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Question: Outline the Causes of Ethical Issues experienced by Students and Health professionals in the New Zealand Healthcare System. Discuss the Sustainability of Providing Healthcare Services under the Current level of funding by the Ministry of Health. Answer: Introduction While dealing with the health care services, ethical issues are very common in the industry. Around every decision that are made in the health care and nursing services can have implications regarding ethical concerns. These implications definitely have effects on the health care providers, leaders and mostly the patients. Ethical queries associated with the health care, health and public health care concerns as very diverse as the issues regarding morality around state obligations in the provision of services associated with health care and suitable measures for controlling infectious disease. Scholars and professionals in health care have argument ethical questions associated with health and health care right from the early years of medicine (Barker Pistrang, 2015). Under the circumstances of competing priorities and limited resources, the providers of health care service, public health and biomedical investigators, and the makers of policy are mostly forced to take difficult choices regarding how best securing of optimal health outcomes for population and individuals can be done. Demands for fast actions may not leave much time for sufficient consideration of the ethical issues. However, any failure to present explicit attention to the ethics may lead in various negativity, such as injustice and harm, the implications of which mostly resulted disproportionately by the vulnerable groups. Hence, it is very important to centralize the ethics in orientation to the decision making in the health care and nursing industry. The students and practitioners of health care and nursing services happen to experience various kinds of ethical issues and challenges throughout their clinical practice in various ways (Black, 2016). It is very important for the educators in the nursing and health care industry to understand the need for recognizing the unique issues that are faced by these professionals and students. The causes that result in various kind so ethical issues during the practice of health and nursing services mostly associate with compromise of safety of patients, unsafe practices of health care, unsafe and unhygienic conditions of work and suspected neglect or abuse (Jacob, Decker Lugg, 2016). The lack of assistance and supervision, bullying concerns and even end of life issues are also included as some of the causes that associated with the resulting ethical issues in the health care system and industry in New Zealand. The idea of sustainability of providing health care services under the current level of funding by the Ministry of Health of New Zealand can be very well conceived form the comparison and contrast between the New Zealand Social Security Act which was passed in 1938 and the claims regarding funding of healthcare in New Zealand. It has been found that the claims of funding in the health care in the country are at an excessive status and increasing further at a very alarming rate (Issel Wells, 2017). The New Zealand Social Security Act was intended for ensuring the presence of universal access for all sorts of comprehensive services of health care and nursing through a taxation system. The sustainability of the provision of healthcare services under the current level of funding by the Ministry of Health is significant as the costs of health care with the advancement of time are increasing as a result of various factors. These include the increase in the availability of new and advanced treatments which are mostly expensive treatments, a widening gap in income, increase in the ageing and total population (Purtilo Doherty, 2015). These factors have left a significant and increased percentage of the population in poverty. Simultaneously, there have been many repeated claim by various agencies and governments that the cost of funding in the public services of health care in New Zealand has turned out to be unsustainable. These claims do not possess scrutiny. But the scenarios definitely need urgent attention regarding how much has to be spend in the system of public health. Thesis statement The healthcare environment has scopes for causing ethical issues regarding unsafe work environment, breach in the privacy, dignity, respect and confidentiality, changing of attitudes; autonomy issues are very much prevalent in the nursing and healthcare industry in New Zealand. Scope of the essay The concerns regarding the ethical issues and there causes encompass the students and professionals in the nursing and health care system in the country of New Zealand. Causes of ethical issues experienced by students and health professionals Although the students and professionals in the nursing and health care system in New Zealand have a significant role in the establishment of the environments and programs that have direct impact on the delivery of patient care, the dilemmas and issues regarding unsafe work environment, feeling of powerlessness, validation and acceptance of decisions of others, and the requirement to compromise which has affected the ability of the students and professional in the health care and nursing service to uphold the standards of ethics. It was observed that around 10 percent of the participants in a research which was conducted in the research study conducted in Nursing students experiences of ethical studies in clinical practice: A New Zealand study, around 4.3 score regarding distress as found among the students and professional in the nursing and healthcare service system in New Zealand. This issue was also found that most of the issues resulted in the students and professionals to prefer to work in safe environment of work and safety of patients (Parahoo, 2014). The research study also provided the facts that presented the fact that 11 out of 15 ethical issues arose when the students and professional in the nursing and health care system in New Zealand experienced unsafe conditions of work and the unsafe practices of health care towards their patients which placed the health and life of patients at risk. It was also found that many participants reported that the lack of veracity or truthfulness which is displayed by the healthcare staff. These issues were found to be at the highest rank in the list of ethical issues and dilemmas in the research study (Pozgar, 2014). Values that are invoked very commonly include fairness, autonomy, honesty, compassion, trust, solidarity, respect and freedom. The students and professionals in the health care and nursing system in New Zealand confront the ethical issues regarding difference in values, culture and autonomy among individuals, groups levels. In the research study, higher scores of distress were found in the majority of issues which resulted due to the difference in the cultural values, conflicts regarding honesty, trust, and freedom in the way of work (Sinclair, Papps Marshall, 2016). The validation of the implications of theses aspects in the distressing of the students and professionals in the nursing and healthcare system in New Zealand could be obtained by the high level of distress scores. This was also supported by the fact that the nursing