ETHICAL DECISION MAKING 6
Physiciansare often faced with situations that require sound ethical decisionmaking ability. This is mainly because the health care sector iscomplex as it involves making decision pertaining to individuals’wellbeing, life and death. The challenge in such decisions is posedby the necessity to apply professional ethical standards and othersituations which present obligations that cannot be overlooked. Intheir capacity, the physicians have to identify the target of theaction. Whether their actions are directed toward doing the rightthing to the community, their co-workers, family or individualpatient, they have to understand that what seems to be right to oneindividual is terribly wrong according to another thereby bringingout an ethical dilemma. The Uustal’s theory therefore, comes inhandy as it lays down the steps to be followed by such professionalsto ensure that they have taken all the aspects into consideration.
Inthis case scenario, the ethical dilemma is the fact that thephysician is charged with the responsibility of safeguarding thehealth of the patient, but he must take into consideration theparents decision as they are independent and are entitled to freedomof choice and action. The physicians is therefore has to allow thechild’s mother to make an independent decision and follow her ownvalues.
Thispaper will be based on the Uustal’s theory of ethical decisionmodel as it not only follows the nursing process but also includesvalue clarification when applying a decision making model. It willalso enable the physician to make an objective decision rather thanreasoning from an emotional perspective (Butts&Rich, 2013).The Uustal’s model lays down steps to be followed in ethicaldilemmas.
Thefirst step involves identifying the problem. Taking note of thepeople involved, how they interrelate and the situation at hand. Inthis scenario, the people involved are the Physician, the child whois the patient and the Mother who insists on following her religiousvalues. The situation at hand is the fact that the child who is illrequires medical attention. The ethical dilemma is whether to treatthe patient, or to respect the religious values of the child’smother. The second step involves the individual values and ethicalposition relating to the problem (Benjamin&Curtis, 2010).The physician is charged with the responsibility of safeguarding thepatients’ health and therefore wouldlike to go ahead with thetreatment. His values are inconsistent with the situation at handsince the patient is a minor and the only person who can makedecisions for the patient is the mother who prefers to follow herreligious beliefs.
Thirdstep is to take into consideration the factors that relate to thesituation and come up with alternatives methods of solving thedilemma. The first alternative will be to make the child’s motherunderstand that her decision will infringe the child’s rights totreatment and may also endanger the life of the child. The physiciansalso should inform the child’s father that he is free to seekanother person’s advice so that he does not threaten thetherapeutic relationship between them (Benjamin&Curtis, 2010).He should also emphasize on the necessity of doing so within a shorttime duration for the sake of the child.
Fourth,the physician should categorize the alternatives available. If themost viable alternative is inconsistent with his values, thephysician should ask evaluation of another physician to avoid bias.In this scenario, following the religious believe is one of thealternative which is inconsistent with the physician ethicalstandards. The physician may seek the recommendation of the doctorsuggested by the child’s father as he has equal rights to make thedecision for the minor (Butts&Rich, 2013).This will also address the child’s right to medical care.
Fifth,predict possible outcomes from the given options. Assumingalternative A, was to follow the mother’s advice. This will beunfair to the patient as he may die or regress if the ailmentcontinues. Alternative B, will be to treat the patient. This wouldalso be an infringement of the patient’s right to independence orrather the principle of independence to determine the kind oftreatment that can be administered to him or her (Butts&Rich, 2013).In essence, the mother’s rights as the guardian would be infringed.Alternative C, will be to allow the child’s father seek alternativeconsultation. This comes in the way of the health of the patient andwould essentially amount to absconding one’s duty pertaining to theprotection of life and acting in the best interests of the patient(Tschudin,2003).
Sixthstep, involves prioritizing the acceptable alternatives. In thisscenario, the most acceptable alternative is to treat the child orallow the father to seek an independent consultation. The leastacceptable alternative would be to deny the child medical carebecause of the child’s mother religious considerations.
Theseventh step involves developing a plan of action using theacceptable alternatives. The physician therefore, may decide to allowthe child’s father option, but give him timelines, failure to whichhe will go ahead and treat the child. The eighth step requires thephysician to implement the plan. The physician will thereforeconsider if the Child’s father has acted accordingly towardsproviding proper medical care to the child (Butts&Rich, 2005).He may also seek to know who is the recommended physicians andevaluate the possibility of calling him on board. If the patientcondition does not allow them time for such consultation, thephysician will go ahead and treat the patient.
Thefinal step involves evaluating the action taken. The physician shouldevaluate his actions and determine whether he acted in the rightmanner. In attempt to evaluate his actions the physician should referto the five principles of ethical guidelines. According to thisprinciples the physician is deemed to have acted in the right way ifhe has taken into consideration the autonomy of the clients (Butts&Rich, 2005).He recognized that the client is independent and entitled to hisopinion. Secondly, his actions did not cause harm to any party and hecontributed towards the welfare of the patient. In addition, he actedjustly by ensuring that he prioritized the acceptable scenarios anddisregarded the unacceptable. He also allowed for independentconsultation to safeguard the fidelity and trustworthiness.
“Letme start by introducing myself. I am humbled to be in the presence ofthis able family, as the physicians entrusted to handle the medicalsituation of one of your siblings. I would like to acknowledge thatit was not an easy decision to make considering that both of you,parents had valuable opinion about the child’s case. I wouldtherefore like to emphasize that, am entrusted with theresponsibility of safeguarding the patients’ health and thus, mymain concern was to get the child back to his normal health as thecondition is curable and any delays would have led to furthercomplications which may be difficult to treat or death of your child.I know each one of you wanted the same and that is why you soughtmedical assistance. I also thank the teachers for bringing the childto hospital immediately. I would also like to inform all of you thatthe medication administered to the child responded positively and thechild is doing well. For further assistance, kindly do not hesitateto contact me. Thanks for listening.”
Benjamin,M., & Curtis, J. (2010). Ethicsin nursing: Cases, principles, and reasoning.Oxford: Oxford University Press.
Butts,J. B., & Rich, K. (2005). Nursingethics: Across the curriculum and into practice.Sudbury, Mass. Toronto: Jones and Bartlett.
Butts,J. B., & Rich, K. L. (2013). Nursingethics: Across the curriculum and into practice.Burlington, MA: Jones & Bartlett Learning.
Tschudin,V. (2003). Ethicsin nursing: The caring relationship.Oxford: Butterworth-Heinemann.