Ethical decision making in a bureaucratic context by senior nursing students. Outline the proposed action (s) you would take in this case, providing justification for the proposed action (s) and a description of the decision-making model used to arrive at that decision. An ethical dilemma arises when the clients and health care providers differ in their understanding of what is right or wrong (Narrigan, 2004). However, if his actions were not a generally accepted practice within the hospital setting then it would generate far more pain for society as a whole. Airedale NHS Trust v Bland, CA 1992.142 NL.J 17, Ambrosino N. and Goldstein, R: Ventilatory Support for Chronic Respiratory Failure ed: illustrated & Published by Informa Healthcare 2008, (Application no.2346/02) (2002) 35 E.H.R.R 1 ). Even if someone were some sort of moral imbecile, and their every effort to do the right thing resulted in their doing the opposite, Kant would claim that their good will would ‘… still shine through like a jewel for its own sake as something which has its full value in itself.’ So as long as they had good intentions, we can be guaranteed that their act was a morally good one. Article 3: Prohibition of torture and inhuman or degrading treatment – is an absolute right and states that, Restraint will generally not be seen as torture unless too much force is used, or it is used to limit your movement in a way other than to protect or prevent further damage. Volume 1 – Report and Formal Minutes. This is because the consequences of an action are often without our control and cannot be easily predicted. Published by, 1834, vol 1, J. Bentham, Principles of Morals and Legislation in 1789. As my scenario is based on a real case, some details have been changed in the effort to maintain patient confidentiality. These resources could be used for other patients who might benefit more. It has even been argued that there should be more emphasis placed on society’s interests. Professional duty is therefore placed on Dina’s consultant to act in a morally good way by providing urgent medical interventions as required. This case raises questions about obstacles to open communication about death and goals of care. 1785), Kant also believes in the motive of duty which is merely a prudent one and not moral one. Bioethical principles and care-based ethics in medical futility. Ethical issues have become important to leadership and management practice as a result of many well known cases of failure by organizations and individuals to observe and maintain ethical standards. It is established to reflect, or at least be consistent with, the patient’s personal view of her interests: this may be established through gaining consent, or by reference to proven facts about the patient’s values. TSO (The Stationery Office). (In reality, there is no quid pro quo: medicines not used on her would have no obvious intended recipient. Dina has spent all her life as an English school teacher. ... Case studies Choose one or more of the following case studies and lead a discussion which allows students to address and debate issues of integrity, ethics and law. This is why Dina’s brother is seen to be taking a paternalistic approach. Nursing often deals with ethical dilemmas in the clinical arena. Rawls goes on to describe ‘Justice as Fairness’ suggesting that any state making rules could be justified in doing so on the basis that the coercion was done under conditions of complete freedom, and would therefore appear to be more of a guidance than an oppression, a ‘social contract’. 1785), Kant also argues that a good will is not good because of what it achieves; it is intrinsically good in and of itself. 2005 Jan-Mar;16(1):3-13. doi: 10.1111/j.1744-618X.2005.00001.x. This lesson will explore the ethical decision making process through two classic case studies. This could be treated in law as a form of degrading treatment as Dina may have become very distressed at the refusal. They should be able to come and go from the hospital within reason and are able to discharge themselves if they decide to go home. Save responses in a word document and upload the document to your certificate record in myKU Portal. Dina’s later life in the nursing home during which she was unable to get out of bed. The doctor can still be found to be negligent if common practice is thought to be unreasonable by the court. Ethical Dilemmas Case Studies Professional Accountants in Public Practice She is not allowed to leave the hospital grounds. Physicians should not provide ineffective treatments to patients as these offer risk with no possibility of benefit. But patients’ classification into competent and incompetent helps to establish their level of capacity. It was reported that the child had been crying since picked up at daycare. The consultant may not be found negligent if he can prove that his actions were in line with common practice. Section IV then considers judicial interpretations of how best interests should be understood and applied. By Toni Cesta, PhD, RN, FAAN Senior Vice President Lutheran Medical Center Brooklyn, NY. Cannot be used in conjunction with other promotional codes. An ethical dilemma arises when the clients and health care providers differ in their understanding of what is right or wrong (Narrigan, 2004). A clinical case study of an ethical dilemma that occurred in a cross-cultural context is examined. Department of Health Review: Winterbourne View Hospital: Interim Report: (June 2012). However in Purdy v Director of Public Prosecutions (DPP), 2009). Dina finally died ten hours later. Excerpt from Case Study : Counseling -- Ethical Dilemma -- Case Study A 17-year-old Jewish female student advises a counselor that she went to a party last weekend with an African-American 17-year-old boy, and ended up passed out in an upstairs bedroom. Paternalism is no longer accepted as the basis for patient care decisions. Utilitarianism is primarily concerned with providing a mechanism for deciding what to do in given situations. Your responses should total at least 300 words. This further led to a decision to stop her medication when it was noted that death was inevitable and she was transferred from ICU to palliative care. The assessment was then presented to the physician; concern was expressed that the child may have been injured. This principle acknowledges that patients have the right to control their own lives and so can decide when to accept treatment or not. It means that the nursing staff has to consider which actions will be better for patient… Laws are a familiar concept, and provide a basic social framework of right and wrong to which the majority adhere. She was awakened by the boy forcing himself on her. Many of these virtue traits can also be seen in the character of Dina’s brother as he was very cooperative with the hospital consultants’ views to provide medical interventions on his sister. C. Faulder (1985:32). Girija, a smart and extremely talented young IAS officer, is posted as SDM of a Sub-Division in a Southern State, under whose jurisdiction the constituency belonging to a young MP falls. I believe though that these interests have been somewhat limited as shown by the Health Secretary after the Liverpool and Bristol body organ scandals. Case Study – 5: Ethical Dilemma Girija, a smart and extremely talented young IAS officer, is posted as SDM of a Sub-Division in a Southern State, under whose jurisdiction the constituency belonging to a young MP falls. The Guidance for Professional Practice -(UKCC 1996). James R. Thobaben, Health-Care Ethics (Downers Grove, Illinois: IVP Academic, 2009). Case studies and scenarios illustrating ethical dilemmas in business, medicine, technology, government, and education The language of the client and provider differed, and no interpreter service was available. Hazel Biggs and Caroline Jones, ‘Legally Vulnerable: What Is Vulnerability and Who Is Vulnerable?’ in Michael Freeman, Sarah Hawkes and Belinda Bennett (eds), Law and Global Health (OUP 2014).