Ethical Dilemma - Health Professional - Case Study - Essay Writing Assessment Answer

Ethical Dilemma Case Study Assignment

Assignment Task

Select a case study from the list below and address the following points.

1. Determine the stakeholders including two health care professionals in the case scenario;
2. 2. Differentiate the ethical and legal conflicts and explain them from the following perspectives:

• The dignity and rights of all stakeholders in this case
• The principles and virtues of health care ethics that inform professional practice
• The relevant codes of ethics and/or codes of professional conduct 3. Propose a legally and ethically defensible resolution to these conflicts

CASE STUDY ONE

Kamil Samra is a sports physiotherapist and specialist in treating musculoskeletal injuries who is employed by an AFL club on the basis of his notable success. Kamil enjoys friendly relations with the players and the club managers and has become a close friend of two of the players. One evening, at a bar, Kamil is made aware that the coach and sports scientists are supplying performance-enhancing drugs to the players. He later verifies this information for himself when he discovers a package containing the banned peptide Thymosin beta-4 at the club headquarters. Kamil discusses this issue with both the coach and the club management who, in turn, offer him an even higher salary in exchange for his silence on this matter. In accepting the offer Kamil can ensure care for his poor, aging parents in Lebanon. However, he is aware that Thymosin beta-4 not only enhances athletic performance (and is in breach of the anti-doping rules in sport), but it may also cause long-term health issues, but the players, in being contractually bound to follow instructions by the coaching team, are not really free to refuse to use this banned peptide.

CASE STUDY TWO

Alex Ng, a senior paramedic in a regional centre, is called out to attend a motor vehicle accident on the main highway, involving two cars and a large transport truck. On arrival at the scene, Alex finds passengers trapped in both cars; two children in a small car are not moving and show no other signs of consciousness while the female driver is slumped over the steering wheel, bleeding from a head wound. The male driver of the other car is conscious but trapped in the wreckage; he tells Alex’s partner that he cannot feel or move his lower limbs. The male truck driver is walking around the wreckage and appears confused and disorientated; at a glance, he does not appear to be physically injured. A woman who was driving past stops her car and comes forward; she tells Alex that she is an emergency physician and can help. Alex is grateful for the offer of help and asks her to attend to the children, however, he notices the smell of alcohol on her breath when she walks past him. After opening the door of the other car, Alex notices that the trapped driver is wearing earphones attached to his mobile phone and the phone screen indicates that he was on a call when the accident occurred. The driver is alone and Alex recognizes him as the local magistrate, and a good family friend. Just then, he hears the screech of brakes and turns to see that the truck driver has walked up the highway and into oncoming traffic. He is lying on the road and does not appear to be breathing.

CASE STUDY THREE

Baby Thomas was born at 24 weeks’ gestation and was at his parents’ request, immediately transferred to the neonatal intensive care unit (NICU) where he is administered an array of invasive measures for ensuring adequate cardio-respiratory function and cerebral perfusion, as well as preventing hypoglycaemia, hypothermia, malnutrition, thromboses and sepsis. Over the subsequent days and weeks, baby Thomas experiences recurrent episodes of apnoea requiring resuscitation. He has also required other medical measures for treating bronchopulmonary dysplasia, repeated episodes of diminished cardiac output, sepsis and pneumonia. Efforts to extubate the baby continue to be unsuccessful. Thomas has been in NICU for 52 days; notwithstanding his poor response to treatment, his parents wish to continue with NICU management. At the same time, the Head of the ICU and Anaesthesia Department is ordering the medical staff to remove Thomas’ advanced life support measures, given the evident medical futility of continuing treatment. The nurses and physiotherapists are very concerned that, in the most unlikely event that baby Thomas survives, he would be living with profound neurological damage, and other serious disabilities. The social worker is concerned that the parents were not properly prepared for the high probability that their baby may not survive at all. The Head of the Finance Department is also requesting that, in light of strict budgetary limits, NICU treatment be withdrawn for this baby, given its cost of $3,000 per day (approximately $156,000 to date). The parents are distressed by the suggestion to withdraw treatment and contact the media in order to draw attention to their baby’s plight.

