Healthcare Ethical Dilemmas
Healthcare facilities have, in the recent past and on several occasions, experience massive setbacks that jeopardize their decisions in issues relating to service delivery. Healthcare professionals will experience several times working with patients where they need to include nursing ethics to help them handle difficult situations. According to an everyday health professional in hospitals, departments face numerous ethical issues, and they need to reconcile their values with professional nursing obligations. Several reasons, such as inadequate time and resources, make it hard for nurses to reconcile the conflict amicably. The potential ethical dilemmas range from autonomy, beneficence, and nonmaleficence to ascertaining the credibility of the entire decision-making process.
Response to Question One
Autonomy Ethical Dilemma
Legal Implication: Informed Consent
Independence is a significant factor among the elderly to provide a quality life and helps them live independently in residential places unless their poor health conditions restrict them. According to Dunbar (2018), older adults with different health conditions must make decisions about their health conditions. It plays a vital role in ensuring a quality life in the future. Informed consent is characterized by concerns that neither patients nor their families are fully informed about clinical prognosis or treatment. In Jamila’s scenario, the lack of full information about her condition created more concerns for nurses who were unsure of the best approach to address the issues. In most cases, patients feel exceptionally satisfied if they can make decisions for themselves. The conflict between Bahir and the health professional about the medical applications that Jamila was to be given hindered some of the essential measures that could be put in place to handle her case.
Beneficence Ethical Dilemma
Legal Implication: Treatment Recommendation
According to Sasson (2017), beneficence as an ethical dilemma addresses the idea that actions exhibited by nurses should aim at promoting good. Practicing good deeds is associated with doing all the right things that are best for the patients. In Jamila’s scenario, doing well was challenged with treatment recommendations that were evident between what the family wants and what the nurses think is worth her condition. In most cases, the nurse tries their level best never to hurt patients, and their actions are related to a positive outcome. However, if the same is limited due to the variations that might be realized between family members, the patient, and the nurse, it is always hard to attain the recommended result.
Nonmaleficence Ethical Dilemma
Legal Implication: Obligations to no Harm
Nonmaleficence in nursing refers to avoiding injuries or harm to the patients. Due to different degrees of damage that are common in most treatments, nonmaleficence implies that the implicated harm should not be disproportionate to the treatment benefits. Similarly, the nonmaleficence principle holds that there exists an obligation not to cause damage to patients regardless of the decisions made or the treatment to be administered.
In most cases, harm significantly impacts the decision-making process and renders patients incompetent in handling issues related to their social life and wellbeing. Due to her age and the contrasting views that were being evident from family members regarding the type of medication she is supposed to be subjected to it is worth noting that proper measures need to be put in place to limit any form of harm that she might be exposed to during treatment. Categorically all steps must be followed and supported based on the doctor’s prescriptions.
Legal Implications Associated with the Potential Ethical Dilemmas
With the correlational setting, all patients are at the core of the needed professional practices. The fact that Jamila was incarcerated is the only circumstance in her situation that requires proper attention. Based on informed consent, that made it hard for retrieval of the necessary information that can be used to handle Jamila’s case amicably and amiably. The legal insinuations associated with the above mentioned possible ethical dilemmas are tied to the federal and state laws as well as the scope of purpose and practice expectation based on the available professional standard. The nurse’s license, education, as well as the nursing standards, provide the necessary framework which is needed among nurses (Ballou, 2018).
Additionally, based on the obligations of not to cause harm, which in most cases associated with negligence, nurses who fail to exercise a reasonable level of care to Jamila may face the law based on the implications related to their practices. Overall, in terms of treatment recommendation, documentation of health needs, the process through which the health need occurred, and the actions to be taken based on the patient’s outcome must be coherent. Categorically, a nurse is appraised based on the health needs of the patients.
Response to Question Two
“Questions Derived from the University of Washington Paradigm.”
The course of Action: Follow Bashir’s Wishes
The history of the patient about adult-onset diabetes mellitus and obstructive pulmonary disease shows that she collapsed while at the protracted care facility, leading to the emergent of a heart attack. The treatment goals were to follow Bashir’s wishes, which are not associated with resuscitation orders with limited interventions as opposed to comfort care. The action reveals that the purpose of treatment was to extend the lifetime of patients.
Medical treatment is not available if an advance directive shows that most of them are Do Not resuscitate. Besides, based on the age and comorbidities as well as the probabilities of success based on the available treatments levels. The benefits of nursing and medical care will prolong the life of the patients after the heart attack (Rady, Verheijde & McGregor, 2016). Overall, through this action, proper treatment and care will protect Jamila from other attacks. Similarly, based on the Bashir’s wish, there were limited prospects for a possible return to a healthy life as he wishes that the patient have DNR status. Bashir also has a plan to forgo the life-sustaining action that his mother may undergo.
