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Ethical Dilemma and Framework in Healthcare Case Study

Healthcare providers often use a systematic process to evaluate the nature of an ethical dilemma to come to a practical solution. Ethical dilemmas occur in a situation where more than one, sometimes opposite, actions arise due to the ones involved in the situation have different perception about the different perspectives (Purtilo & Doherty, 2015). In this case, the ethical dilemma is that of empirical knowledge and personal belief. Therefore, the ethical dilemma that the nurse face is one in which the nurse is torn between valuing religious belief or human life. The child life is at stake, and the mother believes that he should not be assisted because of her religious beliefs. The father, on the other hand, is in support that the treatment should be given. The nurse is aware of the fact that if he does not initiate treatment, the child might die within a very short time.

Ethical decisions are made depending on choices such as ethical dilemma, the principles that exist in the conflict, the individuals involved, and the outcome of the agreed-upon action. There are no right or wrong answers when it comes to decisions concerning life and death ethical issues encountered by physicians. The reason is that ethical decision making is founded on the notion that very different ethical choices about a similar ethical dilemma can be made. However, there are a set of principles that guide nurses in making ethical decisions. The four basic ethical principles that form a basis for moral thought include autonomy (the respect for the dignity of self and others), justice, nonmaleficence (prevent harm or elimination of any harmful conditions), beneficence (act in a manner to remove ham or promote benefit) (Burkhardt & Nathaniel, 2013). These ethics identify the basis of what should be expected from a healthcare professional.

Decision-Making Model

When making decisions in an ethical dilemma, physicians have to use a decision-making model to guide the decision-making process centered on unprejudiced, cognitive perspective, instead of a purely sentimental or emotional point of view. The uustal model has been used in making reasoned decisions based on the steps provided to guide a person in making an ethical decision (Black & Chitty, 2014). The model is effective because it is founded on both the nursing process and value clarification. The following steps can be used to by the physician before arriving at a decision that is best for the child as well as the mother.

The first step is that the physician should identify the problem. The physician should identify the problem by asking and seeking more information about the matter. This can be achieved by asking the mother why she does not want the physicians to begin treatment. He should try to understand the different perspectives of the dilemma by looking at the people involved in the dilemma and how the different issues are interrelated (Black & Chitty, 2014). It is also important to understand what is involved in the situation and what is at stake. After identifying the problem and the different perspectives involved, it is important to pinpoint the ethical dilemma and come up with solid statement of the problem and all the conflicting values.

The second step is that the physician should state his/he ethical values and ethical position about the problem. The physician should identify and understand how the issue fits with his/her personal values and whether the personal values are congruent or incongruent with those of the parties involved in the ethical dilemma.

The third step is to consider all the factors that relate to the state of affairs and come up with some alternatives that can be used to resolve the dilemma. In our case, the physician should take into considerations such as the life of the child, the duration the child can last before death looms, the mother’s Christian beliefs and the father’s opinion about the issue.

After that, it is important that one examines and categorize all the alternatives. A person should identify those alternatives that are consistent with your personal beliefs and those that are not (In Cherry & In Jacob, 2016). If the most appropriate alternative in the situation is the one that is not consistent with one’s personal values, it is important that the physician should look for another provider to assist in facilitating the resolution. This is important in the healthcare so as to eliminate any bias and preserve one’s ethical integrity.

After that, the physician should predict all the possible outcomes of the proposed acceptable alternatives. Physical, social, psychological, and spiritual consequences should be considered when predicting the outcomes. In our case, consider what might happen if a physician chooses to proceed with the treatment of the child and alternatively what might happen if the physician chooses to respect the mother’s religious beliefs.

The next step is to prioritize the alternatives arrived at before making any decision. The physician should list the alternatives in order beginning with the most acceptable to the least acceptable alternative (Black & Chitty, 2014). After that, one should develop a plan of action based on all the acceptable alternatives. It is important to determine the best alternative by looking at the possible outcomes based on the evaluations made, nursing principles, personal beliefs, the different values, and experiences.

In this case, I would resolve the ethical dilemma by emphasizing to the mother the importance of the treatment of the child and the fact that the child would die. I will ensure that I seek some consultation from other physicians, the father and request for the mothers consent to initiate the treatment problem because ethical and morally right to preserve life.

Dialogue

A healthcare provider should be careful when communicating with a family member about a situation concerning a patient. The following dialogue could help me explain my decision to the family.

Me: After a careful consideration of all the options available for the situation, which is to initiate treatment, transfer the case to another physician and finally not to offer any medical treatment, I propose that you should allow me to initiate the treatment. First and foremost, the child life is at stake and he will die within 24 hours and therefore each and every minute remaining is important to save the life of the child. Based on my personal and moral beliefs and nursing ethical principles, life is precious, and we should preserve life.

The second alternative, which is to transfer the case to another physician is not bad either. But I fear we might lose the life of the child because time is not on our side. Therefore, I propose that the case should not be transferred because the process involved before the child gets medical attention may be long, and the physician who will handle the case may not be in a position to save the life of the child.

The last option in which is to respect the mother of the child decision that no medical treatment should be offered is not the best alternative. We should respect religious values, but even the first instinct of religion is to preserve life. Therefore, I propose that the family should sign the document to permit me to initiate the treatment process and save the precious life of the child. Anyone with a different opinion should say so considering the right thing to do in this case to save the child life.

Thank you all for your understanding.

 

 

References

Purtilo, R. B., & Doherty, R. F. (2015). Ethical dimensions in the health professions. Elsevier Health Sciences.

Burkhardt, M., & Nathaniel, A. (2013). Ethics and issues in contemporary nursing. Cengage Learning.

In Cherry, B., & In Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management.

Black, B. P., & Chitty, K. K. (2014). Professional nursing: Concepts & challenges. St. Louis, Mo: Elsevier.

 

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