Health Care Ethics
Assessment Task 3: Essay – An Ethical Dilemma
Select a case study from the list below and address the following points.
2. Identify the ethical and legal conflicts and consider them from the following perspectives:
? The principles and virtues of health care ethics that inform professional practice
3. Propose a legally and ethically defensible resolution to these conflicts
Case scenario give below
CASE STUDY TWO
Alex Ng, a senior paramedic in a regional centre, is called out to attend a motor vehicle accident on the main highway, involving two cars and a large transport truck. On arrival at the scene, Alex finds passengers trapped in both cars; two children in a small car are not moving and show no other signs of consciousness while the female driver is slumped over the steering wheel, bleeding from a head wound. The male driver of the other car is conscious but trapped in the wreckage; he tells Alex’s partner that he cannot feel or move his lower limbs. The male truck driver is walking around the wreckage and appears confused and disorientated; at a glance, he does not appear to be physically injured. A woman who was driving past stops her car and comes forward; she tells Alex that she is an emergency physician and can help. Alex is grateful for the offer of help and asks her to attend to the children, however, he notices the smell of alcohol on her breath when she walks past him. After opening the door of the other car, Alex notices that the trapped driver is wearing earphones attached to his mobile phone and the phone screen indicates that he was on a call when the accident occurred. The driver is alone and Alex recognizes him as the local magistrate, and a good family friend. Just then, he hears the screech of brakes and turns to see that the truck driver has walked up the highway and into oncoming traffic. He is lying on the road and does not appear to be breathing.
Health Care Ethics
Ethics affects every part of healthcare setting, and this calls for healthcare providers to be vigilant when providing health care services. These settings include when providing direct care to patients, resource allocation, and staffing. It is important to note that in some situations ethics do not provide answers, but instead, they lead to getting solutions (Burkhardt & Nathaniel, 2013). Sometimes, healthcare providers are faced with situations which may or may not be life threatening, and they make decisions which go beyond their profession or technical concerns.
Nurses and physicians often encounter challenges on what ought to be done event in ordinary situations despite the laid down ethics and professional code of conduct (Corey & Callanan, 2014).Consequently, it leads to the health care providers being faced with ethical dilemmas, where one is expected to make a choice from two alternatives.
When dealing with ethics, healthcare professionals requires possessing skills, in processes of value clarification, ethical decision making. Health care professionals should be aware that when faced with ethical dilemmas evoke powerful emotions and strong opinions, however, these emotions and opinions are not enough to solve ethical dilemmas (Corey & Callahan, 2014).
Professional nursing actions are supposed to be both legally and ethically right. There are various factors which fuel discrepancies between law and ethics. They include, ethical opinions that reflect individual differences, human behaviors are usually complex to be accurately reflected in law, the legal system judge’s action rather than intention.
Finally, rules change according to social and political influences. Therefore, some issues that may appear to be ethically right may in real sense appear to be legally wrong, and those that are legally right may be ethically wrong, therefore posing a challenge in provision of care by health care providers.
From the case scenario, the magistrate appeared to have been in a conversation through the earphones during the time the accident occurred. According to the law, it is wrong to drive while communicating with a cell phone. In this case, it appears as the accident occurred as result of the magistrate being on a call.
Clients are supposed to be respected and be treated with dignity, to make decisions regarding provision of care and to be actively involved in treatment plan. However, nurses and other health care providers are supposed to act as advocates for those clients who are unconscious, the minors and those that are not in their right mind.
These rights should be considered in any set up where care is being provided. Awareness of the client’s rights increases the health care providers’ awareness of the need to treat the clients in an ethical manner and ascertain that the rights of the patients are protected ( O’Donnell, 2015). When nurses are providing care, they should always respect the values, customs and beliefs of their clients.
In the event of accident victims, like in the case of Alex, nurses and other health care providers might have a challenge in attending the accident victims since everybody is entitled to the provision of care. However, due to the limited number of health care providers in the scene one might not be sure who to attend to first. This is because everybody at the accident scene was entitled to medical attention.
Ethical principles direct or govern on the best course of action. When nurses and other healthcare professions are making ethical decisions, they should be based on principles. (González-PA chon & Romero, 2016). They reflect on what is best for the patients. When these principles are employed in the nursing field, nurses are in a better position in solving ethical conflicts.
Furthermore, these principles can be used as references in analyzing ethical dilemmas and provide rationales to solving ethical problems. However, these principles are not absolute; hence there can be exemptions to every principle in any given situation.
The principle of autonomy outlines that an individual has a right to make a decision and act on it and nurses should respect the client’s rights and protect those unable to decide for themselves. Nurses uphold this principle by accepting the client’s decision even if they are not patient’s best interest (O’Donnell, 2015). Nonmaleficence means that every health care provider has a duty not to cause physiological, physical, social or spiritual harm to others either potential or actual.
A nurse is responsible for weighing the potential risks and benefits of any plan of action. When upholding this principle, healthcare providers practices according to their profession and laid down legal standard (González-Pachón & Romero, 2016).