and health care practitioners and students in New Zealand related there increasing concern regarding the structure and function of their environment of work towards the end of their training and associated the their own high levels of stress (Whitehead et al., 2015). They also were observed to analyze their own coping abilities along with the deficits in the care of patients which are found to be very much pronounced in the health care and nursing environment which is unsafe. The net scores for overall distress were found to have significant increase in a year. The ethical issues regarding the commitment of the authorities to the workforce was one of the leading issues according to the research. The change in the commitment of the institution to its human resource which included the students and professional in the nursing and health care department led to many ethical issues in the nursing and healthcare system of New Zealand. The ethical concerns do not necessarily revolve around the loyalty, instead regarding the commitment of the organization to its workforce which when not materialize enables the latter to leave the organization and learn new and innovative skills. Supervision and support are very crucial for the development of clinical skills along with ethical competence according to the research studies on nursing students (Savery, 2015). The participant in the research study reviewed that there was a lack of support from the authorities of the nursing and health care students and professionals in the health system of New Zealand. It was also observed that the nursing staff was not much interested in working with the students and professionals in the nursing and health care system in New Zealand. Regarding the scenario of bullying or abuse of any kind also resulted in ethical issues and concerns in the nursing and healthcare system of New Zealand. According to the research paper, bullying was considered to be more suitable for assessing eh unsolicited reports regarding abuse and bullying by the NZNO National Nursing Student Survey. Form the research it was obtained that the participants did not find bullying to be considered as an ethical issue. On the other hand, 10 percent of the participants review that there have been significant instances of experiences regarding bullying and abuse (Ventola, 2014). Thus, the frequency score in this regard was 4.2 and it was found to be reported as extremely distressing with a very mean score of distress of 4.5. The other aspects that led to arising of ethical issues associated with veracity and end of life care. The concerns and issues that were associated with the end of life care were not exactly found on the questionnaire as this issue is much more complex in nature and more challenging in the nursing and health care (Webb, Bain Page, 2016). The issues associated with the end of life care include the issues of ethics where care was imparted either to avoid the measures taken for saving life or to prolong the life of the participants by the students and professionals in the nursing and health care experienced that it contradicted the wishes of the patients. There were ethical issues associated with dishonesty in the nursing and healthcare system in New Zealand. It was also found that the students and the professional in the health care and nursing sector had low frequency rates regarding the high levels of distress when the experience was felt (Whitehead et al., 2015). Other various issues that were obtained from analysis of the research study included the involvement of other staff in the nursing and health care system in New Zealand and concentrated on the lack of guidance and supervision afforded to the students and professionals. The breach of privacy and confidential aspects indiscriminately and distressing regarding the practices also placed both the students and professionals of health care and nursing practices along with the patients at risk (Purtilo Doherty, 2015). Conclusion The New Zealanders of have high status of health but a significant level of inequalities regarding health and ethical status regarding health. The students and practitioners of nursing and healthcare are very prone to face ethical issues and dilemma during their work experience in the health care industry in New Zealand. Managing to perform efficiently in the midst of ethical issues in the circumstances where there will be breach in the privacy and confidential information, dominance of higher authority, on-cooperation and no support from the senior officials, unsafe environment of work, change of attitudes and behavior of the people associated with both the authorities and patients along with high stakes of respect, dignity and security has proved to be a daunting task for the students and practitioners of nursing and healthcare system in New Zealand. The health care environment is leading to a huge space for growth of distress among the students and practitioners of nursing as well as health care. It is due to the increase in the ethically complex and highly challenging nature of work. The outcome of this distress one the students and practitioners is comparatively unexplored territory. The health care institutions need to provide ethics education to all its employees and practitioners in order to prevent the ethical issues form arising in the work place. Moreover, due to ethical education the students will also be able to prepare themselves for facing varying situations which are ethically challenging by nature. The students and practitioners in this industry need to be educated and empowered for enabling to be intelligently and actively raise their voices and take appropriate measures to make their voices heard and settle their challenges with dignity. References Barker, C., Pistrang, N. (2015). Research methods in clinical psychology: An introduction for students and practitioners. John Wiley Sons. Black, B. (2016). Professional Nursing-E-Book: Concepts Challenges. Elsevier Health Sciences. Jacob, S., Decker, D. M., Lugg, E. T. (2016). Ethics and law for school psychologists. John Wiley Sons. Issel, L. M., Wells, R. (2017). Health program planning and evaluation. Jones Bartlett Learning. Purtilo, R. B., Doherty, R. F. (2015). Ethical dimensions in the health professions. Elsevier Health Sciences. Parahoo, K. (2014). Nursing research: principles, process and issues. Palgrave Macmillan. Pozgar, G. D. (2014). Legal and ethical issues for health professionals. Jones Bartlett Publishers. Sinclair, J., Papps, E., Marshall, B. (2016). Nursing students' experiences of ethical issues in clinical practice: A New Zealand study. Nurse education in practice, 17, 1-7. Savery, J. R. (2015). Overview of problem-based learning: Definitions and distinctions. Essential readings in problem-based learning: Exploring and extending the legacy of Howard S. Barrows, 9, 5-15. Ventola, C. L. (2014). Social media and health care professionals: benefits, risks, and best practices. Pharmacy and Therapeutics, 39(7), 491. Webb, P., Bain, C., Page, A. (2016). Essential epidemiology: an introduction for students and health professionals. Cambridge University Press. Whitehead, P. B., Herbertson, R. K., Hamric, A. B., Epstein, E. G., Fisher, J. M. (2015). Moral Distress Among Healthcare Professionals: Report of an Institution?Wide Survey. Journal of Nursing Scholarship, 47(2), 117-125.

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