Healthcare workers and professionals in different spheres of serving have ethics and obligations towards service users, both in the public and private sectors. Globally, there are governing bodies which ensure that various health professionals such as psychologists, psychiatrists, medical doctors and nurses uphold their ethical obligations towards service users. In the Namibian context, we have the Health Professions Council of Namibia (HPCNA) that carries out this duty.
The primary objective of the HPCNA is to safeguard the public, who are predominantly service users. Specific governing standards, values and ethical principles are put in place to align health professional practices and behaviours to those of the entity because of the power relationship that exists between the health professionals and the service users. Generally, health professionals are deemed knowledgeable on the subject matter of health-related issues because of their professional training and experience, and as a result, service users trust and rely on the guidance and treatment provided by health professionals.
Hence, it’s crucial that healthcare workers and professionals need to take caution in how they engage and treat service users. Health professionals are responsible for providing diagnoses, recommending or providing treatment, whether that is medicinal or psychotherapy, providing physical care in the wards, such as administering medication, checking blood pressure as well as making sure that those who require palliative care are provided with the integrated care needed for their well-being. If a respective department doesn’t have a multidisciplinary team needed to provide a holistic service to the service users, it is the healthcare workers’ responsibility to refer the service users accordingly, and to educate them on the steps how to achieve optimal health.
In addition, healthcare workers and professionals upon registration with the governing bodies, whether it’s for internships or professional purposes, declare under oath to treat service users humanely, with dignity, respect and empathy. The cornerstone of any health professional is to serve, or at least be mindful of professional roles when serving specifically, in the public sector, where the majority of service users are from vulnerable groups due to their low socio-economic and educational backgrounds. Global studies indicate that some healthcare workers and professionals’ negative attitudes and treatment of service users deters the public from engaging in help-seeking behaviours.
It could be argued that the frequent local media coverage of healthcare workers’ negligence towards service users, which sometimes carries grave consequences for service users and their families, may coincide with the findings of global research.
Service users seek help because they have identified a need for either psychological, physiological or psychiatric intervention. Therefore, it’s the healthcare workers and professionals’ duty to do their best to alleviate the main complaint, not to exacerbate the problem or be a perpetuating factor to the service users’ conditions.
To improve the wellbeing of the service users, the following four main principles of ethics are crucial for healthcare workers in all settings.
• Autonomy – respecting service users’ freedom to choose what is right for them without influencing them with your values, beliefs as healthcare workers, including discussing informed consent, transparency and confidentiality.
However, there may be situations in which the beneficence principle may override autonomy – for e.g. when a service user is admitted involuntarily into a facility due to their mental health condition under a certain Act for their own benefit, their decision-making power is then overridden.
• Beneficence – intent to do good; acting in the best interest of the service user. However, it’s crucial to treat each case individually, as what may seem as a good option for one service user may not apply to the other due to their cultural context or values.
• Non-maleficence – do no harm. Healthcare workers should avoid causing any harm to service users at all times. Good outcomes should always rule out the bad ones.
• Justice – be fair and make opportunities for treatment available for everyone, irrespective of their culture, status or creed.
(Clinical psychologist intern)