Navigating Ethical Dilemmas in Healthcare- A Practical Application of Ethical Principles

Navigating Ethical Dilemmas in Healthcare- A Practical Application of Ethical Principles

End-of-life decisions create a complex ethical environment for healthcare providers who face related cases. This article presents a case involving a 72-year-old woman who was diagnosed with and has been battling an aggressive form of ovarian cancer for the past three years. It will summarize the case, including the facts of the case study, apply the components of the Ethical Decision-Making Model in analyzing the ethical issues, and apply peer-reviewed journal articles as evidence to support the analysis of the ethical problem in the case. The article also analyzes the effectiveness of the communication and professional approaches present in the case study and applies ethical principles to provide a solution to the ethical problems in the case.

Summary of Facts of the Case Study

The patient presented in the case study is Eleanor Thompson. She is a 72-year-old woman who has been living with an aggressive form of ovarian cancer for the past three years. Eleanor Thompson has undergone multiple rounds of chemotherapy and radiation without any success as her condition continues to deteriorate. She is now experiencing severe pain and suffering. Dr. Samuel Martinez, an oncologist, has been managing Eleanor’s case. He recently presented Eleanor’s family with the option of an experimental treatment. He has also suggested considering transitioning Eleanor to palliative care. Her family does not agree with this decision, and they are currently deeply divided. Maria, Eleanor’s eldest daughter, believes the experimental treatment should be pursued. She hopes for a miracle with the treatment. Her argument is that her mother has always been a fighter and would want to continue the battle against her illness. However, Eleanor’s son, Michael, feels that his mother has suffered enough and believes that transitioning their mother to palliative care would allow her to spend her remaining days in comfort and peace. Eleanor’s husband Robert, who has lived with her for over 50 years, is in a dilemma as he is torn between wanting to honor his wife’s fighting spirit, desiring to ease her pain and the painful finality of either decision.

Notably, the healthcare team must ensure that the principles of doing good, beneficence, the principle of not doing harm, non-maleficence, and the principle of justice are considered to guide the decisions made in the case and that they are justified to ensure Eleanor receives the best quality care that reduces her suffering.

Analysis of Ethical Issues in Eleanor’s Case and Factors Contributing to the Ethical Problem/Issue Identified

Various ethical issues that the healthcare team must navigate can be identified in Eleanor’s case. First, the family is in disagreement on what decision to make regarding the options they have been provided by Dr. Samuel Martinez, including the option for an experimental treatment and the option for transitioning her to palliative care settings. Secondly, the husband is confused about what would be best for Eleanor since they have lived together for a long. Thirdly, an ethical issue arises from the fact that regardless of the knowledge of the care team for the best care for Eleanor, they must first allow the family to agree on the way forward. This creates moral distress among the care team members as they are constrained from doing the ‘right thing’ to ensure the best outcomes for the patient (St Ledger et al., 2021).

The complex ethical landscape in the case of Eleanor develops mainly due to the disagreement among the family members. Disagreement during the making of end-of-life decisions majorly arises due to the differences in perspectives and opinions of the individuals entrusted with making the decisions (St Ledger et al., 2021). Conflicts among family members in end-of-life care are common in most care settings due to a lack of advance care planning and uncertainty with experimental or palliative care (Senior et al., 2019). In this case, despite Dr. Samuel Martinez providing the family members with two good options, the family members do not agree on the option to choose. For instance, the eldest daughter wants her mother to undergo the experimental treatment with hopes for better outcomes. However, Eleanor’s son, Michael, wishes that she be transitioned to palliative care as she has suffered enough. The husband has yet to decide what option he believes is the best.

Application of the Ethical Decision-Making Model in the Case Study

The Ethical Decision-Making Model presents three main components including; 1) moral awareness, which is related to the ability to identify and appreciate the existence of an ethical issue within a present scenario in practice settings; 2) moral judgment, which means having the capacity to recognize the nature of a situation and choose between right and wrong; and 3) ethical behavior, which relates to behaviors that are informed from considering the components of moral awareness and moral judgment. Ethical behavior is simply behaving in a manner that is in accordance with the set standards within practice settings.

