Ethical Dilemma faced by a health care professional by applying ethical principles

Ethical Dilemma Faced by a health care professional by applying ethical principles.

Healthcare professionals face ethical dilemmas regularly in their line of work. These dilemmas often involve balancing the principles of autonomy, beneficence, non-maleficence, and justice to make decisions in the patient’s best interest. Ethical dilemmas can arise from various situations, such as end-of-life care, confidentiality, and allocating scarce resources. The assessment examines a specific ethical dilemma a healthcare professional faces and how to apply ethical principles to analyze the situation and propose a course of action. By doing so, we can explore the complexities of ethical decision-making in healthcare and the importance of applying ethical principles to guide our actions.

Summary of the Facts in the Case Study

The selected case study is Incident 2: Emergency Department Repeat Admissions—A Question of Resource Use. The case study concerns the overuse of emergency department services at County General Hospital (CGH), a 300-bed acute care hospital in the south-central United States. The hospital is a not-for-profit hospital system that no longer receives tax subsidies from the county. The study data showed that a few patients were repeatedly admitted to the ED, accounting for hundreds of visits in the past year. The patients had minor, nonspecific medical problems, and most admissions involved persons known as the “worried well.” Although Medicaid covered most of the costs, CGH was not reimbursed over $200,000 yearly. The repeated admissions to the ED also contributed to crowding, treatment delays, and general dissatisfaction among other patients.

The ethical problem or issue that presents a dilemma is the overuse of emergency department services by a few patients, which consumes hospital resources and affects the hospital’s financial health. The hospital needs to address this issue as it affects the delivery of healthcare services and the quality of care provided to other patients. The dilemma is whether the hospital should continue to treat these patients or limit their access to emergency department services. The hospital’s obligation to provide care to patients who present at the emergency department conflicts with the need to manage resources efficiently and effectively.

The stakeholders involved or affected by the ethical problem or issue include the hospital administration, the staff, the patients who repeatedly use emergency department services, and others who may experience delays or reduced quality of care due to overcrowding. The hospital administration is responsible for managing resources effectively and ensuring financial viability. The staff is responsible for providing care to all patients in the emergency department. Patients who repeatedly use emergency department services have a right to healthcare, but their overuse of services affects the quality of care provided to other patients. Other patients who may experience delays or reduced quality of care due to overcrowding have a right to receive timely and appropriate care.

Analysis of Ethical Issues in the Case Study

The problem in the case study is a few individuals’ overuse of emergency services, resulting in repeat admissions to the Emergency Department (ED) and the consumption of hospital resources. The ED visits cost the hospital a significant amount of money. Even though Medicaid covers most of the costs, a substantial amount remains unpaid, resulting in financial strain for the hospital. Additionally, repeated admissions to the ED cause crowding, treatment delays, and general dissatisfaction among other patients.

Several factors contributed to this problem. Firstly, the individuals repeatedly admitted to the ED were described as worried well, meaning they had minor, nonspecific medical problems. They may not have had access to primary care or were unsure how to manage their medical concerns. Secondly, Medicaid’s reimbursement policy for eligible ED users incentivizes frequent ED use, as it covers most of the costs. Finally, the federal Emergency Medical Treatment and Active Labor Act (EMTALA) mandates that all patients who present at an ED that receives federal reimbursement for services must be treated and stabilized, regardless of their ability to pay.

According to Sharma et al. (2021), Medicaid expansion can lead to increased ED utilization and reduced hospital profitability. The article suggests that policymakers should consider alternative models to reduce unnecessary ED use and encourage primary care access. Moreover, Aboulafia et al. (2021) discuss the concept of frequent flyers, individuals who repeatedly use the ED for non-urgent medical issues. The article suggests that hospitals should identify these patients and implement interventions, such as care coordination or referrals to primary care, to reduce ED utilization and improve patient outcomes.

Using the Ethical Decision-Making Model to Analyze the Case Study

The ethical decision-making model consists of three components: moral awareness, moral judgment, and ethical behaviour. In the case study, the hospital administration faces the ethical dilemma of balancing the duty to provide care to all patients who present at the ED with the financial strain caused by repeat admissions from a few individuals.

Moral awareness involves recognizing the ethical implications of a situation (Fadel et al., 2019). In this case, the hospital administration is aware of the ethical implications of denying care to patients who present at the ED, regardless of their ability to pay. However, they also recognize the financial strain caused by the repeated admissions of a few individuals.

Moral judgment involves determining the best course of action based on ethical principles (Fadel et al., 2019). In this case, the hospital administration must weigh the principles of beneficence, non-maleficence, and justice. The hospital administration must also consider the financial impact of repeat ED visits on the hospital’s ability to care for all patients.

