Ethical Case Study Assignment Paper
Ethical Case Study Assignment Paper
In their book on Principlism, Beauchamp and Childress proposed a method for guaranteeing that all clients and those under the care of others in care environments have their interests represented and cherished. They offered four bioethical principles, which have since been expanded to five with the inclusion of fidelity. Autonomy, nonmaleficence, beneficence, justice, and fidelity are the new bioethical concepts (Haswell, 2019; Melnyk & Fineout-Overholt, 2019)Ethical Case Study Assignment Paper. Autonomy refers to a client’s ability to participate in making choices that influence their management. Beneficence refers to the act of always doing what will benefit the patient. Nonmaleficence, often known as primum non nocere, refers to not causing wilful injury to the patient. Justice entails treating all patients equally and without active discrimination. Finally, fidelity sets out the ethical requirement that the healthcare staff be straightforward and honest. This paper is about an ethical situation in a clinical setting representing what would be seen as an ethical dilemma.
ORDER A PLAGIARISM-FREE PAPER HERE
The Chosen Scenario and the Facts about the Case in the “Missing Needle Protector”
The ethical scenario chosen in this case is that referred to as “The Missing Needle Protector” (Capella University, n.d.). It is set in a hospital in which Mr E.L. Straight is the Director of Clinical Services. At the same hospital, there is a long serving surgeon by the name of Dr. Cutrite who does full scale operations but has lately been showing worrying signs of incompetence. This is by Mr Straight’s own admission. Despite his physical and mental incapacities lately, Dr Cutrite has been allowed to still perform sensitive major procedures. Mr Straight admits that the surgeon by virtue of having worked at Hopewell hospital “for longer than anyone can remember” was well connected and politically very influential in the organization. It is for this reason that he “didn’t relish crossing swords with Cutrite”Ethical Case Study Assignment Paper.
Concerning the matter of the missing needle protector from a syringe used during a major operation, it would appear that Dr Cutrite left it in the abdomen of a patient that he closed without confirming first with the nurse carrying out instrument count as a “time-out” component. The patient’s name was Mrs. Jameson and she had undergone a major operation in her abdomen. The needle protector that was allegedly left in her abdomen by Dr Cutrite is said to be red-pink and the color of blood and therefore would be very difficult even to see on radiography. She had not yet complained about anything and had even been discharged to go home a few days earlier.
It is the operating room supervisor that informed Mr Straight of the possible error that they had just discovered while going through instrument pack reconciliation. She told him that they had possibly left a needle protector belonging to a disposable syringe inside the belly of Mrs Jameson. When asked, the scrub nurse that was assisting Dr Cutrite during the procedure admitted to seeing the syringe but did not give much thought to the protective sheath when the final instrument count was done at the end of the procedure.
Three Components of the Ethical Decision Making Model
The above case will now be looked at through the ethical decision making model comprising of the three steps of moral awareness, moral judgment, and ethical behavior or moral action (Lind & Wakenhut, 2016)Ethical Case Study Assignment Paper.
Moral Awareness
This stage has been described as the “I feel” stage and it is the stage in which one feels strongly that there is a moral issue in the situation. It is in this stage that one may start feeling disgusted about what has just happened (Lind & Wakenhut, 2016). Specifically, one asks themselves whether something is wrong, whether a moral principle has been violated, whether there are competing values at work, or whether the profession may lose respect and dignity from the actions of individuals.
At this first stage, one must also feel the proximity they can relate with to those that are affected by the situation and how this influences their moral awareness. Crucially, one must ask themselves if other colleagues in the profession would also detect a moral issue in the situation. Then they need to ask themselves if that will affect their moral awareness in any way. In the above case, it clear that it is the operating room supervisor that has the highest level of moral awareness of all. She discovers what had happened and approaches Mr Straight who is the Director of Clinical Services. Surprisingly, he asks that the patient (Mrs. Jameson be taken back to surgery and not told the exact reason why Ethical Case Study Assignment Paper.
This breaches the bioethical principles of autonomy (informed consent), nonmaleficence and fidelity or honesty (Haswell, 2019; OHRP, 2018; Shah et al., 2021). This lack of ethical or moral awareness of Mr Straight is shared by Dr Cutrite who is the surgeon that left the needle protector in the abdomen of Mrs Jameson; and the Chief of Surgery who appears helpless and does nothing to protect the patient. Mr Straight fears Dr Cutrite and says that he “didn’t relish crossing swords with Cutrite”. Dr Cutrite on the other hand nonchalantly lies that the plastic needle protector was not going to hurt the patient but probably only give her “a little discomfort Ethical Case Study Assignment Paper.”