The course of Action 2: Refuse to Follow Bashir’s Wishes
The goal of the treatment was mainly aimed at extending the lifetime of the patient. After the testing was done, it was evident that the patient had had a heart attack. In terms of medical indications, the process is never done if the patient at hand has an advance directive that states that she is Do Not resuscitate (DNR). Similarly, based on her condition, the treatment options can very low. However, in terms of the patient’s preference, Jamila was never informed of the risks and benefits of the time due to the language barrier. There was no consent given by the patient, either. All the decisions were made based on the necessity of the needed medical services. Overall, in terms of quality life, refusing Bashir’s wishes could lead to an increase in the life of the patient. However, without proper treatment, the patient may die after a short while. It is never easy to judge a patient’s condition based on the nature of his or her life.
The course of Action 3: Briefly Delay the Decision to Gather Additional Information and Other Perspectives
The medical indication here reveals that after performing the test, it was evident that Jamila had a heart attack. Such a condition is a cure disorder and not associated with chronic conditions. Due to the critical state of heart attack, it requires proper attention, and the delayed decision may hinder the collection of the needed data. Overall, there was no evidence about the patient’s condition in terms of risk and benefits. In terms of preference, the patients were both legally and mentally competent.
Response to Question Three
Describe two Resources That Could Have Made or Could Still Make Jamilah’s Wishes More Clear
Ventilator Use: Using a ventilator in emergency cases helps control one’s breath. The ventilator has a tube that is put through one’s throat into the windpipe for the machine to force air into the patient’s lungs. Using respirators can help the provision of the needed air to keep her safe during other treatments that she might be subject to.
Artificial Hydration and Nutrition: If one is unable to eat, he or she can be fed using tubes that are threaded via the nose to the stomach. In the case of Jamilah, who has been unable to eat for some time, artificial hydration and nutrition can be useful for her recovery from the illness? This resource may be limited to the dying body may fail to use the diet appropriately. Overall, due to being deficient in English, Jamillah did not hear everything her son said, and the agreement could have been due to misinformation (Glendon, Clarke & McKenna, 2016). The family should have never used the healthcare setting as a translator.
Choose and Justify the Correct Course of Action (in Response to Bashir’s Demands for Only Comfort Care).
The course of action 1: Follow Bashir’s wishes
I would refuse Bashir’s requests because of several legal and ethical consequences that are to be followed if the hospital is limited in the provision of comfort care. Similarly, Bashir’s wish had no prospects of returning the patient to a healthy life. The action also raises ethical issues that enhance the patient’s quality of life. In the Bashir’s wish reveals that he is forcing his mother towards suicide status. Overall, Jamillah can access all the available legal rights regardless of the setbacks that in making choices. The action has no conflict of interest with administrations and institutions that would affect patient welfare and clinical decisions.
Response to Question Four
Create three policy recommendations that you could make as an administrator to help your employees, and the facility’s medical staff handles similar situations in the future.
Standard Practices: This involves developing approaches that had already existed with another domain, which can ascertain the credibility of the first ones. Discrepancies that medical staff experiences should be associated with other rationales that aim at ensuring quality services throughout the practice.
Compliance with Statutes, Accreditations, and regulations requirements: All employees are governed by laws and regulations that not only determine their credibility bt also ensure that they are capable of following them. The failure of a nurse or medical staff in adhering to the policy may be regarded as inconsistent with the laws that govern their operations and service delivery.
Resource for staff: According to Vonderembse & Dobrzykowski (2016), this policy maintains that all employees ensure that patients get all the necessary attention for a quality life. Similarly, staff as a resource will ensure that they are active in ensuring that all the measures are appropriately adhered to based on other conditions that might hinder the success and outcome of their services.
Ballou, K. A. (2018). A concept analysis of autonomy. Journal of professional nursing, 14(2), 102-110.
Dunbar, T. (2018). Autonomy versus beneficence: An ethical dilemma.
Glendon, A. I., Clarke, S., & McKenna, E. (2016). Human safety and risk management. CRC Press.
Rady, M. Y., Verheijde, J. L., & McGregor, J. L. (2016). In emergency medicine, there are scientific, legal, and ethical challenges of end-of-life organ procurement. Resuscitation, 81(9), 1069-1078.
Sasson, S. (2017). Beneficence versus respect for autonomy: An ethical dilemma in social work practice. Journal of Gerontological Social Work, 33(1), 5-16.
Vonderembse, M. A., & Dobrzykowski, D. D. (2016). A Healthcare Solution: A Patient-Centered, Resource Management Perspective. CRC Press.