CASE STUDY FOUR

Elsie Lee, 88 years old had recently moved to a Residential Aged Care Facility (RAC). She had difficulty mobilising due to severe rheumatoid arthritis as well as short-term memory and vision impairment. Elsie also had a history of AMI, removal of bilateral cataracts, and a (L) hip replacement four years ago. On admission to the RAC facility, on Tuesday afternoon, the Nurse Manager suggested that Elsie consider making out an advanced care directive (ACD), indicating what she would want done in the event that her health should deteriorate. Elsie agreed and awaited the help of her family when they visited on Sunday. She was pleased to have this opportunity as, although she had discussed her wishes with her family, she wanted to make it clear to staff caring for her that she did not want aggressive treatment of any kind and did not want to be resuscitated. On Friday night, Elsie developed severe chest pain which radiated down her (L) shoulder, an irregular pulse and a BP of 73/48 and the RN on duty called the ambulance. Elsie pleaded with the paramedics to leave her ‘as she was’; the R.N. insisted that they transport Elsie to hospital as she had not filled out an ACD indicating otherwise. In transit to the hospital, Elsie suffered a cardiac arrest. The paramedics attempted resuscitation but were unsuccessful. On arrival to the ED, Elsie was pronounced dead. Her family determined that Elsie’s death was brought on by the stress of being moved to hospital. They decided to sue the R.N., the paramedics and the RAC facility for assault and battery.

Task:

Selection of your Case Study

Students are required to select the scenario representative of their own health professional discipline and compare and contrast their duties in the chosen scenario to the duties of different health care professionals. If students are studying in a course that is a dual degree, they can focus on their two professional specialties for this assessment task.

As there are many disciplines undertaking the unit, you should pick the scenario that will represent a moral dilemma in your discipline. The scenarios are mainly generic and if you look at them holistically, they will demonstrate a multidisciplinary perspective. Think about how you would be involved in any given scenario.

• Determine the stakeholders including two health care professionals in the case scenario;

This refers to the people who are affected by the ethical dilemma in the chosen scenario, including you in your discipline area and a selected other health care professional that would be affected.

2. Differentiate the ethical and legal conflicts and explain them from the following perspectives:
3. The dignity and rights of all stakeholders in this case

This will be assessed on the content you have learned in the classroom with regards to ethical theories, and health care and human rights charters.

• The principles and virtues of health care ethics that inform professional practice

This is self-explanatory. It is expected that you make references to specific ethical principles in health care ethics and discuss how they are relevant in your chosen scenario and possible how they conflict with each other.

• The relevant codes of ethics and/or codes of professional conduct

This refers to your codes of professional conduct and what parts are particularly relevant in your chosen scenario and how they will guide your ethical practice.

• Propose a legally and ethically defensible resolution to these conflicts

This point will look at how you bring all the above to propose a resolution to the identified ethical dilemma. It is expected that each student will propose different solutions as the theories; principles and codes of professional conduct are so diverse.

ETHICAL DILEMMA

Case Study Two

Introduction

In most cases nurses are usually faced with dilemma while undertaking their duties. The medical world is one of the most complicated field especially for physicians who must have the knowledge and wisdom to balance between their work and that of their patients who are the customers. In this case scenario Alex and the female lady who is an emergency nurse are in a dilemma. Alex’s friend whom he identifies as a magistrate is allegedly the cause of the accident because he has been found with earphones in his ears and the phones screen indicate that he was on a call during the accident. On the other hand the female lady an emergency nurse who stops to assist Alex smells alcohol. Alex is caught up with already two dilemmas. Meanwhile as he tries to contemplate the scenario the truck driver who was confused and was walking up and down has been hit dead on the road. Is Alex and the female nurse to be blamed for that death since it happened when the two had already arrived at the scene? This paper will provide detailed explanation and possible solutions for the dilemma that faces the two health nurses and the magistrate who allegedly caused the accident. First the paper will highlight the case scenario and explore the possible unethical conducts. The paper will then highlight unethical actions undertaken by the two health stakeholders. The paper will then explore and provide possible solutions and actions to be taken against the magistrate who allegedly caused the accident. The paper will also give cause of actions and solutions for the two nurses. The paper will then make recommendations and conclusions for the ethical dilemmas.