Dr. Samuel Martinez, the oncologist, can be noted to express moral awareness as per the Ethical Decision-Making Model, as he understands how difficult it is for the family members to have their mother in such a situation. He advises the family on the available options to ensure the best care for Eleanor. He also expresses moral judgment by allowing the family to discuss the options he has provided and agree among themselves on the next course of care for Eleanor. He also shows high levels of ethical behavior by letting the family consider the options and agree among themselves. He does not first decide on the course of care for Eleanor. His ethical behavior will further be judged based on how he proceeds with advising the family on the decision he thinks is best from a professional perspective and ensuring Eleanor’s needs are met regardless of family disagreements.

Effectiveness of the Communication and Professional Approaches Present in the Case Study

The communication and professional approaches in the case can be considered to be effective to some extent. Dr. Samuel Martinez presents the family with options to consider regarding Eleanor’s care, including an experimental treatment and considering transitioning to palliative care. This allows them to discuss the options. However, the communication among the family members is not clear and is filled with disagreements. The daughter opts for the experimental treatment, while the son chooses to transition Eleanor into palliative care. On the other hand, the father is still in a dilemma regarding the choice to make. The communication strategies would be effective enough to help the family agree on the best course of care for Eleanor if Dr. Samuel Martinez were to provide more details on the experimental treatment and the requirements for palliative care. as he has suggested. Dr. Samuel and the care team for Eleanor also need to support family communication by providing sufficient education on experimental treatments and palliative care, as they are key to decision-making in end-of-life care (Laryionava et al., 2021). Additionally, supporting more open and effective communication among family members can support end-of-life decisions for older people (Gerber et al., 2020).

Applying Ethical Principles to Resolve the Ethical Issue in the Case Study

The complex ethical environment created in Eleanor’s case due to family disagreements can be navigated by applying the ethical principles of beneficence, non-maleficence, and justice. In this case, by considering the principle of beneficence, the healthcare team would educate the family members on what course of Eleanor’s care would be most beneficial to her to help them make an informed decision. On applying the principles of non-maleficence and justice, the healthcare team would push the family to make a decision that has less harm to Eleanor and the family in terms of mental health and economic well-being. They would also provide clear information, including considering aspects of open communication to ensure that the best of care, including the level of deserved care, is selected for Eleanor to ease her suffering.

Conclusion

Healthcare providers are set to be met and experience cases with major ethical complications during many points in their practice. The most devasting moments are when they are required to make or assist patients in making their end-of-life decisions, as observed in the case of Eleanor and her family. In conclusion, regardless of the case or situation, healthcare providers are expected to apply ethical principles to guide every decision made to the best of their knowledge.

References

Gerber, K., Lemmon, C., Williams, S., Watt, J., Panayiotou, A., Batchelor, F., Hayes, B., & Brijnath, B. (2020). ‘There for me’: A qualitative study of family communication and decision-making in end-of-life care for older people. Progress in Palliative Care, 28(6), 354–361. https://doi.org/10.1080/09699260.2020.1767437

Laryionava, K., Hauke, D., Heußner, P., Hiddemann, W., & Winkler, E. C. (2021). “Often relatives are the key […]” –Family Involvement in treatment decision-making in patients with advanced cancer near the end of life. The Oncologist, 26(5), e831–e837. https://doi.org/10.1002/ONCO.13557

Senior, H., Grant, M., Rhee, J. J., Aubin, M., McVey, P., Johnson, C., Monterosso, L., Nwachukwu, H., Fallon-Ferguson, J., Yates, P., Williams, B., & Mitchell, G. (2019). General practice physicians’ and nurses’ self-reported multidisciplinary end-of-life care: a systematic review. BMJ Supportive & Palliative Care. https://doi.org/10.1136/BMJSPCARE-2019-001852

St Ledger, U., Reid, J., Begley, A., Dodek, P., McAuley, D. F., Prior, L., & Blackwood, B. (2021). Moral distress in end-of-life decisions: A qualitative study of intensive care physicians. Journal of Critical Care, 62, 185–189. https://doi.org/10.1016/

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

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 behavior. 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.

Navigating Ethical Dilemmas in Healthcare- A Practical Application of Ethical Principles

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, develop a solution to a specific ethical dilemma faced by a healthcare professional. In your assessment:

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 behavior. 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, develop a solution to a specific ethical dilemma faced by a health care professional. In your assessment:

Read the case study presented above Applying Ethical Principles.
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.
Summarize the facts in the selected 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( diagram attached in documents below)
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 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 Library will help you locate appropriate references. You will select at least one current scholarly or academic peer-reviewed journal articles published during the past 3–5 years that relate to your topic.
Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.