Case Study Ethical Study Review
Case Study Ethical Study Review Free sample paper
Scenario: A 96-year-old male patient is admitted to the ICU with terminal liver cancer. He is confused and disoriented, very skinny and appears underfed, and is covered with bruises, which are common in patients with liver disorders. His daughter, who is a naturopathic physician, insists that she can cure her father by administering unknown substances, some of which smell like feces and look like tar, down his NG tube. He is clearly in pain after she does this. She insists that these are life-saving interventions on her part, but the nursing and physician staff caring for the patient are very upset and concerned that she is hastening his death. They have come to you for help.
1) Write a paper (1,250-1,500 words) that describes how to use the method of ethical decision making, reviewed in the module, to help resolve this ethical dilemma. Address the following to generate your conclusions about how you would proceed:
a) What are the dimensions of the ethical dilemma?
b) What are the issues?
c) Apply the four core ethical principles and the process of ethical decision making.
2) Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
Case Study Ethical Study Review
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Related:
The Four Ethical Principles
Applying the four ethical principles to a case scenario
Ethics are guided by the core principles to which most of our society agrees. The devil is in the details, however, as we will see in specific instances.
Autonomy:
The principle of autonomy ties into patients’ rights to self-determination, or the right to make their own fully informed choices about their care; treatments they may accept or reject; and the ultimate consequences of their choices.
Beneficence:
The principle of beneficence requires that all actions taken on behalf of a patient are designed to provide good outcomes.
Non-malfeasance:
This principle derives from the Hippocratic Oath, where the pledge is “First, do not harm.”
Justice:
The concept of justice focuses on the finite nature of available resources of care.
Role of Ethics in Health Care
Ethics serve a number of different roles in the health care setting. We will explore several of these in the discussion to follow.
- Ethics as a set of values
Ethics as a guide to help resolve complex conflicts
A method of ethical decision making
The Four Aspects of Ethical Decisions
- Welfare
- Interests
- Moral Status
- Social Mores
Get an Original Top Nursing Paper on Ethics in Healthcare. Grab a Nursing Essay on Ethics
Case Study Ethical Study Review Free sample paper
Paper type: Essay
Course Level: Master
Subject Area: Nursing
# Pages: 5
Ethical Study Review
Due to the rapid increase in the complexity of diseases, application of ethics in decision making has become a cornerstone of healthcare delivery process. More than 90 percent of primary care physicians have reported that ethical dilemma has become ubiquitous in a majority of therapeutic relationships (Mackenzie, 2017). Therefore, healthcare practitioners are faced with the challenge of engaging in actions that demonstrate adherence to professional conducts while at the same time helping their patients to achieve positive health outcomes. The purpose of this study review is to analyze the moral issues and the dimensions of ethical dilemma in the care of an elderly male patient. The scenario shows how the process of ethical decision making and ethical principles can be applied by a healthcare practitioner in selecting the most appropriate action to be taken in case of an ethical dilemma.
In the given scenario, a 96-year-old man currently has terminal liver cancer, and he has been admitted to the intensive care unit. Following an objective assessment, the clinician has discovered that the patient is disoriented and confused. Furthermore, he looks emaciated, malnourished, and bruised. These are the common clinical signs of liver disorders. The client’s daughter is a naturopathic physician, and she claims that she can administer some unknown substances using a nasogastric tube to cure his father. The “drugs” look like tar and have a feces-like smell. After administering the substances, the patient suffers an extreme pain as compared to that felt before they were used. According to the client’s daughter, the stuff is an effective intervention that can easily relieve his father of symptoms of liver cancer. However, the attending physician and nurse are not pleased with the girl’s actions and are concerned that they are speeding up the death of the patient.
There are two dimensions of ethical dilemma inherent in the scenario described above. One of them is that the patient under discussion is suffering from a terminal illness. Therefore, it is apparent that he will not recover from his current health condition however much the physician might try to treat him. The ethical dilemma is that, “Should the patient be allowed to receive medication in the ICU until when he will die or should the physicians limit treatment for him to allow him to die slowly?” The other dimension of ethical dilemma is that the client’s daughter insists that she has to administer unknown substances to cure his father. One question that might arise from the idea is that “should the physician allow the patient to continue using the substances that smell like feces until when he will recover from cancer?” These two ethical dilemmas form the basis of the moral issue in the given scenario.
