Ethical Decisions in Health Care PDF

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Ethical Decisions in Health Care

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Ethical Decisions in Health Care Grand Canyon University: HLT305 June 19, 2020

Ethical Decisions in Health Care As a professional in the health care field, there will always be an ethical dilemma just down the road. It is extremely important for professionals within the health care industry to understand how to cope with such dilemmas. As part of the training and studying health care professionals from administrative staff to physicians are taught various was to wade through the tide of health care dilemmas they face with each passing day. One such method is the Uustal’s Ethical Decision-Making Model. Uustal’s Ethical Decision-Making Model is a nine-step approach to clinical decision making, when it is complicated by different values and belief

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systems of the various parties involved (Adam, Odell, Welch, & Welch, 2010). The decisions, by their very nature have the complexity involved to evoke powerful emotions and cause considerable stress to all parties involved (Adam, Odell, Welch, & Welch, 2010). To better understand the application of Uustal’s Ethical Decision-Making Model, we will apply it to the following case: “A 6-year-old develops a high fever accompanied by violent vomiting and convulsions while at school. The child is rushed to a nearby hospital. The attending physician makes a diagnosis of meningitis and requests permission from the parents to initiate treatment. Both parents are Christian Scientists, and they insist that no medical treatment be given to the child. The physician initiates treatment anyway, and the parents later sue the physician and the hospital” (Topic 5, 2020). To face this ethical dilemma, it is important to understand the steps involved with Uustal’s Ethical Decision-Making Model. As Uustal say, “I am the ethic of care” (Uustal 2003). The steps are as follows: “Identify the problem.  Who are the people involved?  How are they interrelated?  What is involved?  Identify the values/ethical dilemmas.  Make a concise statement of the problem, stating the conflicts

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State your values and ethical position. Explore the patient’s values.  The Patient’s choices should be the primary focus of the direction of decision making. The providers should communicate these choices to others in the healthcare team.  If your own values conflict with those of the patient, it may be that you should replace yourself as the patient’s primary care-giver.  Identify the ethical principles that are inherently important in the dilemma, and rank order. This will help identify the primary ethical principle that will influence decisions and behavior. Generate alternatives for resolving the dilemma.  Use a brainstorming technique. Do not pass judgment on any alternatives at this stage. If possible, involve the patient and relatives and all health carers involved. Examine and categorize the alternatives.  Examine those that are consistent and those that are inconsistent with your values, and those of the patient. Predict the possible consequences of those acceptable alternatives.  For each alternative, predict its physical, psychological, social spiritual and short- and long-term consequences according to the patient’s standpoint. Prioritize the acceptable alternatives.  Which have the most merit in the given situation? Rank order the alternatives. If it is difficult, choose the alternative that breaks the fewest ethical principles, or results in the least harm, or greatest good for the patient. Develop a plan of action. Implement the plan.  Communicate with all involved. Evaluate the action taken.  Ask yourself: ‘Did I do the right thing?’ ‘Were my actions ethical?’ All should be involved in the evaluation. Would you repeat your actions if you came across the same situation again? If ‘yes’, then good. If ‘no’, then recheck steps 1 and 3, and continue through the stages” (Adam, Odell,

Welch, & Welch, 2010). By recognizing that the difference of opinion between the parent’s Christian Scientist views and the providers western medicine background/view, it can be ascertained that Uustal’s Ethical Decision-Making Model would be best suited to utilize here. The dilemma in this situation is to provide care for the 6-year old or not to provide care. He has been diagnosis with meningitis. “Meningitis is an inflammation of the membranes (meninges) surrounding your brain and spinal cord, often caused by a viral infection, it can also be bacterial, parasitic or fungal infections,

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depending on cause; anyone expressing symptoms should seek immediate medical care if you suspect that someone has meningitis, as early treatment of bacterial meningitis can prevent serious complications (Mayoclinic.org, 2020). Given the scenario in the opening paragraph, stakeholders would include the minor child patient, the minor patient’s parents, the physician who rendered care, the hospital were care was rendered, the administrator of the hospital, attorneys for representing the family of the patient, the physician’s attorney and the attorney representing the hospital. The perspectives of each side would vary vastly. The child at 6 years old, would be unable to express his wishes. His parents expressed they wanted to medical treatment to be given to the child. The treating physician obviously had the view that he was there to save the child’s life and provide any medically necessary treatment to do so. The hospital would likely back the physician as the family did enter their facility seeking assistance, and it is assumed that the provider rendered services that are within the normal scope of treating a 6-year-old child with the signs, symptoms, and diagnosis of meningitis. The conflicting values of western medicine (physician) and Christian Scientist (parents) were at odds on what level of care, if any should be rendered. Assuming the role of the hospital administrator in this scenario, I likely would have sided with the decision of the physician. The child present with a severe and potentially deadly illness that can easily be treated. The parents in concern brought the child to our facility for diagnosis, which typically includes treatment. One thing not clearly outlined in this particular dilemma is the extent of effort put into explaining the seriousness of the child’s illness to his/her parents. I would have had a department head, case manager, chaplain and an administrator attempt to intervene before actually applying medical care to the child....