The scenario

Alex is a senior paramedic and has been called urgently to attend to a motor vehicle accident. The accident has involved a large truck and two small cars. When Alex arrives he finds that one car had two children and a woman probably their mother. Both the two children are lying unconscious in the car while the female driver is bleeding from the head after knocking her head on the steering. She is also unconscious. The other small car involved in the accident has a man whom Alex identifies as a magistrate and a very close friend. Preliminary investigations conducted by Alex reveals that he was allegedly communicating using his cell phone while driving. That is confirmed by the presence of earphones in the ears as well as the screen of the phone which reveals that he was on a phone. However, the magistrate is conscious but he reveals to Alex that he is unable to move. Meanwhile, a woman who identifies herself to Alex as an emergency physician arrives at the sight but on passing by Alex it is determined that she smells alcohol posing another ethical dilemma. Before the two can settle down and begin their emergency services the truck driver who was roaming around seemingly very confused by the scenario is hit dead by a speeding vehicle. All the physicians head were screech of brakes before seeing a lifeless body on the road.

The two nurses are encountering an ethical dilemma. One of the account of the dilemma involves the female nurse who is the emergency physician. She coincidentally stops at the scene of the accident but she is smelling alcohol. She has definitely broken the traffic rules that warns against driving while drunk. The second account is that she is also willing to attend to the accident while drunk which is against the code of ethics for physicians and nurses. The third account is how comes the track driver who was alive when they arrived is now hit dead behind her back. Which action did she take to prevent the accident from happening? Alex is also involved in different accounts of dilemma. One of the account is whether to report to the authorities that the magistrate who allegedly caused the accident was using his phone while driving. Like the emergency nurse Alex is also in a dilemma to explain how the truck driver died despite arriving at the scene while he was alive (Gay, 2012, p. 408). What measures did Alex take to prevent the truck driver from being hit by the speeding vehicles?

The person who allegedly caused the accident is a magistrate at a local court and he is also a good family friend to Alex. However, he has committed traffic offenses by using his cellphone while driving. His actions have led to the accident that has now claimed a life and the others are yet to be confirmed. Alex is in a dilemma on whether to report that the magistrate was using his phone or not to the authorities (Redelmeier & Tibshirani, 2013).

The American Association Principles of Medical Ethics requires that nurses uphold their standards and adhere to the codes of regulations. One of the codes of principles is the duty of care. The duty of care or commonly known as beneficence aims at providing the best care for the patients (David Crundall, 2013). On arrival at the scene it was necessary that all the patients provided with first aid measures including the truck driver who is reported to have been looking confused and walking up and down. The first person who should have been accorded immediate care was the truck driver. He would have been contained by the physicians and calmed down before the physicians start attending to the rest of the injuries. That would have helped save his life. The principle of justice also applies in this case. The principle argues that nurses and physicians have the responsibility of providing fair and equal services to all patients (Brandt, 2014). It could be argued that Alex and the female physician were concentrating with the magistrate more enough than with the other patients involved in the accident hence the reason why the truck driver was later hit by a car. The reason behind this is because the magistrate is a family friend to Alex (Strayer, 2013). It was necessary that the nurses consult the truck driver and conduct the necessary physical examination. During that process it would have also been easy for the nurses to find out exactly what might have led to the accident. All patients must treated with respect all the times and there is need not to prejudice the patients especially during emergencies according to Australian Medical Board (Brian Martin, 2013).

