Anna Gorman A Medical Ethical Dilemma

Truth – telling in medicine is a broad area and often encompasses several ethical issues. These issues include the right of patients or their family to receive information about their diagnosis as well as illness. On the other hand, the physician must balance his or her obligation to tell the truth against the imperative of - do no harm.

Ethical Dilemmas in Healthcare Healthcare Values and Ethics Western Governors University Jean Renelien 000809006 January 16, 2018 A1: Potential Ethical Dilemmas As healthcare providers, we are often faced with situations and decisions that require us to make ethical and moral decisions. As a healthcare provider, we take an oath to do no harm and put our patients first. I am a licensed registered respiratory therapist, and in my role, I have a duty to care for my patients and provide adequate treatment and respiratory support that falls within my scope of practice.

Ethics are a set of moral principles that serve as a guiding philosophy for behavior. Consequently it is not a surprise that ethical dilemmas occur daily in the health care setting. Any nurse who refuses to provide care for a patient faces an ethical dilemma (Kuhn, 2012, pp. 412-418). The reasons given for refusal range anywhere from a conflict of personal values to fear of personal risk of injury. Nurses do have the right, at times, to refuse patient care assignments. The decision to accept or reject an assignment must be based upon a judgment by the nurse of the nurse 's ability to provide competent patient care. This paper aims to show both sides of the argument when it comes to nurses refusing a patient assignment. One side believes that nurses has the right to refuse patient assignment, as they must be true to themselves if they want to perform their best on the job. On the other hand, the other side believes that it is the nurse’s responsibility to care for all patients and, therefore nurses cannot simply refuse a patient.

In today’s health care industry, mechanical restraints are often used to maintain patients’ behavior and ensure their safety when treating the elderly and the severely ill (Gatsmans & Milisen, 2006). There are many variations of mechanical restraints, but all are defined as “any device, material or equipment attached to or near a person 's body and which cannot be controlled or easily removed by the person and which deliberately prevents or is deliberately intended to prevent a person 's free body movement to a position of choice and/or a person 's normal access to their body” (Gatsmans & Milisen, 2006, p.

Identify and explain two ethical issues/dilemmas in healthcare as identified and discussed in the scholarly literature (ProQuest, EBSCO,

4.1 - Describe ethical dilemmas that may arise in own area of responsibility when balancing individual rights and duty of care There are a number of factors to consider in the ethics of providing support to vulnerable adults in the community, it is the duty of the organisation, staff and other professionals (psychiatrist, care coordinator, O.T and social worker), to work alongside and ensure the ethic of delivery to individuals is: • The “right service” (appropriate) • In the “right amount” (to meet the clients need) • Delivered by the “right provider” (qualified and competent) • To the “right person” (a client that needs the service); • In the “right setting” (least restrictive, most integrated setting as appropriate to the person’s needs); • At the “right time” (a balance between clients preference and provider ability); •

“If you don’t have integrity, you have nothing. You can’t buy it. You can have all the money in the world, but if you are not a moral and ethical person, you really have nothing”. –Henry Kravis - The American healthcare system delivers some of the finest care in the world. However, despite the high level of achievement delivered from the American healthcare system, it is afflicted with problems. Ethical issues that occur in the healthcare delivery system are indeed common. Almost every decision that is made in a healthcare organization has ethical implications. These ethical implications are towards the patient, provider and the leader of the organization. Ethics tend to determine which actions will contribute to an individual fulfillment of happiness. Ethics are very powerful and tend to presuppose freedom and responsibility in the organization. In my current place of employment the care of patients is integrated with medical research, which in return allows for the healthcare practices to continuously be studied and improved. As a healthcare leader or worker, decisions will be made when the common good of both the patients and organization must be taken into consideration. As an effective healthcare leader one must practice adhering to the ethical standards and codes of conduct for his or her individual place of employment. According to Rae (2009), there are 7 steps in making moral decisions. The seven

A physician has the responsibility to determine the legitimacy of all work injuries and to report its finding accurately. If a physician prepares a report with the intent to use it in support of a fraudulent claim and knowingly submitted for payment under an insurance contract, the physician may be subject to fines or imprisonment and risks the possibility of having his or her medical license revoked. Presenting a claim for an item or services based on a code known to result in greater payment or submit a claim for services not medically needed is a violation of the false claim act.

