Introduction to Ethical and Legal Perspectives in Healthcare
Case 1
What Is an Ethically Informed Approach to Managing Patient Safety Risk During Discharge Planning?
In this case, a decision has to be made whether the patient (RQ) is supposed to be discharged or not. Besides, it should be decided whether a medical device could be used on him when his condition worsens or not. Initially, RQ’s electronic health record had no advance directive on using a ventilator on him. This made Dr. C and his parents agree on the use of a ventilator. However, after the stabilization of his condition, he said that he did not want any machine used on him, and he wanted to go home. Although Dr. C respects RQ’s decisions, his father is against the decisions and would take legal action against Dr. C in case anything bad happened.
The ethical principle relevant in this case is autonomy. Regarding patient autonomy, a patient should be allowed to make decisions regarding his/her healthcare so long he/she has a competent decision-making capacity (Greaney et al., 2012). The ethical principle of autonomy is relevant in this case since RQ, his father, and Dr. C have contradicting opinions regarding the discharge plans. When RQ has a decision-making capacity, he clearly states that he does not want any machine used on him and that he wants to go home. While Dr. C thinks that RQ’s suggestions should be implemented, his father is against it and threatens to take legal action against Dr. C. However, RQ’s requests should be put into consideration based on the ethical principle of patient autonomy. Based on this principle, RQ had the right to consent or refuse since he had the capacity for decision-making.
Another ethical principle relevant in this case is beneficence. In beneficence, the actions of a medical practitioner should be aimed at producing a positive outcome (Mawere, 2012). Healthcare professionals should thus ensure that their actions benefit the patient. Therefore, all the treatments and procedures a health care provider recommends for a patient should benefit the patient. The ethical principle of beneficence is relevant in this case since Dr. C was required to make a decision that would benefit RQ. Even though RQ himself requested to be discharged and any machine not to be used on him, Dr. C was required to make a decision that would be appropriate for him in case his medical condition worsened. Continuing to hospitalize RQ would mean that his condition would be taken care of appropriately in case it worsens. Although discharging him would be as per his wish, it would be necessary to consider if there were ways in which his condition would be taken care of in case it worsened.
As a healthcare professional, I would have discharged RQ as per his wish. However, I would request one of the family members to be with him always so that he could be taken to a nearby nursing facility in case his condition worsens. Discharging him would be the best option since he had the capacity to make decisions at the time when he requested to be discharged. Even though his father would be against this decision, I would talk to him and tell him it would be unnecessary to continue hospitalizing RQ just because he had a condition that could worsen over time.
Case 2
How Should Allopathic Physicians Respond to Native American Patients Hesitant About Allopathic Medicine?
In this case, Dr. S has to decide on whether to allow Ms. Q to seek medical assistance from her medicine man or not. Ms. Q had visited Dr. S’s clinic and was suspected to be suffering from pancreatic cancer. To confirm the diagnosis, it was necessary for endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic ultrasound to be done. However, Ms. Q was hesitant to pursue the procedure, and she wanted to discuss her symptoms and Dr. S’s recommendations with her medicine man. In this case, it is very difficult for Dr. S to decide since he is unfamiliar with Navajo traditional medicine and healing. Moreover, he would be going against the patient’s decision if he did not allow her to visit her medicine man.
The ethical principle relevant in this case is patient autonomy. Inpatient autonomy: A health professional should respect the decision of a patient regarding his/her treatment so long as the patient has the capacity for decision-making. A patient’s decision should be respected by a health professional regardless of the outcome of the decision (Zolkefli, 2017). The ethical principle of patient autonomy is relevant in this case since Dr. S has to decide on whether to allow Ms. Q to visit her medicine man or not. This is a very difficult decision for him since he has little knowledge of traditional medicine and healing. The ethical issue Dr. S is facing is a common challenge that healthcare practitioners face. Most healthcare practitioners are supposed to respect patient autonomy and allow patients to choose complementary and alternative approaches. However, in this case, Dr. S has to assess the risks and benefits of allowing Ms. Q to visit her medicine man.
As a healthcare professional, I would request a collaborative discussion with the patient, her family, and the medicine man she was to visit. In the discussion, I would explain in detail the procedure Ms. Q was to go through and the importance of the procedure in diagnosing pancreatic cancer. I would also have to explain the risks that may be associated with the procedure. I would then allow Ms. Q, her family members, and the medicine man to give their views about the procedure. From their views, we would discuss whether an integrative approach could be helpful. However, when making the final decision, it would be very important to ensure that Ms. Q’s decision is not manipulated by anyone. In addition, some practices used in traditional healing are sacred and should not be shared with anyone (Portman & Garrett, 2006). It would be important for me to respect such practices.
References
Greaney, A. M., O’Mathúna, D. P., & Scott, P. A. (2012). Patient autonomy and choice in healthcare: Self-testing devices as a case in point. Medicine, Health Care and Philosophy, 15(4), 383–395. https://doi.org/10.1007/s11019-011-9356-6
Mawere, M. (2012). Critical reflections on the principle of beneficence in biomedicine. Pan African Medical Journal, 11, 29. https://doi.org/10.11604/pamj.2012.11.29.1246
Portman, T. A. A., & Garrett, M. T. (2006). Native American healing traditions. International Journal of Disability, Development and Education, 53(4), 453–469. https://doi.org/10.1080/10349120601008647
Zolkefli, Y. (2017). Patient autonomy in health care ethics – A concept analysis. Brunei Darussalam Journal of Health, May, 43–52.
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Question
BHA310Module 1 – Case
INTRODUCTION TO ETHICAL AND LEGAL PERSPECTIVES IN HEALTHCARE
Assignment Overview
As a healthcare professional, it is your responsibility to be ethically sound. You have an essential responsibility to apply ethical reasoning to crucial decisions effectively. One method of elevating your ethical reasoning abilities is practicing, reading, and understanding case studies. While every case is not identical, the review of ethical case studies prepares you for similar incidents that may arise.
Introduction to Ethical and Legal Perspectives in Healthcare
Case Assignment
For the Module 1 Case Assignment, review 2 cases from the AMA Journal of Ethics (http://journalofethics.ama-assn.org/site/cases.html).
In a 2- to 3-page paper complete the following:
Identify each case that you have selected.
Explain in detail the ethical issue of each case.
Identify the ethical principle(s) that are relevant in the cases from the 4 basic ethical principles (justice, autonomy, non-maleficence, beneficence).
Explain from a healthcare professional perspective what you would have done differently in the case, or if you agree with how it was handled, explain your reasoning. This should not be an opinion but a supported ethical analysis.
You are to support your analysis and views with at least 3 scholarly references (e.g., peer-reviewed journals).
Assignment Expectations
Conduct additional research to gather sufficient information to justify/support your analysis.
Limit your response to a maximum of 3 pages.