The principle of beneficence states that every health care provider has a fundamental duty to do good and prevent harm. Justice is a principle which is based on the fairness concept, both benefits and burdens should be distributed fairly. All individuals should be treated equally unless there is justification for unfair treatment (Myers & Venable, 2014)
A close relationship exists between ethics and values, and this makes it difficult for the nurses to balance between principles that apply to clients and those that apply to health care systems. Therefore, nurses should examine their value system to be in a position to provide care to clients whose values may differ. (Myers & Venable, 2014).
Health care providers should be aware that values are different depending on individuals and are not alike to everybody. Therefore, nurses should be careful not incorporate and practice their values on their patients.
Code of Conduct
Professional code of conduct outlines the nurse’s obligations to clients and the society as a whole. The ethical code provides broad principles for determining and evaluating nursing care. There are professional bodies which deal with the nurses who act unprofessionally. For example, a nurse is supposed to provide care on human dignity and treat clients differently without considering any other factor. Nurses and other health care providers draw their moral guidance from their families, religious beliefs, family and parental values. However, they may not be the only guidance in professional ethics (Lee& Divaris, 2014).
Ethical Conflicts/Ethical Dilemmas
Ethical conflicts result when a person if faced with a decision to make and none is clear since it collides with morality, ethics, justice or personal situations. In health care settings, healthcare providers should evaluate the best choice to take since in some situations doing what is termed as morally right may yield negative impacts while doing morally wrong may result in a positive outcome (DeKeyser ,Ganz & Berkovitz 2011). Furthermore, the moral position can be substantiated or not substantiated. Alex and the colleague might have been faced with a dilemma on the accident victim to attend to.
However, when an ethical conflict is encountered, any healthcare provider should make the best decision which is in line with principles, laid down rules and the law. In the event a person is unable to resolve the conflict, he shall be required to address the consequences. Therefore, it is necessary for health professionals to consult a colleague before undertaking any plan of action and in case a conflict is unresolved, it will necessitate further consultation from the relevant professional body or legal counsel (DeKeyser ,Ganz & Berkovitz 2011).
From the case scenario, both Alex and his colleague might have been faced with a dilemma parting the first victim to attend to. Health care providers are supposed to attend to victims who urgently need care and for this case that’s what Alex did. Unfortunately, the truck driver appeared to be stable despite the orientation and he passed on before being attended to. It is unethical for health care professional to attend to clients when they are under the influence of alcohol. However, it becomes challenging in the event of an accident due to the limited number of healthcare providers at a scene
When making a choice between two alternatives, various ideas can be employed so as to help in solving the ethical dilemmas. Ethical theories are used to analyze ethical problems rather than provide answers to ethical conflicts. Teleology stipulates that importance of a situation is based on the outcome and not activity. This theory is founded on the principle of utility which states that for any action to be termed beneficial, it must impact a good number of people in any given situation. Every alternative is assessed for positive and negative outcomes (González-Pachón & Romero, 2016). The selected action is the one that maximizes benefits and minimizes occurrence of any harm.
Deontology applies the criteria of the action itself to determine what is right rather than the consequence. This theory is based on the categorical imperative concept which points out that one should take action if the act applies a universal principle. This means taking an action that one would take when faced with a similar situation (DeKeyser Ganz & Berkovitz, 2011).
Resolution to Ethical Conflicts and Ethical Dilemmas
When an ethical conflict of choice manifests itself, the nurse should be able to identify it and come up with the relevant resolutions. The following are some of the issues that should be factored in to before coming up with a resolution. This includes ethical theories; principals involved, parties that will be affected and the consequences of ethical options. Nurses can be able to make decisions to resolve ethical dilemmas if only they are done systematically (Lo, B, 2012).
There exists a need to help address the ethical concerns in health care setting. Formation of an ethics committee will go a long way in addressing the ethical dilemma issue. Also, this committee should formulate policies and procedures which will help in prevention and resolutions of the dilemmas (Kangasniemi, Pakkanen & Korhonen, 2015).
It is of significance for nurses to understand the basis on which they make their decisions. This means that they should think through what needs to be done and provide a rationale for every activity (Shapiro & Stefkovich, 2016). Therefore, it would be important for healthcare providers to know that the decisions they make cannot be based entirely on intuition and emotions instead, they should be based on an ethical basis. Ethical decision making should be made in situations in which the right decision is not clear or where there are conflicts of rights and duties (Shapiro & Stefkovich, 2016).
As professionals, nurses and physicians are obliged to protect the client’s rights and interests. Consequently, sound nursing practice involves making ethical decisions. In every healthcare setting, health care providers are usually faced with ethical concerns, and they are required to balance their ethical responsibilities with their professional obligations. Often a conflict results when a nurse is trying to balance the two. It is, therefore, necessary for health care providers to handle situations putting ethics into consideration. This should necessitate the application of different principles in the profession, justification of actions through the use of ethical theories.
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