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Ethical Dilemma Investigative Brief

Overview
Health care administrators often face ethical dilemmas and the need to make challenging decisions in their work. It is crucial for them to comprehend the connections and differences between ethical behaviors and legal issues. Ethics committees within healthcare institutions play a central part in safeguarding patients’ rights and protecting the organization and its staff.

Imagine yourself as a health care administrator in a large medical center. You have been assigned to present a paper at a professional conference focusing on medical ethics and caregiver-patient interactions. Your task is to write an investigative brief, examining a significant ethical dilemma between a physician and a patient in a medical setting, defending the decisions and conclusions made.

Preparation
Refer to the linked resource below, which presents various ethical case studies involving patients, families, and the interdisciplinary team. Choose a scenario from this resource or select a case from another source of your choice.

Medical Ethics and Physician-Patient Encounters: Case Studies and Best PracticesLinks to an external site..
Instructions
Prepare a 3-5-page brief in which you:

Present a brief from the perspective of a lead administrator addressing the ethical dilemma involving a caregiver-patient interaction discussed in the chosen case study.
Apply ethical and moral theories to the chosen case study.
Identify the ethical concerns and potential outcomes associated with the selected case study.
Propose a solution to address and resolve the ethical issues raised in the selected dilemma, providing a well-supported ethical justification.

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Sample Answer

 

 

 

Investigative Brief: Addressing Ethical Dilemmas in Physician-Patient Interactions

To: Professional Conference on Medical Ethics From: [Your Name], Lead Administrator, [Medical Center Name] Date: [Current Date] Subject: Resolving Ethical Conflicts: A Case Study Analysis

Executive Summary:

This brief examines the ethical dilemma presented in the case study of [Choose a case from the provided resource or another source. For this example, I will use “Case 3: The Refusal of Life-Saving Treatment”], where a competent adult patient refuses life-saving treatment due to personal beliefs. This brief will analyze the ethical concerns, apply relevant ethical theories, identify potential outcomes, and propose a solution with ethical justification.

Case Presentation:

In Case 3, a 65-year-old patient, Mr. Smith, is admitted to our medical center with acute respiratory failure. Physicians determine that mechanical ventilation is necessary to save his life. However, Mr. Smith, a devout member of a religious group, refuses the treatment, citing his belief that artificial life support violates his faith. Despite extensive counseling and explanations of the potential consequences, Mr. Smith remains adamant in his refusal.

Ethical and Moral Theories Applied:

  1. Autonomy: This principle emphasizes the patient’s right to self-determination and informed decision-making. Mr. Smith’s refusal, despite understanding the risks, reflects his autonomous choice.
  2. Beneficence: This principle obligates healthcare professionals to act in the patient’s best interest. In this case, physicians believe mechanical ventilation is in Mr. Smith’s best medical interest.
  3. Non-maleficence: This principle requires healthcare professionals to avoid causing harm. Refusing treatment could lead to Mr. Smith’s death, which could be considered harm.
  4. Justice: This principle requires fairness and equitable distribution of resources. While not directly relevant to the patient’s refusal, it underscores the need to treat all patients with respect and dignity.
  5. Deontology (Kant’s Categorical Imperative): This theory emphasizes adherence to moral duties and rules. In this case, respecting patient autonomy is a moral duty.
  6. Utilitarianism: This theory focuses on maximizing overall well-being. From a purely utilitarian perspective, saving Mr. Smith’s life might be considered the best outcome. However, it disregards his personal beliefs and autonomy.

Ethical Concerns and Potential Outcomes:

 

 

Full Answer Section

 

 

 

  • Ethical Concerns:
    • Balancing patient autonomy with the duty to preserve life.
    • Addressing the potential for coercion or undue influence.
    • Navigating religious and cultural sensitivities.
    • Managing the emotional distress of the medical team.
  • Potential Outcomes:
    • Honoring Mr. Smith’s refusal: This upholds patient autonomy but could lead to his death.
    • Overriding Mr. Smith’s refusal: This potentially saves his life but violates his autonomy and could damage trust.
    • Seeking a compromise: This could involve exploring alternative treatments or providing spiritual counseling.
    • Involving the ethics committee: This ensures a thorough review and consideration of all factors.

Proposed Solution and Ethical Justification:

Given the ethical complexities, I propose the following solution:

  1. Comprehensive Assessment of Competency: Ensure Mr. Smith fully understands the risks and benefits of his decision. A thorough assessment of his cognitive abilities and mental state is crucial.
  2. Enhanced Communication and Counseling: Provide additional counseling, including spiritual support, to address Mr. Smith’s concerns and explore potential compromises.
  3. Documentation and Informed Consent: Meticulously document all discussions, assessments, and Mr. Smith’s informed refusal. Ensure he signs a clear and comprehensive informed refusal form.
  4. Ethics Committee Consultation: Convene an ethics committee to review the case, provide guidance, and ensure all ethical principles are considered.
  5. Palliative Care Option: If Mr. Smith’s condition deteriorates, offer palliative care to ensure his comfort and dignity.

Ethical Justification:

  • This solution prioritizes patient autonomy by respecting Mr. Smith’s right to make informed decisions about his care.
  • It acknowledges the duty of beneficence by providing thorough counseling and exploring alternative options.
  • It upholds non-maleficence by ensuring Mr. Smith’s comfort and dignity, even if his refusal leads to death.
  • It ensures justice by providing equitable care and respecting his religious beliefs.
  • By consulting the ethics commitee, the hospital is ensuring that it is acting in an ethical manner.

Conclusion:

This case highlights the challenges of balancing patient autonomy with medical imperatives. By applying ethical theories, thoroughly assessing the situation, and engaging in open communication, healthcare administrators can navigate these complex dilemmas and ensure patient-centered care.

 

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