Ethical Decisions in Designing Patient-Centered Health Interventions NURS-FPX 4050 Assessment 4

The decision to educate patients on medication adherence and behavior modification will promote better health outcomes that uphold beneficence. However, there is a need to engage patients in lifestyle changes and allow them to make dietary changes that align with their preferences and cultural diet practices rather than imposing the changes on them (Clark III et al., 2020). This promotes autonomy and increases the likelihood of the patient adhering to the lifestyle changes. In addition, the intervention in intensive BP-lowering therapy promotes beneficence by improving BP control as well as nonmaleficence by protecting patients from complications of uncontrolled BP (Clark III et al., 2020). Patients will be closely monitored for adverse effects to prevent causing more harm. Furthermore, consent will be obtained before initiating new treatments to respect the patient’s right to autonomy. These interventions promote social justice by ensuring that resources for hypertension management are available to the persons who need them most, that is, hypertensive patients.

Nonetheless, ethical questions have surfaced, which has created some level of uncertainty about the decisions I have made above. One of the questions is: Does driving the concept of medication adherence go against the patient’s right to refuse treatment? What if the medications used in intensive BP therapy put the patients at risk of adverse effects from medication errors? How will clinicians establish that a certain drug will promote the best BP control in a specific patient?

Relevant Health Policy Implications for the Coordination and Continuum of Care

The Affordable Care Act (ACA) mentions that care coordination is under sections on payment reform, quality improvement, and monitoring savings. It also mentions it under full Medicare Medicaid beneficiaries, special considerations of patients with diabetes and depression, and health home members (Natkin et al., 2023). Section 3502 of the ACA establishes Community Health Teams, which link clinical and community settings to support Patient-Centered Medical Homes. The act outlines the role of the Community Health Teams as coordinating disease prevention and chronic illness management, creating interdisciplinary care plans, and engaging patients and caregivers (Natkin et al., 2023). Furthermore, they support PCPs by coordinating access to preventive services and services that are cost-effective, quality-driven, culturally appropriate, and patient- and family-centered.

Section 2703 of the ACA requires the CMS to establish health home services for Medicaid beneficiaries with chronic illnesses. This is a Medicaid State Plan Option that provides a comprehensive care coordination system for Medicaid beneficiaries (De Marchis et al., 2023). The services include: Comprehensive care management, Care coordination, Health promotion, Comprehensive transitional care, patient and family support, and Referral to community and social support service