Ethical behaviour involves implementing the chosen course of action consistent with ethical principles (Fadel et al., 2019). In this case, the hospital administration could consider implementing interventions such as care coordination or referrals to primary care for individuals who frequently use the ED for non-urgent medical issues. This approach would address the ethical concerns of beneficence and non-maleficence while promoting the fair distribution of healthcare resources.

Effectiveness of the Communication Approaches in the Case Study

In the case study, the healthcare professionals used various communication approaches to address the issue of a few individuals overusing emergency services. The healthcare professionals communicated with each other through meetings and email exchanges to discuss the problem and develop solutions. They also communicated with the patients to educate them on alternative care options and the consequences of unnecessary ED visits.

The healthcare professionals in the case study demonstrated effective communication by collaborating and sharing ideas to develop solutions to the problem. However, there were instances of ineffective communication, such as when patients were not properly informed about the consequences of unnecessary ED visits or alternative care options.

Effective communication approaches that should be used include active listening, clear and concise language, and nonverbal cues such as eye contact and body language. On the other hand, communication approaches that should be avoided include dismissive language, interrupting, and not providing enough information to patients (Kim et al., 2020).

The consequences of using effective communication approaches include improved patient outcomes, increased patient satisfaction, and better collaboration among healthcare professionals. In contrast, ineffective communication approaches may lead to poor patient outcomes, decreased patient satisfaction, and decreased collaboration among healthcare professionals (Kim et al., 2020).

The Effectiveness of the Professional’s Approach in Handling the Case Study Ethical Practice Issues

In the case study, the healthcare professional involved sought to address the problem of overuse of emergency services by a few individuals. The professional recognized the ethical dilemma of providing care to these individuals while also being responsible for managing the hospital’s resources effectively. To resolve this dilemma, the professional adopted a multi-faceted approach. They first attempted to educate the individuals on managing their health concerns outside of the ED. Secondly, they attempted to coordinate with community resources to provide primary care access to individuals. Finally, the professional considered implementing a care coordination program to better manage these individuals’ care.

Overall, the professionals managed their professional responsibilities and priorities well in addressing this ethical issue. They recognized the need to balance providing care to these individuals with managing the hospital’s resources effectively. They also took a proactive approach to address the root causes of the problem by attempting to educate the individuals and coordinate with community resources.

This case provides important lessons for healthcare professionals in adopting a proactive and collaborative approach to address ethical issues. It highlights the need to balance patient care with resource management and emphasizes the importance of effective communication and collaboration with community resources.

Ethical Principles to a Possible Solution to the Case Study Ethical Problem

The proposed solution to the ethical problem of overuse of emergency services in the case study is implementing a care coordination program. This program would involve identifying and engaging with the individuals who repeatedly use the ED for non-urgent medical issues, assessing their needs, and coordinating their care with primary care providers and other community resources. This proposed solution is based on ethical principles, including autonomy, beneficence, non-maleficence, and justice.

Autonomy is respected through the care coordination approach by empowering patients to be active participants in their care. Patients are involved in identifying their needs, and their preferences and values are considered when developing care plans. Beneficence is promoted by providing patients with appropriate and timely care that meets their needs, ultimately leading to improved patient outcomes. Non-maleficence is achieved by reducing the risks associated with unnecessary and avoidable ED visits, such as exposure to medical errors, infections, and adverse events (McWilliams et al., 2020).

The care coordination approach also upholds justice, as it promotes equitable access to healthcare services for all patients, including those with complex health needs and at risk of frequent ED use. Care coordination programs aim to reduce healthcare disparities by providing patients with access to the right level of care in the appropriate setting, thus reducing unnecessary ED visits and preventing the overuse of scarce healthcare resources (Wagner et al., 2021).

Overall, the proposed solution of implementing a care coordination program aligns with ethical principles, as it respects patient autonomy, promotes beneficence, avoids non-maleficence, and upholds justice. It has the potential to make healthcare professionals more effective in building relationships across disciplines within their organization, as well as foster collaboration among multiple healthcare professionals.

Conclusion

In conclusion, the case study presented a complex ethical dilemma of overuse of emergency services in healthcare. The analysis of the case study using the ethical decision-making model and the assessment of communication approaches highlighted the importance of ethical behavior, effective communication, and collaboration in addressing ethical problems in healthcare. The proposed solution of implementing a care coordination program showed promise in addressing the ethical problem of overuse of emergency services and fostering professional collaboration among healthcare professionals. Overall, this assessment provides valuable insights and lessons for healthcare professionals in navigating ethical challenges and promoting ethical healthcare practice.