The ethical dilemma I encountered at my placement involves a male in his late-sixties, who has recently suffered a stroke. Mr. A’s situation is unique as he has been unable to speak and his cognitive abilities have declined since. The Fraser Health agency protocol is to contact the patient’s family to determine who would be the temporary substitute decision makers (“Information for temporary substitute,” 2015). The health care consent and care facility admission act describes how decisions are to be made if a patient is determined incapable (Nidus Personal Planning Resource Centre, 2012). The next steps required liaising with the home health team in the community to determine if Mr. A had ever listed any family members as his emergency contacts.

The discussion on Patrick Dismuke's condition concentrated on his incapability to improve. After reviewing his symptoms and considering possible scenarios resulting from certain kinds of treatment, such as the tube that delivered nutrients into his veins that "broke the barrier between blood and air" and became "a bacteria-laden Trojan horse, opening the door to infection", we attempted to come to a consensus on what would constitute a quality life, as deliberated among the committee. We took into consideration that after every kind of surgery, his status would be temporarily improved but ultimately decline in keeping with his body's proclivity. We acknowledged that the idea of a successful stomach transplant was remote since, as

Last week I had the opportunity to talk to Mr. R who was brought in to the hospital due to a workplace injury. The referral was put through by the attending physician indicating that there was concerns of substance use. I started the conversation by introducing my role as a hospital social worker and tried to build report by asking Mr. R how he was managing at the hospital. Being transparent is important and explaining the reason for the visit helps in creating trust for the therapeutic intervention. I probed Mr. R about his alcohol use and if he identified that as being an issue for him. Mr. R indicated that he has been using alcohol for over a long period and reports this as a part of his daily social life, which makes it hard for abstinence.

We, the Hospital Ethical Decision-Making Committee, have been given a situation where Jeanne, a patient that is pregnant, is on a ventilator with no brain activity, and the unborn child will not be viable for another seven weeks. The dilemma is between the sister, Dianna, and the husband, Greg. Dianna wants to take her off the ventilator causing the unborn child to die and Greg wants to keep her on the ventilator in order to keep the fetus alive until it is viable.

Ethical problem solving and decision making is an arduous process for any nurse or health care worker. As Marquis and Huston, (2015) point out, that ethical decision making takes thinking skills and risk taking abilities to address and solve ethical problems. An ethical dilemma occurred during my charge in the NICU many years ago. A twenty-two week baby was born breathing and crying, it was decided by the team of neonatologists and the parents that no heroic efforts would be made to keep this baby alive. At the time the neonatal resuscitation guidelines for saving a baby were twenty-four weeks. Meanwhile, the baby came to the unit and placed in an isolette while the parents visited and held the baby. After numerous hour of life one of the doctors decided to place the baby on a nasal cannula and place lines in the baby for comfort care, however, no

Professionals in every field are always confronted with some kind of ethical issues. It has however been noted that these ethical issues become high in magnitude and extent when public officials are involved. Due to the involvement of human life, an industry like healthcare holds ethics in highest regard. Even though these healthcare practitioners are highly trained to deal with issues of these kinds, their decisions can sometimes have a lasting impact on their professional and personal lives (Edwards 2009).

Imagine you are injured or sick and have sought a doctor’s help. Although you trusted your doctor, something, something seemingly very in control of the doctor, went wrong. You are angry and confused, but also think of the commonality of medical malpractice. So, why do doctors, who are supposed to help, harm? Though many flaws influence it, malpractice can be, and often is unintentional. Most doctors aren’t trained to harm their patients. Inexperience and lack of medical discovery led to unintentional suffering of the patient. Personal flaws, like lack of willingness to abandon previous medical methods and shortcomings in communication also harm patients. Further reasons why doctors harm are socio-medical understandings that breed hate, prejudices stemming from a society’s belief about certain people, such as the medical practice under the Nazi regime. Additionally, displayed in the case of Ignác Semmelweis, judgement of one to oneself can be detrimental to any progress one’s ideas could make. We will examine these concepts through Jerome Groopman’s “Flesh-and-Blood Decision Making”, Sherwin Nuland’s The Doctors’ Plague and Barbara Bachrach’s “In the Name of Public Health”. Those who practice medicine are, unfortunately, unfree from the imperfections that plague all of humanity. Through these intimate and varied faults, doctors do harm.