Ethical Decisions in Health Care

Ethical Decisions in Health Care In the health care industry, professionals will often experience ethical dilemmas while administering treatment. It is crucial for all individuals in health care whether it be Ethical Decisions in Health Care administration, providers or even patients to understand how to deal with ethical dilemmas in the most professional way possible. Administration staff and physicians are taught multiple different methods of decision making and options of dealing with ethical dilemmas faced. One method of decision making is the Uustal’s Ethical Decision-Making Model. This model consists of a ninestep approach to ethical decisions made in a clinical setting when decisions are complicated due to a difference of values and beliefs held by all parties involved (Brace-McDonald, 2015). The decisions made with this model by nature are complex and provoke emotions that may cause a considerable amount of different stress to each party. (Brace-McDonald, 2015). In order to completely understand the use of Uustal’s Ethical Decision-Making Model, it will be applied to the following case study: “A 6-year-old develops a high fever accompanied by violent vomiting and convulsions while at school. The child is rushed to a nearby hospital. The attending physician makes a diagnosis of meningitis and requests permission from the parents to initiate treatment. Both parents are Christian Scientists, and they insist that no medical treatment be given to the child. The physician initiates treatment anyway, and the parents later sue the physician and the hospital” (Topic 5, HLT 305, 2020). Throughout this paper, the ethical dilemma of administered care after the parents of the child refused care, will be analyzed and thoroughly discussed as to if the health care professional made the right decisions to treat the patient against the parent’s wishes. To help understand the ethical dilemma that occurred, it is crucial to acknowledge the steps of Uustal’s Ethical Decision Model in making decisions. There are 9 main steps that involved perspectives of all parties in each step. The steps are: identify the problem, state personal beliefs and values; explore the patients values, generate alternative options for resolutions, examine and categorize alternative options, predict all possible outcomes and Ethical Decisions in Health Care consequences of each alternative option, prioritize the acceptable alternative, develop a plan of action, implement the plan and finally evaluate the action plan that was just implemented (BraceMcDonald, 2015). Each step within this model provide multiple questions to help further develop an opinion or educated assumption as to what the right decision is and are described below. Identify the Problem; The problem with this scenario is that the physician initiated unwanted care against parental request to their 6-year-old. State personal beliefs and explore patient beliefs; it is important to keep the patients values as a priority and all values stated by the patient must be communicated to other members of the health care team. If any values conflict with the provider, it may be the best option to pass on this patient to other provider with similar beliefs. Generate alternatives for resolutions; it is crucial to brainstorm ideas before and after dilemmas occur, health care professionals are recommended to always think one step ahead. There should be no judgement in this stage, simply ask for any and all opinions of each party involved. Examine and Categorize alternative options; alternative options must always be available for patient needs and request, make sure these options are consistent with values of both the patient and health care provider. Predict all possible outcomes and consequences of each alternative option; predicting whether consequences will be physical, psychological or social may help determine what treatment option is the best option for each individual patient. Prioritize the acceptable alternative; once the alternative option is chosen, health care providers need to make sure that treatment follows the path of achieving this alternative. It is important to choose an alternative that follows the morals and ethics of the patient first. Develop a plan; once the alternative is chosen, a course of action will be taken to assure the patient that they will receive quality treatment according to the chosen alternative treatment plan. Implement the plan; Ethical Decisions in Health Care health care providers are required to communicate the plan to patients and family members so that there is no mistakes made or ethical barriers broken. Finally, evaluate the action plan; once treatment is administered and understood, health care providers take this time to question their own actions. This last and final step is crucial as it builds up moral and ethical barriers for providers as to what steps should be taken next time, and what steps need to be avoided if any mistakes were made (Brace-McDonald, 2015). The Uustals’s Ethical Decision-Making Model can assist in this ethical dilemma in more ways than one. By providing detailed steps to health care providers, the model helps communicate how to discuss appropriate action in order to resolve dilemmas the providers and patients face. In a study conducted by Rizalar & Baltaci (2020), it was found that “problems originated from ethical dilemmas happen because nurses are affected from traditions and other limitations during decision process”, (p. 50). This shows that personal beliefs and values based on professional’s backgrounds and cultures can get in the way of making an appropriate ethical decision regarding the patient. According to Uustal (2003), “the ethic of care is based on covenant, not a contract,” (p. 17). With this, all relationships need to be based on shaping responses and behaviors towards actions taken. In order to resolve ethical dilemmas, it is crucial that provider recognize the difference of opinions between the parent’s beliefs of Christian Science compared to the providers westernized medicine views. According to the case study, the young child was diagnosed with meningitis which by definition is “an inflammation of the protective membranes covering the brain and spinal cord,” (CDC, 2020). The inflammation of the membranes can be caused by many things such as bacterial or viral infection of the fluid within the cranial cavity. Ethical Decisions in Health Care Taking the scenario and applying it to real life, the stakeholders within this dilemma would include the patient, the parents, the physician that approved care, the facility of rendered care, and attorneys who represent the hospital, the parents and the physician. The needs and expectations of each stakeholder is crucial in resolving the issue at hand. The child, who happens to be a minor at 6 years old, is very unlikely to have a say in treatment options and would be unable to express his own wishes. The child’s parents therefore take jurisdiction for his treatment options as they have the legal obligation to refuse treatment. The physician disagrees and seeks to provide medical treatment as that is his job. The hospital first would take the side of the provider given that the patients parent came to the Emergency room looking for assistance but as soon as the parents denied treatment, tis when the hospital legally had to back the parents. Assuming that the physician treated the 6-year-old accordingly based on knowledge and symptoms of the diagnosis, the physician should be covered by appropriately treating an ill patient. However legally, the physician broke the law. According to Frezza (2019), “a patient has a right to refuse treatment. They must be able to trust the beneficence of the physician; that the doctor is working in their best interest,” (p. 19). If the doctor disagree with the request of the patient or those who are responsible for the patient, they are required to offer other options, however the physician decided to take matters into their own hands. In the stance of all attorney’s involved, clinical judgment will be taken into account as well as the thought process of the practicing physician to see if they made the appropriate choice. With this Ethical DecisionMaking Model, an ethical framework will be implemented in the decision-making process when applying constraints against the law suit the parents decided to file. The conflicting values between westernized medicine vs Christian Scientist were the major contenders of this ethical dilemma. When administering care, the physician used his own Ethical Decisions in Health Care values and beliefs which are recommended to be put aside when treating patients who have disagreeing values. Assuming the role of a hospital administration member, the appropriate course of action would be to side with the parent, however using personal values and beliefs, the physician would be in the right. If and when a child who is diagnosed with a life-threatening disease that is easily treatable comes in, morally, it is right to save the child’s life. One major concept of this dilemma that was not addressed was the communication of the severity of the illness. If this information was communicated appropriately, the ethical dilemma and lawsuit would most likely never had happened. Understanding and knowing how to appropriately deal with ethical dilemmas is all a part of health care. It is important to recognize that creating trusting relationships and keeping communication open is the only way dilemmas will be avoided. Keeping personal beliefs and values based on religion and culture out of health care will help patients feel comfortable. The use of Uustal’s Ethical Decision-Making Model has helped health care professionals and administration make difficult decisions nationwide.