The main ethical issues in the case revolve around the need to save a life, equitable use of resources, and professionalism. Many people will agree that the goal of every healthcare provider is to eliminate ill-health and to restore normal body functioning. In this case, the clinician can choose to either provide treatment to the client or restrict it provided he or she supports the selected action with relevant ethical principle. Again, it is upon the healthcare practitioner to ensure equitable resource use when delivering care to the patient. In that regard, it will be unethical to continue utilizing limited healthcare resources on a terminally-ill patient, whereas there are some other patients with curable diseases who can benefit from them (Karnik & Kanekar, 2016). Moreover, the client’s daughter is not a professionally qualified physician, and the substances she recommends are not clinically-proven. Therefore, administering them to the patient may generate even more serious complications thereby making her actions unethical.
The ethical dilemma and the moral issues in the given case can best be resolved through the application of ethical decision-making process and the core ethical principles that are best known to healthcare professionals. An objective analysis of the circumstances in the scenario reveals three major relevant facts and ideas in the conflict. First, the nature of care that is offered to the patient by her daughter has not generated positive health outcomes for him. Second, the patient has not been treated by a qualified healthcare professional. Besides, the intervention that has been recommended by the patient’s daughter is not supported by research-based evidence. Third, should the clinician utilize the principle of equal justice whenever he or she decides to use available resources to treat the patient? When selecting the most appropriate action to take, the healthcare professional will discard the notion that old and terminally-ill patients should die because they are unproductive members of society.
The best action to be taken by the attending physician will be guided by the core principles of ethics namely, autonomy, beneficence, non-maleficence, and justice. As far as the principle of autonomy is concerned, the patient has a right to make an informed choice about the type of care that should be offered to him by the physician (Page, 2012). However, the patient in the given case lacks the power of self-determination because he is in a critical condition and also appears disoriented and confused. Even in his current status, his daughter is wrong to administer unknown substances whose effectiveness have not been confirmed. The physician and the nurse have the power to settle on the most appropriate treatment for the client based on the three ethical principles explained in the subsequent paragraphs.
With regards to the ethical principle of beneficence, the action taken by the physician should generate good outcomes (Page, 2012). In this case, the concept of “good outcome” may have two viewpoints. First, a ‘good outcome’ for the patient is helping him to recover from the current illness. Second, the attending clinician may view the concept under discussion as the elimination of burden not only to the patient but also to his family members. Essentially, the option of recovery should not be thought of because the client has terminal liver cancer. Therefore, the action that will generate good outcome is limiting treatment for the patient or administering a drug that will allow him to die slowly. The act will reduce the burden of disease to the patient and that of caring for the family members (Page, 2012).
The principle of non-maleficence guides healthcare professionals to engage in actions that minimize harm for their clients (Page, 2012). The fact that the patient in the given scenario has liver cancer means that he will be in pain until death. Besides, the degree of pain has significantly increased following the administration of the unknown substances by the client’s daughter. Therefore, the goal of the attending clinician should be to eliminate suffering for him (Page, 2012). The best action to be taken is to perform a euthanasia by administering a drug that will allow the patient to die slowly. By so doing, the patient will have been prevented from suffering.
Healthcare professionals who apply the principle of justice base their decisions about care on the availability of resources. In today’s society, healthcare resources are limited, and the concerned parties are expected to put them to correct use. In the given scenario, using drugs and bed-space on a patient who is terminally-ill implies wastage of the limited resources available. The reason is that the drugs that are used to treat the client can be used on other patients with curable diseases (Karnik & Kanekar, 2016). Therefore, to ensure equitable justice, the most appropriate action that should be taken by the physician is to perform euthanasia as this will leave the drugs and bed-space available for use with other patients.
In summary, moral reasoning has become an important concept in healthcare today due to the complexities of medical conditions that place clinicians in a state of ethical dilemma whenever they are delivering care. One of the best approaches to addressing an ethical dilemma is to apply the process of ethical decision-making. This strategy is crucial because it assists the nurse and the physician to develop an understanding of the patient’s situation and establishing the causes of conflict. Besides, the tactic is the best way to eliminate all other factors that may negatively impact the therapeutic relationship. The other approach to addressing an ethical dilemma is to apply the core ethical principles namely autonomy, beneficence, non-maleficence, and justice. After combining these two methodologies in the given scenario, it is evident that the best action that should be taken by the physician and the nurse is to perform euthanasia as it will generate a good outcome, minimize harm, and ensure equitable justice.
References: Case Study Ethical Study Review Free sample paper: We have best nursing essay writers for your assignments.
Karnik, S. & Kanekar, A. (2016). Ethical issues surrounding end-of-life care: A narrative review. Healthcare, 4(2), 24. doi:10.3390/healthcare4020024
Mackenzie, C. R. (2017). Ethics and professionalism 2016. Transactions of the American Clinical and Climatological Association, 128, 75-82.
Page, K. (2012). The four principles: Can they be measures and do they predict ethical decision making? BMC Medical Ethics, 13, 10. doi:10.1186/1472-6939-13-10
