Applying Ethical Frameworks in Practice

Applying Ethical Frameworks in Practice

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Applying Ethical Frameworks in Practice

Ethical Dilemma

In this case, the child’s step-mother who has the primary custody of the child refuses to allow the child to undergo immediate medical treatment based on religious ground. The child’s biological fathers who is in a different state in the time of the incidence authorizes for treatment and seeking of second medical treatment. However, he is not around and his wish can only be executed with his wife’s permission. The two parents contradict on what need to be done. Although the doctor advocates for immediate treatment, it is clear that the step-mother who has the full authority of the child at the moment does not support treatment. In this case, the main ethical dilemma is whether to start the child treatment as the father wants or to obey the mother.

Selected Decision Making Model

The selected decision making model is the Uustal’s Model. This model is selected because it follows the process of nursing and includes clarification of values when used in ethical decision making. The model enhances the process of ethical decision making through steps. It contains nine main steps which when effectively followed it enhances the identification of the most optimal solution for the identified ethical problem. The first step involves problem identification. The model guide the user on identifying the problem based on the people involved, their relation and the situation at hand. The second step guides the user on defining personal ethical and value position based on the problem. The third step guides the user in considering aspects which are associated to the situation and creating possible alternatives for addressing the dilemma. The fourth step guides the user in evaluating and classifying alternatives based on their consistency to the user’s personal value. The fifth step guides the user on predicting all probable results for the alternatives that are acceptable. The sixth step guides the user in prioritizing on the most viable alternatives by ranking them based on their priorities. Step seven involves creating action plan using the list of the most viable alternative. Step eight involves plan implementation, while step nine involves examination of the action taken to find how right and ethical it was (Uustal, 1993).

Resolving the Dilemma Using the Model

Problem Identification

There is a contradiction on whether to treat the child or not based on the step-mother stand; the child’s primary custodian stand, and the child’s biological father. The step-mother objects treatment based on her religious stands, while the father prefers the child’s treatment and obtaining second opinion. The main issue in this case is whether to start the treatment as the father wants or forget about it based on the step-mother’s stand.

My Value and Ethical Position on this Issue

The medical assessment demonstrates that the child needs for urgent treatment. Physician’s value is to enhance the welfare of patients by offering the suitable and quality care. However, Physicians’ ethical duties demand that they may seek patient’s consent if of majority age or parent’s consent if a child before offering performing any medical procedure. They are required to offer them their advice to ensure that parents or patients make informed decision. Their ethical duty demands that they may adhere to their decision after ensuring that they have the right information. Thus, the child can only be treated with parents’ permission (Kurtz & Burr, n.d.).

Factors Related to the Situation

The child in this case is suffering from meningitis which is considerably fatal. Immediate treatment is highly required failure to which the child may die or get other advanced results. The biological parents of the child are divorced and thus the step-mother is making decisions as the child’s mother. The situation could be resolved by getting the child’s biological mother’s opinion based on her legal term on the child.

Examination and Categorization of Alternatives

The main alternatives include:

Following the father’s decision of treating the child and then taking a second opinion. This will ensure that the child’s life is saved without further delays.

Seeking second opinion before starting the treatment and only start the treatment if the opinion affirms the first observation. This will cause minimum delays in treatment but the second opinion may make it easy to convince the parents on the need of urgent treatment.

Contacting the child’s biological mother to know her stand regarding the case and follow the majorities’ decision. This may assist in easing the process of decision making based on biological mother’s legal power to make decision pertaining her children’s welfare. However, it may attract some family conflicts

Abandoning the treatment completely to preserve step-mother’s religious values. This is the most dangerous option since, it can results to the child’s death.

Possible Outcomes for the Accepted Alternatives

The first alternative will surely save the child’s life. This will preserve the family’s happiness but interfere with step-mother’s religious value. Nevertheless if the second opinion differs from the first opinion, the parents may feel cheated and the child may suffer medical errors complications. The second alternatives will increase the level of certainty on need of treatment or may also eliminate the need for the treatment. It will assist in saving the child’s life and eliminating possibility of future medical error and thus restoring the family happiness. The third alternative will ease making decisions however, it may initiate family conflict. The fourth alternatives will preserve the step-mother’s religious value but bring sorrow into the family.

Prioritizing Acceptable Alternatives

Seeking second opinion before starting the treatment

Following the father’s decision of treating the child and referring the child for second the opinion

Contacting the child’s biological mother to know her stand regarding the case and follow the majorities’ decision

Action Plan

In the first case the child will be referred to another laboratory for second blood evaluation. If the diagnosis is same, treatment will start as per the father’s authorization. In the second case, the child will be treated and then referred to another hospital with right physicians to evaluate the child’s condition. In case the diagnosis matches, the child will continue with the treatment, failure to which the child will stop the treatment and be treated for the right condition. In the third case, more will be inquired on the biological mother’s right to make decisions regarding the child. In case her judgment is viable, she will be contacted for her opinion. Action will then be taken as per majority score.

Plan Implementation

I will consider the first option and thus, I would identify the best referral and give the family an ambulance to the referral. An evaluation will be done and in case the same condition is obtained, treatment will be started immediately.

Evaluation of the Action

The action taken is right since it will enhance the child’s safety. It will eliminate chances of child’s death and also prevent any future medical related error complications. The action is also ethical since it adheres to the father’s decision and also affirms the physician’s value. Saving the child’s life is the most important physician goal and thus the decision is right.

Dialog on My Decision

Physician: Do you know that Meningitis is among the most fatal diseases and if not addressed handled urgently it can cause death or other advanced medical effects that include brain damage, deafness, and body parts amputation?

Family: We do not have any information regarding the condition.

Physician: I would like you to consider the danger that you are putting this child in when delaying to make decision regarding his treatment. Meningitis is a condition caused by bacteria, and it is considerably fatal when not arrested on time. It normally does not have directly recognizable sings in the onset and thus, it is normally noted when in advanced stage. For instance, in this case, seizure is among the late signs of the disease. The fact that this child has already experienced this stage means that the disease is tending to damage his mental and neurological system. This means, we cannot afford further delays. Delayed treatment may results to deformities while complete lack of treatment may results to death. You now have to choose what you want, the child’s death, handling a deformed child, or having the child treated (Menigities.org, 2016).

Conclusion

It is normally hard to make decision in a dilemmatic condition. Although the physician may have clear mind of what need to be done, there are legal and ethical aspects that involves other stakeholders in decision making. In this regard, the physician is required to offer the professional stand and wait for the decisions of others. Wrong decision can be made even with the right medical deposition, especially where people have other values they prioritize compared to medical intervention. To arrive to the best possible solution, ethical decision making models may need to be employed to evaluate alternatives priorities based on stakeholders’ stand.

References

Kurtz, P., & Burr, R. L. (n.d.). Chapter 11: Ethics and health. Jones and Bartlett drafters. Retrieved from < http://www.jblearning.com/samples/076371786x/1786x_ch11_248_269.pdf >

Menigities.org. (2016). Meningococcal meningitis and septicaemia: Guidance note. Meningitis Research Foundation. Retrieved from < http://www.meningitis.org/assets/x/50631 >

Uustal. D. B. (1993).  Clinical ethics & values: Issues and insights. East Greenwich, RI: Educational Resources in Healthcare.