Two Scenarios Where an Ethical Dilemma Might Present Itself in My Career Field
Scenario 1
One of the scenarios might involve making a decision on whether to withdraw or withhold care for a patient who is terminally ill and wishes to continue with a method of treatment that is highly advanced and might be considered futile for the patient. In this case, the ethical dilemma involves whether the healthcare practitioners should honor the patient’s wish and continue with the possibly futile method of treatment or withdraw the treatment.
Consequentialism in medical ethics considers good practice as one that involves securing good results for the patient and society as a whole. In contrast, deontologism involves practicing based on ethical principles and rules (Kotzee, Ignatowicz & Thomas, 2017). By contrast, virtue ethics considers good practice as a practice that results from the virtuous and moral character of the healthcare practitioner. Virtue ethics investigates the manner in which the healthcare practitioner’s good character makes it possible for them to promote the good of the patient.
Regarding the deontological theory, it will be important for the physician or nurse to perform their duty rightfully by offering the patient detailed information regarding the drawbacks, limitations, and benefits of the treatment. By using the deontological theory, it will be the duty of the healthcare practitioner to perform their duty to gain the greatest good for the patient and act for the benefit of the patient. Although the patient has the autonomy to select a treatment, the physician needs to explain the various implications and focus on the consequences. In this case, the patient will need to perform a self-beneficence duty in order to make an autonomous decision as a competent person to undergo the treatment and prolong their life or forgo the treatment for the greatest good of society through saving emotional distress and saving cost (Kamik & Kamekar, 2017). Suppose the patient persists in prolonging life with medically advanced treatment interventions, which might be futile based on the healthcare practitioner’s assessment. In that case, the practitioner is responsible for explaining the information and facts regarding withdrawing or withholding the medical treatment and ensuring that there is no unnecessary deployment of resources for the futile treatment devoid of causing harm to the patient. It is important to respect the values and beliefs of the patient before withdrawing or withholding treatment or even giving the order to resuscitate or not to resuscitate.
According to Kamik and Kamekar (2017), healthcare practitioners have the duty of preserving the life of the patient, but this duty should not be confused with the unnecessary deployment of resources and inflicting more harm than good to the patient through continuing with medically futile treatments. It is important for the healthcare practitioner to reach a mutual agreement with the patient regarding withdrawing or withholding a futile treatment and explaining the drawbacks of unrealistic expectations from a particular treatment method. Communication between families and patients, discussing the goal of the patient regarding care and treatment, can be beneficial in bridging the gap between the physician, the patient, and their families.
Regarding consequentialist theory, the healthcare practitioner needs to assess the outcome of the actions. Act utilitarianism expects one to act in a manner that leads to the greatest good compared to evil, and how other people will be impacted should also be considered (Skelton, 2017). It is challenging for family members and health professionals to agree to withdraw life-sustaining interventions. If the patient has been connected to life-sustaining technologies, they tend to acquire the status of the patient’s organs, and therefore, it would be wrong to cut it out. A healthcare provider should have both a medical indication and consent to begin treatment, and the treatment can only continue when and as long as the treatment is medically indicated and the patient continues to consent to this provision. If, for instance, the anticipated benefits of a treatment fail to materialize and the harmful side effects seem more serious than expected, then the treatment is expected to be discontinued. Withholding treatment is considered morally riskier compared to withdrawing (Welie & ten Have, 2014). In the event that the treatment was tested for a while and then found to have not benefited the patient, then there is clear evidence that it is no longer medically indicated. However, decisions to withhold treatment before a trial period are usually based on predictions. Through consequentialist theories, the healthcare practitioners will need to assess or predict the impact of the treatment option chosen by the client, offer in-depth information regarding the benefits and detriments of the treatment option and pursue the option following consent by the client, as is the case in this scenario.
Scenario 2
Another ethical dilemma that might present during my career might involve having limited resources for too many critically ill patients, probably following a disaster. The ethical dilemma might involve deciding which patients should get higher levels of care that might increase their survival rates and which patients should get lower care levels that reduce their survival rates during life-threatening situations.
This is considered a triage challenge for nurses, which requires great clinical judgment, experience, and critical thinking. The knowledge of staff expertise, appropriate equipment, and available support staff, as well as an understanding of the seriousness of the patient’s condition, will help guide me in analyzing which patients could have the best chance of survival by getting the highest care levels.
According to Mallia (2015), healthcare professionals, in the face of disasters, face ethical choices that are very different from the choices in everyday hospital life. The nature of a disaster requires a kind of management that shifts from treating individuals to the management of crowds. The initial period of the disaster is highly critical as it can determine the outcome of the number of people that can be saved. Using virtue ethics, healthcare practitioners might focus on benevolence and morality. The decision on which patient to treat first might be based on what the healthcare practitioner considers moral and beneficial to the patient. In this case, saving the lives of critical patients will be a virtuous thing to do, and hence, an assessment of the patients should be done, and these patients should be categorized into groups, with seriously wounded patients with a high probability of survival being treated first.
Based on the deontological approach, an act is not considered morally worthy if it is based on concern, compassion, or affection. This means that the act might be justified, but once it fails to apply pure reason, then it lacks moral worth (Mallia, 2015). Deontological ethics is highly tied to reason and following strict rules, causing it to be very rigid as it fails to consider that human nature, based on such factors as compassion, is important in certain situations. In emergency cases, Mallia (2015) claims that the number of lives saved is more important than the individual who is being saved. It would be important to triage patients based on expected prognoses such as immediate, minimal, delayed, and expectant. Looking out for individuals with urgent threats of loss of life, eyesight, or limb who need care immediately and have a reasonable probability of successful treatment would be important. Delayed patients, like those with abdominal wounds and soft tissue fragment injuries and in stable conditions, might represent the largest group, and their treatment might be delayed. Minimal patients who are considered the walking wounded might help with their care and even help in the care of others. Based on the deontological approach, it might be important to begin with the less critical patients, who might be the majority, to save the lives of as many people as possible. Making the decision on who to treat first, especially when resources are limited, will still remain challenging.
References
Karnik, S., & Kanekar, A. (2016, June). Ethical issues surrounding end-of-life care: a narrative review. Healthcare, 4(2), 24.
Kotzee, B., Ignatowicz, A., & Thomas, H. (2017, March). Virtue in medical practice: an exploratory study. HEC Forum, 29(1): 1–19.
Mallia, P. (2015). Towards an ethical theory in disaster situations. Medicine, Health Care and Philosophy, 18(1), 3-11.
Skelton, L. (2017). Ethical Theories and Perspectives on End-of-Life Decisions. Dialogue & Nexus, 4(1), 13.
Welie, J. V., & ten Have, H. A. (2014). The ethics of forgoing life-sustaining treatment: theoretical considerations and clinical decision making. Multidisciplinary respiratory medicine, 9(1), 1-8.
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Question 
Two Scenarios Where an Ethical Dilemma Might Present Itself in My Career Field
After exploring the videos and readings in this week’s Lesson regarding applied ethics, consider where it is evidenced in your field of study here at Stratford University.
Two Scenarios Where an Ethical Dilemma Might Present Itself in My Career Field
Please use APA formatting and a minimum of 4 sources (you may include the videos and/or readings from this course).
Additional information:
We’ve been discussing morals and ethics in terms of what is right or wrong, good or evil, and why things are the way they are over the past few weeks. We’ll talk about meta-ethics this week, which is the most metaphysical and abstract way of thinking about morality. Ware is now debating the questions, the essence of moral judgments, and whether they represent sincere convictions and can be critically valid and constitute genuine knowledge.