The National Transport and Service Authority also reveal that over 50% of the accidents caused annually arise due to drivers who drive while texting. According to a research conducted in 2014 it was revealed that most of the car crash accidents affect people aged between 25-60 years old. In addition, the research also reveals that most of the people affected by the crush are the children and the elderly (Gabrielle Kratsas, 2014). Already from the scenario we can confirm that two children are lying unconsciously from the accident. The use of mobile phone like in the case of this scenario has been largely criticized and governments have been requested to barn such drivers (Hare, 1981). In this case, the code of ethics does not require any physician or a nurse to practice while intoxicated with alcohol. The code of conduct requires that doctors and physicians practice effectively by being ethical and trustworthy (Sue Baier, 213). In addition, doctors and physicians are supposed to be truthful, dependable compassionate with integrity. Patients also expect that the physicians are going to protect their confidentiality. According to the Medical Board of Australia doctors and physicians must understand that patients are different and are of different cultures and therefore they must practice while considering their patients background.

Discrimination medically is abhorred and should not be allowed based on sex, religion, race according to the anti-discrimination legislation. The two nurses must also understand that it was their duty to conduct investigations on the basis of clinical need (Brian Martin, 2013). Meanwhile while offering emergency care there is need for the nurses to ensure that their practice involves offering emergency care while taking care of their health. The code of conduct requires that doctors establish a good communication with the patients. That did not happen in this case. The two physicians did not establish contact with the truck driver and hence the reason why the driver was killed by the speeding car (Smith, 2013) . Alex has the responsibility of notifying the authority about the accident. Alex is also expected to inform the authorities that the magistrate was using his phone while driving. That will help curb such drivers and reduce road carnage in future and help save lives. On the other hand Alex has also the responsibility of ensuring that he reports the female physicians to the road safety authorities. It is expected that the female physician be charged with the offense of driving while drunk. That will also help reduce the road carnage and ensure safety in our roads. Meanwhile Alex is also supposed to report to the medical board about the drunk physician and appropriate disciplinary measures should be taken against her. That is because a physician is always on duty every time and since she is an emergency physician she is required to be prepared for duty any time (Hardin, 1990). For that reason, she must abstain from drinking alcohol since she may be required to practice her duties any time. It is also not proper to attend to patients while drunk. The drunk nurse may be in a compromising situation since most patients may lose trust on her.

The code of conduct also requires that the young people and children are given priority. The child’s interest must be considered. In this case, it was expected that the two children who were lying unconsciously in the car would be given first priority in terms of medical care. It is important to be alert to children and the physicians should have given them the first priority and call for rescue teams to come and assist them immediately. Alex seemed to adhere to the rules of the profession since when the female emergency nurse arrived he instructed her to attend to the children first. It shows that Alex was having children at his heart and was willing to give priority to children.

It may be difficult for Alex to prove to the authorities that the female nurse was drunk and was driving. It therefore means that Alex should act in urgency and inform the road and safety authorities immediately regarding the drunk female nurse so that they can have evidence and proof to charge her in a court of law. That would be the easiest way to press charges against her. It seems like a very difficult position but that is the easiest way through which Alex can help bring himself out of the dilemma (Hume, 2002, p. 552). Alex will also be forced to report to the authorities regarding the magistrate. In a quick rejoinder Alex might be forced to report immediately to the road safety and transport authority regarding the issue of the magistrate who was on a call while driving. In order to have evidence and charge the magistrate later when he recovers it is necessary for the safety authority to collect the evidence immediately in order to have proof at the court of law.

In conclusion, the medical field is faced with a lot of dilemma which requires that the nurses, and doctors to be able to balance between their duties and relationship with the other people in the profession. Alex and the female nurse are caught in a compromising situation by allowing the truck driver to be hit by a speeding car. That is because they did not offer quick medical care after the impact of the accident. They are therefore responsible for his death. Meanwhile, Alex has the responsibility of informing the authorities about the negligence shown by the magistrate and the female physicians regarding the use of the roads. Both of them are guilty for breaking traffic rules. The easiest way of solving such dilemma usually involves following the codes of ethics and principles that requires that the overall good of the largest number of people is followed.