Moral Judgment
The moral judgment stage is the second stage and is often referred to as the “I ask” stage. This is where one comes up with and assesses the potential choices and what possible outcomes could arise from them. At this stage, every possible solution must be critically assessed before any judgment is made (Lind & Wakenhut, 2016). Some of the questions here are whether the decision taken by the people in authority (Mr Straight, Dr Cutrite, and the Chief of Surgery) was just and fair. In the above case the answer would be negative since they took the matter lightly and even wanted to return the patient to surgery without revealing to her the true reason for that. The other question here would be whether the decision and behavior of those concerned reflect the organizational culture and principles of the hospital in question.
Hospitals operate under strict regulations and policies and therefore it would beat logic to assume that the hospital’s policies condone the kind of moral and ethical breaches that the above three were engaging in. Last but not least, one must ask whether the decision of the three above to not tell the patient the truth and possibly take her back to theatre without informed consent violates the Hippocratic Oath taken by Dr Cutrite. Indeed, it goes without question that it does. The best solution after critical assessment in the above case would have been to recall the patient to the hospital as soon as possible and explain t her truthfully what happened. a formal apology should be offered and the patient asked to give consent for the plastic needle protector to be removed. This “never event” should also be reported to the regulatory bodies such as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the National Committee for Quality Assurance or NCQA Ethical Case Study Assignment Paper.
Ethical Behavior
This is the “I think I will” and “I act” stage and involves the professional (in this case the operating room supervisor) deciding on her intention to act. It is at this stage that she will decide on what to do and exactly how she would act (Lind & Wakenhut, 2016). This is keeping in mind that the patient had already been discharged and went home without knowing what happened. At this point, it is accepted also that deciding not to act may also be a valid decision. The operating room supervisor should thus think of what they should do and how they intend to act on their decision. Moral courage dictates that she should take the correct and ethical action and inform the patient of what happened. She can also alert the JCAHO and the NCQA privately to protect other patients in future.
Effectiveness of the Communication
Judging from the above engagement among the professionals involved in the above case, it is clear that effective communication is lacking at the above workplace. This is why the Chief of Surgery was not even aware of what had happened until the operating room supervisor approached them all including Dr Cutrite himself and the Director of Clinical Services Mr Straight. The staff communicated ineffectively all the time because they admitted to fearing to correct the long-serving but inept surgeon Dr Cutrite. Under the above circumstances, the organization’s laid down protocols and procedures for sentinel events should be followed to the letter. This was not done. Using effective communication helps in solving ethical dilemmas as per protocol. Not doing so leads to disorganization and harm to the patient as seen in this case Ethical Case Study Assignment Paper.
The lessons the above case provides are that professionalism should be maintained at all times and that there should be no compromise when it comes to morality and ethics in healthcare. In the above case, the staff responsible for the patient’s safety compromised their obligations by fearing to confront Dr Cutrite just because he was “politically very powerful”. The proposed solution will foster professional collaboration in that the institutions concerned will take action against Dr Cutrite and may even revoke his licensure. This will serve as an example and make the others collaborate more effectively as professionals for the benefit of the patients.
Conclusion
The bioethical principles of autonomy, beneficence, nonmaleficence, justice, and fidelity are there to help safeguard the safety and ethical treatment of patients. In the above case, it can be seen how healthcare professionals may violate these and put the patient’s health and life at risk. When faced with such ethical dilemmas, the ethical decision making model comprising of the three steps of moral awareness, moral judgment, and ethical behavior come in handy.
References
Capella University (n.d.). Incident 9: The missing needle protector. https://www.capella.edu/
Haswell, N. (2019). The four ethical principles and their application in aesthetic practice. Journal of Aesthetic Nursing, 8(4), 177-179. https://doi.org/10.12968/joan.2019.8.4.177
Lind, G., & Wakenhut, R. (2016). Testing for moral judgment competence. In Lind, G., Hartmann, H.A., & Wakenhut, R. (Eds). Moral judgments and social education (pp. 9-12). Routledge.
Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice, 4th ed. Wolters Kluwer.
ORDER NOW
Office for Human Research Protections [OHRP] (January 15, 2018). The Belmont Report: Ethical principles and guidelines for the protection of human subjects of research. https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/read-the-belmont-report/index.html
Shah, P., Thornton, I., Turrin, D., & Hipskind, J.E. (June 14, 2021). Informed consent. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK430827/#:~:text=Valid%20informed%20consent%20for%20research,study%20and%20its%20potential%20risks Ethical Case Study Assignment Paper