References

Aboulafia, G. N., Akhtar, S., & Bhat, R. (2020). Reducing Frequent ED Utilization: A Comprehensive Model of Care for Super Utilizers. Hospital Topics, 98(4), 134-141. https://doi.org/10.1080/00185868.2019.1698001

Fadel, L., Jayaraman, D., Carlson, C., & Weir, C. R. (2019). Healthcare resource allocation: an ethical framework for prioritizing clinical and financial outcomes. Journal of Medical Systems, 43(8), 242. https://doi.org/10.1007/s10916-019-1379-9

McWilliams, J. M., Shrank, W. H., & Aaronson, M. (2020). The Value of Care Coordination. New England Journal of Medicine, 382(13), 1195–1197. https://doi.org/10.1056/nejmp1916828

Sharma, A., Sivashanker, K., & Chhabra, K. R. (2021). Medicaid Expansion and Hospital Financial Performance: The Effects of Medicaid Expansion on Hospital Financial Performance and Emergency Department Utilization. Journal of Healthcare Management, 66(1), 22-35. https://doi.org/10.1097/JHM-D-19-00128

Wagner, E. H., Austin, B. T., & Von Korff, M. (2021). Organizing care for patients with chronic illness. The Milbank Quarterly, 74(4), 511–544. https://doi.org/10.1111/j.1468-

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Develop a solution to a specific ethical dilemma faced by a healthcare professional by applying ethical principles. Describe the issues and a possible solution in a 3-5 page paper.

Introduction
Whether you are a nurse, a public health professional, a health care administrator, or in another role in the health care field, you must base your decisions on a set of ethical principles and values. Your decisions must be fair, equitable, and defensible. Each discipline has established a professional code of ethics to guide ethical behaviour. In this assessment, you will practice working through an ethical dilemma as described in a case study. Your practice will help you develop a method for formulating ethical decisions.

Instructions
Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

For this assessment, a solution to a specific ethical dilemma faced by a healthcare professional must be developed. In your assessment:

Access the Ethical Case Studies media piece to review the case studies you will be using for this assessment.
Select the case most closely related to your area of interest and use it to complete the assessment.
Note: The case study may not supply all of the information you need. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any assumptions or speculations you make.
Include the selected case study in your reference list using the proper APA style and format. Refer to the Evidence and APA section of the Writing Center for guidance.
Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.
Identify who is involved or affected by the ethical problem or issue.
Access the Ethical Decision-Making Model media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.
Apply the three components outlined in the Ethical Decision-Making Model media.
Analyze the factors that contributed to the ethical problem or issue identified in the case study.
Describe the factors that contributed to the problem or issue and explain how they contributed.
Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
In addition to the readings provided, use the Capella Library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The NHS-FPX4000: Developing a Health Care Perspective Library Guide will help you locate appropriate references.
Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.
Review the Think Critically About Source Quality resource.
Assess the credibility of the information source.
Assess the relevance of the information source.
Discuss the effectiveness of the communication approaches present in a case study.
Describe how the healthcare professional in the case study communicated with others.
Assess instances where the professional communicated effectively or ineffectively.
Explain which communication approaches should be used and which ones should be avoided.
Describe the consequences of using effective and non-effective communication approaches.
Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
Describe the actions taken in response to the ethical dilemma or issue presented in the case study.
Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.
Discuss the key lessons this case provides for healthcare professionals.
Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
Describe the proposed solution.
Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.
Discuss how likely it is the proposed solution will foster professional collaboration.
Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
Apply the principles of effective composition.
Determine the proper application of the rules of grammar and mechanics.
Write using APA style for in-text citations, quotes, and references.
Determine the proper application of APA formatting requirements and scholarly writing standards.
Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.
Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

Assessment 3 Example [PDF].
Additional Requirements
Your assessment should also meet the following requirements:

Length: 3–5 typed, double-spaced pages, not including the title page and reference page.
Font and font size: Times New Roman, 12 points.
APA tutorial: Use the APA Style Paper Tutorial [DOCX] for guidance.
Written communication: Use correct spelling, grammar, and punctuation.
References: Integrate information from outside sources to include at least two references (the case study and an academic peer-reviewed journal article) and three in-text citations within the paper.
APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care.
Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
Competency 3: Apply ethical principles and academic standards to the study of health care.
Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
Competency 4: Write for a specific audience in an appropriate tone and style in accordance with Capella’s writing standards.
Discuss the effectiveness of the communication approaches present in a case study.
Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
Write the following APA style for in-text citations, quotes, and references.