Legal and Ethical Issues Related to CHF in Women

Legal and Ethical Issues Related to CHF in Women

Polyakov, Fomin & Vaysberg (2019) states that consideration of the cultural norms, ethical norms and legal issues involved in the management of a patient with Congestive heart failure is significant and essential. Healthcare workers have a role in decision making concerning the management of women with heart failure. Still, they must also take into consideration the preferences of the family and the patient. Management of heart failure in women or the general population must involve the exploration of the various treatment modalities, limitations of the treatments, decision-making capacity and objectives of treatment or management. The disease progresses inexorably to end-stage and most women suffering from this always don’t have a say on how the end of life care should be. Some of them still prefer the don not resuscitate status. Some of them also favoured the use of advanced directives. Most of the women feared that the physicians would not respect their wishes or options in the management of the condition. According to Santema et al. (2019), the concept of autonomy of the patient must be respected at both ethical and legal level. An adult patient can understand any procedure that is being done regarding CHF and has a role to either accept or refuse it.  Health care workers should be able to obtain consent, explain each procedure, the side effects, risks, benefits and get written consent with a signature before going forward with any surgical operation on the heart or help relieve symptoms. The ethical principles, e.g. beneficence and non-maleficence should be upheld when dealing with this group of patients

Best Practices/Recommendations for Case Management for Women with CHF

Case management involves the planning, organizing and reviewing the care of an individual with CHF. Family involvement in the case management and care of the patients has been shown to reduce the rate of readmission or development of complications. The family hence should be involved as much as possible in the care of these patients as it has been shown that those who lacked the family involvement had poor outcomes (Ho et al., 2019). Monitoring of signs and symptoms, this is mainly the general care that is given to CHF patients. The same should also be done to women with CHF to establish with the patient over a specified period. In each visit or contact, there should be an assessment of the lifestyle, checking of the physical and cardiac status, general medication assessment and other screening tests like dementia and depression. These recommendations will ensure that any complication or harmful behaviour is handled and managed as early as possible during the therapeutic relationship, as in Santema et al. (2019).

Reviewing medications is also another best practice. An experienced case manager should do this. The medications should be reviewed periodically to determine the best medication combination for the women with CHF during case management. Assessment of the home environment should also be added to case management. A case manager should visit the homes of these patients ad identify challenges or conditions in the environment that may be harmful or lead to ineffective recuperation. Through this, there is the identification of an environment that has long stairs that is not appropriate for the patients and recommend changes (Ho et al., 2019).  Feedbacks of case management should be provided to other healthcare professionals to ensure coordination and collaboration in care. The feedbacks will ensure that others involved in the care of the patients have a clear view of the general interventions, requirements and health condition of the CHF patient and hence continue care within the requirements to achieve the stated objectives, as in Polyakov, Fomin & Vaysberg (2019)

How to Overcome Barriers

CHF puts a lot of self-care demands on the women with the condition. There are recommendations that the women patients are put on to achieve the self-care. Most of them always fail to adhere to the self-care recommendations and end up being hospitalized or re-hospitalized. There should be follow-ups are given and involvement of the family to ensure that patients comply with the self-care recommendations. The barriers that come because of the legal and ethical recommendations should be addressed through an effective policy change that addresses the legal; issues that affect the care of these women. The problem of multiple medicine or polypharmacy in CHF in women can also be addressed through appropriate coping strategies and being advised on taking medication and following prescriptions (Polyakov, Fomin & Vaysberg, 2019). There is also a lack of facilities and poor access to medical services. There is need to create awareness on the cardiovascular conditions and provide free screenings and access to health. Non-adherence to the dietary and medication among these group of patients is also another challenges.  To overcome these barriers, there is a need for education of the women with the condition, teach some situational skills to achieve the needed self-care recommendations, as in Santema et al. (2019).

Conclusion

There are several ethical and legal issues that healthcare providers must consider when taking care of women with CHF. These include obtaining consent, explanation of any surgical procedure to ensure that the patient knows what is happening. In case management, recommendations include involvement of the family, reviewing medications, and assessing the home environment. Barriers should be alleviated to ensure adequate care to women with CHF.