Step in Ethical Dilemma Situations Assignment

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Step in Ethical Dilemma Situations Assignment

Principle’s Approach
Ethical Decision-Making Worksheet

 

STEP ONE: CASE IDENTIFICATION/IDENTIFYIG THE ETHICAL PRINCIPLES

  1. Identify the ethical

What is the ethical dilemma or the situation which seems to demand ethical analysis? Is there critical information missing that would be helpful?

 

  1. Identify and define the two or more ethical principles that are in contention. Remember, the principles must be equally justifiable.

Which principles are present in the scenario? Which are opposing one another leading to the ethical dilemma? Step in Ethical Dilemma Situations Assignment

 

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STEP TWO: ANALYZING THE ETHICAL ISSUE

  1. Identify those likely to be affected by the

Who are the individuals/groups that need to be part of the interprofessional team? Who are the individuals, groups and/or communities that are likely to feel the impact of this decision in a significant way?

 

 

  1. Identify three viable courses of action, including benefits & risks for

 

 

 

STEP THREE: RESOLVING THE ETHICAL ISSUE

 

 

  1. Make the decision & document the decision-making process. What do you believe is the best decision? How/where would you document this decision and decision-making process?

 

  1. Implement the

What issues might be anticipated as you implement the decision? How might you resolve these if they do arise?

 

 

 

  1. Monitor, evaluate & document the

What resources do you need to monitor and evaluate the outcomes of the decision? How do you plan to evaluate the outcomes? What are the benchmarks you will be looking for as measures of success? Step in Ethical Dilemma Situations Assignment

 

 

 

 

STEP FOUR: REFLECTION

  1. Look back.

Individual and group reflection is a critical step in ethical dilemma situations. This reflection includes instances of differing opinions and high emotions. What insight did you gain? What do you wish would have happened differently?

Principle’s Approach: Ethical Decision-Making Worksheet

STEP ONE: CASE IDENTIFICATION/IDENTIFYIG THE ETHICAL PRINCIPLES

  1. Identify the ethical

In the provided scenario, the apparent ethical dilemma centers on the tension between respecting the patient’s privacy as requested and the duty of a medical practitioner to promote the patient health wellbeing and safety (Haahr et al., 2020). The patient in question in the case, Mary Lou, desires and requests that her medical condition; depression diagnosis, is kept a secret in a bid to protect her job in a large and reputable organization. The challenge, however, is that the act of withholding this information triggers unique risks especially as regards her regular provider. This risk emerges from the potential harm in the event that the regular provider prescribes medications without knowledge of her current treatment. One of the critical missing information in this case is the patient’s informed consent for this level of privacy especially considering the awareness that this arrangement has huge potential health risks. Step in Ethical Dilemma Situations Assignment

  1. Identify and define the two or more ethical principles that are in contention

Remember, the principles must be equally justifiable.

There are a few ethical principles that emerge from this particular case. Examples of these include patient autonomy, confidentiality, and beneficence. According to Molina-Mula and Gallo-Estrada (2020), patient autonomy supports the right for the patient to privacy meaning that she has the right and freedom to make decisions regarding her health. This principles is however challenged by the principles of confidentiality and beneficence principles. These two oppose autonomy because the act of withholding relevant medical information may lead to potential harm. In view of this, it is necessary for these three principles to be balanced with an aim to achieve the best for the patient.

STEP TWO: ANALYZING THE ETHICAL ISSUE

  1. Identify those likely to be affected by the

Among the individuals that will be affected by this decision include the patient Mary Lou, the prescribing healthcare provider, the PCP for the patient, and possibly a mental health specialist. Others that will likely be affected are Miss Lou’s colleagues at work as her performance in the workplace will likely be impacted.

  1. Identify three viable courses of action, including benefits & risks for
  2. The first course of action is respecting Mary Lou’s confidentiality which would have the benefit of honoring her autonomy. The risk that this course of action could have is potential harm on her health and the organization she is working for Step in Ethical Dilemma Situations Assignment
  3. The second course of action is encouraging Mary Lou to disclose her mental condition to her primary provider and her employer. The notable benefit this approach would have is ensuring the patient receives proper care and avoids potential harm. The risk that this second course of action has is potentially violating patient autonomy and trust.
  • The third option is seeking a compromise with the patient. This would have the benefit of balancing privacy and health, possibly by involving a trusted third party to hold the information. The associated risk in this case is that it may not fully satisfy the principles of autonomy and beneficence.

 

STEP THREE: RESOLVING THE ETHICAL ISSUE

  1. Make the decision & document the decision-making process

Considering everything, the most appropriate decision in this case is encouraging patient disclosure while respecting the patient autonomy. According to Jacobs (2019), in such a case it would then be necessary for the nurse to record in the medical record of the patient explaining in detail the importance of shared information for her safety. The decision-making process for the patient should include detailed conversations with the patient with emphasis being placed on the benefits of shared information for her health. Step in Ethical Dilemma Situations Assignment

  1. Implement the decision

Anticipated issues may include patient resistance and concerns about job security. These can be addressed through open and empathetic communication, assuring her that her health is the top priority.

  1. Monitor, evaluate & document the outcomes

Resources for monitoring and evaluating the decision include Mary Lou’s medical records and regular check-ins to assess her well-being. Benchmarks would include improvements in her mental health, successful management of her depression, and her ongoing ability to perform her job effectively.

In this particular case, it is important to record that the patient finally accepted to disclose her diagnosis and this also be recorded in the report for future reference and as a measure for upholding their autonomy.

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STEP FOUR: REFLECTION

There is an ethical dilemma that is present in this case. In addition to this, I gathered several important insights from this case and these will be helpful in my practice as a nurse. In particular I have gained a lot of knowledge on how to balance patient autonomy, confidentiality, and beneficence. I have also gained insight on the importance of open communication with patients about the potential risks of withholding medical information. In this particular case for Mary Lou, despite the wishes she has in withholding her health condition, whet has emerged as more important are the potential health risks that her decision presents.  Needless to say, a more structured approach to managing such cases would involve the development of clear policies on patient confidentiality and shared information. Step in Ethical Dilemma Situations Assignment

 

 

References

Haahr, A., Norlyk, A., Martinsen, B., & Dreyer, P. (2020). Nurses experiences of ethical dilemmas: A review. Nursing ethics, 27(1), 258-272. https://doi.org/10.1177/0969733019832941

Jacobs, G. (2019). Patient autonomy in home care: Nurses’ relational practices of responsibility. Nursing ethics, 26(6), 1638-1653. https://doi.org/10.1177/0969733018772070

Molina-Mula, J., & Gallo-Estrada, J. (2020). Impact of nurse-patient relationship on quality of care and patient autonomy in decision-making. International journal of environmental research and public health, 17(3), 8 Step in Ethical Dilemma Situations Assignment