Ethics and Patient-Centered Care

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Capella University *

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Jan 9, 2024

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1 Ethics in Health Care Management Connie Osiecki School of Business, Technology, and Health Care Administration, Capella University BUS-FPX4121: Ethics and Patient-Centered Care Professor: Karen Coleman December 23, 2023

2 Ethics and Patient-Centered Care Many ethical and legal issues evolve while treating patients. Healthcare professionals' ultimate duty is to deal with these issues according to the medical code of ethics, prioritizing patient care (Tomaselli et al., 2020). This report discusses ethical dilemmas, contributing factors, and decision-making according to ethical principles. Moreover, they propose strategies to resolve ethical dilemmas, keeping Mr. Joseph Nichol's scenario in view. Overview of the Scenario Concerning the Nichols Family Mr. and Mrs. Joseph Nichols are in their 80s and were married fifty-six years ago. They lived together in the home they bought thirty years ago. They have two grown children, Mary and John, who are married and have their own children. Mrs. Barbara Nichols is in good health, other than worsening dementia, which causes anxiety. Mr. Joseph Nichols is the primary caretaker for himself and his wife despite suffering two heart attacks. Mary, Mr. and Mrs. Nichols's daughter, is the designated healthcare agent in case of an emergency. While visiting John, Mr. and Mrs. Nichols's son, Mr. Nichols was urgently transported to Brookside Hospital, unconscious. Healthcare professionals on duty subjected him to the intensive care unit to stabilize his condition. As the Healthcare Administrator of Brookside Hospital, the staff reported on an argument between Mary and John about their father's treatment when I arrived for work. Mary met with me and informed me of the situation that transpired. She stated that her brother, John, wanted to send their father to a hospice facility, their mother to a senior care living facility, and sell their parents’ home, but Mary wanted to respect the wishes of their father to die peacefully in his home as they do not have long-term care insurance.

3 Ethical Dilemmas in Health Care Management Ethical dilemmas involved in healthcare management are of three categories, i.e., organizational dilemmas, formal process dilemmas, and discharge and end-of-life dilemmas (Albert et al., 2020). In Mr. Nichols's current situation, all three dilemmas are involved. Mary was complaining about the nurse's behavior on duty as she was not allowing her to meet the physician caring for her father. Mary wanted to meet with the physician to discuss her father's condition and the advanced directive with his end-of-life treatment decisions. It is a matter of organizational and formal process dilemmas. Mr. Nichols was subjected to a ventilator as the healthcare staff did not research if he had an advanced directive. The healthcare professionals began treating Mr. Nichols without first discussing his wishes with the designated healthcare agent, Mary. This issue falls under the dilemma of discharge and end-of-life. Organizational Dilemma As her parents’ healthcare agent, Mary complained that she was not informed of her father's condition. Moreover, the healthcare workers did not ask for the advanced directive to ensure her father's wishes were respected. In addition to Mary's complaints, the nurse would not allow her to meet the physician to discuss her father's current condition and review her father's will. In this scenario, the nurse ignored patient-centered care and prioritized her schedule and ease (Haahr et al., 2019). According to the ethical principle of autonomy, healthcare workers should respect what Mary asks for and the advanced directive. Formal Process Dilemma

4 Formal process dilemmas include communication-related issues, treatment initiation, and staff behavior with the patient's family (Goodwin et al., 2019). Communication during medical interaction is key among the medical staff treating the patient and the patient's family. Communication plays a pivotal role in positively impacting the patient and the family. The second complaint from Mary was about not investigating her father's advanced directive. Brookside Hospital's management should start treatment after clearing the above steps. The patient's wife and granddaughter could not say anything as the healthcare workers decided treatment according to Mr. Nichols' condition. He needed intensive care because of cardiac arrest (Armstrong et al., 2018). Discharge and End-of-Life Decisions Ethically, healthcare professionals should take do-not-resuscitate (DNR) orders and do- not-intubate (DNI) orders from patients or their designated healthcare agents about discharge and end-of-life decisions. Sometimes, when life-sustaining ways increase the difficulties and pain for the patient, doctors adopt these ways with the patient's will (Azzazy et al., 2019). Luckily, in this case study scenario, Mr. Nichols already has his DNR and DNI wishes listed in his advanced directive, so if he ends up in the hospital, they can decide on end-of-life treatment easily. Unfortunately, in this scenario, Brookside Hospital did not investigate if the patient had a will, nor did they seek out who his healthcare agent was to discuss his treatment wishes. Decision-Making in Healthcare According to Ethical Principles In healthcare, we employ four fundamental principles of ethics for treatment, priorities, and decision-making. These four principles include autonomy, justice, beneficence, and non-

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