw how it was not the current capacity of medicine that was contributing to these patients’ poor health, but rather their inability to speak English or their ability to understand their health.

For example, upon being asked what she ate today, one hyperglycemic diabetic patient proudly replied “a large cup of orange juice.” She thought she was adhering to a diabetic diet by eating fruit, however was unaware that orange juice causes large blood sugar spikes. As a PA, I want to use my ability to speak Spanish to not only eliminate that language barrier but to be thorough with my patients to ensure they are well-informed about their condition and how to manage it.

Both beneficence and dignity will influence how I make ethical decisions regarding my patients. Beneficence is acting in a way that is good for my patients and does not harm them (Yeo et al.). In my practice, I hope to do good for my patients, especially those who only speak Spanish, by eliminating the barriers of language and low health literacy to provide the best care possible. Dignity is seeing the value of a person and recognizing them as deserving of time, effort, and respect, as well as entitled to make his or her own decisions (Royal College of Nursing). Dignity would be an important consideration for me as I evaluate whether my past and future actions strive to maintain the patient’s dignity.

Beneficence encompasses my goal to minimize the effect of language barriers and low patient literacy. Regardless of the specialty, the central focus is the patient and thus, all my decisions will be focused on doing good for the patient. In order to do so, I must ensure my patient can do good for him or herself, which can be accomplished through patient education. However, with increasing patient load and time constraints, I may feel pressure to not take the extra time to help the patient understand and ensure the patient understands. According to Yeo and Moorhouse, an aspect of beneficence is when “the call of duty may spur us into action when concern for ourselves pulls us in another direction” (106). While pressure from my superiors may tempt me to not invest that extra time, it is my duty to do so, as I would be compromising the patient’s care if I did not. I may have ordered the correct tests and prescribed medication for a patient with hypertension, but if I do not ensure the patient knows how to take the medication and what lifestyle modifications must be made, I have not ensured the patient has all the means to improve their health.

Furthermore, seeing dignity in my patients will also help in my decision-making. Overall, it will help me see my patients as people deserving of privacy, time and effort. Accounting for patient dignity will help me justify to myself and my supervisor the need to invest extra time and effort to compensate for the language barrier and low health literacy. The patient is a person who deserves to understand his or her condition and should not be “punished” for having a lower health literacy or not being able to speak English. For many of my patients, the answer to the Patient Dignity Question may be “I don’t speak English well” or perhaps expressed indirectly “I do not always understand when doctors speak to me.” In addressing these concerns, I am treating the patient with the dignity and care deserved.

Beneficence and dignity will be essential to my future practice to ensure that non-clinical obstacles do not result in poorer health outcomes for my patients.