In his book How We Do Harm: A Doctor Breaks Ranks about Being Sick in America, Otis Brawley illustrates the battle between doctors honest practice based on ethics and evidence-based science and corrupt medical practice that seeks greed, clinical experiments that cause harm and inadequate standards. Ethical importance encompasses: doing everything reasonable to avoid injury to patients, preventing medication errors, providing individualized care to each patient, dealing honestly and openly with patients and contemporaries, and owning judgment and the actions of nurses/providers. The aspect of the book that stood out to me the most was the demonstration of honesty and skepticism about how providers practice. Before becoming a nurse, I was a patient. As a patient, I believed that my providers were aware of the best evidence and practice and that my best interests would be at stake. When I became a nurse, I realized that this was not always true. There are good, honest, knowledgeable providers, and there are those who have enough basic knowledge to provide care and pay a paycheck. Organizations tend to adhere to the same mold. It's time for honest providers to speak out, like Otis Brawley, and call for standards of care to rise to the occasion by relying on evidence, not making up rules as they go. and gradually. “The particularity of the health professions is that our actions are guided by a code of ethics.” Inappropriate and inadequate policies and standards deprive nurses and healthcare providers of the opportunity to provide appropriate patient care, compromising their ethical responsibility. Say no to plagiarism. Get a Custom Essay on “Why Violent Video Games Should Not Be Banned”?Get the original essayThe current “social mandate” of health care is largely influenced by the individual mandate of the Affordable Care Act (ACA) and by how the health care budget is allocated through federal, state, and private insurance by directly linking quality to payment and patient satisfaction. Under the ACA, individuals are required to carry insurance or receive a penalty if they are not covered by some type of insurance entity. In 2019, this mandate will end and individuals will no longer receive a penalty. The coming year will bring many concerns as America eliminates penalties for uninsurance, changes Medicaid and Medicare, defunds the opioid crisis, and attempts to reduce drug spending by lowering prices . Change begins with those in leadership positions. Advanced practice registered nurses (APRNs) can serve as excellent mediators in shaping public policies and standards. APRNs are trained in advanced communication skills/processes to lead quality improvement and initiatives in health care systems. APRNs should seek support that values ​​the nursing profession and empower them by including them in the process as respected shareholders. In doing so, APRNs are empowered to improve the health of their patients. As healthcare professionals, we have a duty to serve our patients and provide them with quality care. Brawley explains in chapters 20 and 21 how he witnessed the harms associated with unnecessary health care and screenings, based on the idea that screenings decrease mortality when detected early(Brawley, 2012). It describes a man named Ralph whose wife sees an advertisement for free prostate screening and insists that her husband get tested. This screening leads to a biopsy, an internist for hypertension, a radical prostatectomy using the Da Vinci robot which causes impotence and incontinence, a remaining piece of the prostate which produces 0.9 d prostate specific antigen (PSA) and radiotherapy which causes rectal proctitis which in turn forms a rectal fistula in the bladder which requires a colostomy and ureterostomy. He explains that there are debates about the usefulness of prostate screening and how the studies he conducted found as many cancers as he found. The type of cancer Ralph had, based on knowledge from that time, left questions about whether it could be treated or not. Ralph had now lost a good quality of health due to screening, when in fact he could have been fine without treatment. Brawley adds to the need to define disease criteria and evidence-based practices based on hard science versus relative risks and theoretical treatments. In the same chapter, he also explains how trials showed that the use of X-ray exposure revealed more mortality risk than life-saving measures. One study suggests that screenings may reduce cancer-specific mortality, but overall mortality will not. In Chapter 5, Brawley describes Mr. Schmidt as a "confident" white man with colon cancer, seeking care from a well-known doctor whose specialty is not colon cancer. Brawley expresses disgust with the system for policyholders who incur heavy expenses due to suboptimal care, medications, time lost from work and ultimately loss of insurance while the doctor makes money. Mr. Schmidt was forced to go to Grady Hospital due to lack of funds, but in return he was treated with the appropriate treatment and had no further illnesses. A study of non-trauma center emergency departments (EDs) and transfers to trauma centers highlights that patients' needs must come before their ability to pay; this article found that policyholders receive lower quality care while paying in a non-trauma emergency department when their serious illness requires transfer to a trauma center. One ethical problem I found appalling in Brawley's book was how the patient so easily influenced a doctor. administering unnecessary treatment due to patient persistence, even if it went against standards and evidence-based practices. Brawley argues throughout his book that more is not better. Debbie Kurtz fears the cancer is returning and contacts several doctors to receive additional treatment for Dukes' colon cancer. Debbie received all appropriate treatments based on the most current medical evidence regarding Dukes A colon cancer. Debbie ignores this information, a doctor chooses to give her treatment thinking that if he didn't do it, someone else would, and insurance pays for this unnecessary treatment due to lack of information. Even though Debbie had surgery to remove the cancer and an impeccable post-op pathology report, she chooses to harm herself. Providers must practice with the patient's best interest in mind, even if that means saying NO to the patient, to ensure they do no harm. Brawley addresses cultural issues related to the African American population's fear of.