ASSIGNMENT 1
trooperwarxhw3
ReportPDF1.pdf
9% SIMILARITY SCORE 4 PLAGIARISM ISSUES 32 GRAMMAR ISSUES Int ernet Source 9% Inst it ut ion 0%
Zeena John EthicalDilemma.docx
Summary 1305 Words
Running head: ETHICAL DILEMMA 1
ETHICAL DILEMMA 2
Et hical Dilemma
Et hical Dilemma
Physicians are oft en faced in et hical dilemmas in t heir line of dut y. Et hical Decision
making is needed when healt hcare professionals are required t o address a conflict ing
or uncert ain issues regarding compet ing values. As indicat ed by Holt , Sarment o, Ket t
and Goodman (2018), hysicians must consider et hical principles such as just ice,
beneficence, non-maleficence and aut onomy as well as t he et hical st andards of t heir
organizat ion and t heir profession. The case of an unconscious pat ient wit h a DNR
t at t oo present ed an et hical dilemma for t he crit ical and emergency care physicians
who were in charge of t he pat ient . These physicians were led by quest ionable
recommendat ions from t he consult ant s of et hics. The pat ient had no known ident it y,
he was t aken t o t he emergency depart ment while in a crit ical condit ion, and
unconscious. He had a “Do Not Resuscit at e” t at t oo on his ant erior chest , and even a
signat ure t hat accompanied t he t at t oo. The healt h care t eam had decided not t o
honor t he t at t oo, but t hey lat er reversed t he decision aft er consult ing t he et hics
consult ant s. It was agreed t hat t he t at t oo could be represent ing aut hent ic
preferences of t he pat ient . A case like t his raises an et hical dilemma; should t he
pat ient be resuscit at ed against t heir will as seen on t he t at t oo, or should t he healt h
at t endant s honor t he t at t oo?
For a sit uat ion t o be called an et hical dilemma, it has t o meet t hree condit ions (Holt ,
Sarment o, Ket t & Goodman, 2018). The first condit ion is in a case where an individual
or ‘agent ’ has t o decide on t he best course of act ion. These et hical dilemmas have t o
offer opt ions; t hey should not be hard or creat e uncomfort able sit uat ions which do
not have alt ernat ives. In t he case of t he DNR pat ient , t he healt h care t eam could
decide t o eit her resuscit at e t he pat ient or follow what his t at t oo said. There should
also be different courses of act ions t o choose from. In t his case, t here were t wo
Spelling mistake: hysicians physicians
Passive voice: physicians were led by
accompany: accompanied go wit h
Web Content: https://www.acepnow.com/article/do-not…
Passive voice: It was agreed that
in the case of (abou...: In the case of About
choices, t o save or not t o save t he DNR pat ient . This is a hard decision t o make for
any person involved. The last condit ion is t hat regardless of t he course of act ion
t aken, t here will be a compromise of t he et hical principles. Following t he st at ement
writ t en on t he t at t oo would see a loss of life, amidst t he chance t o save him. On t he
ot her hand, t rying t o resuscit at e t he pat ient will be against t he will expressed in t he
t at t oo, and t here is no informat ion as t o why it is writ t en not t o resuscit at e him.
In det ermining t he const it uent s of an et hical dilemma, a dist inct ion has t o be made
bet ween et hics, laws, policies, values, and morals (Holt , Sarment o, Ket t & Goodman,
2018). Et hics are t he st andards used t o det ermine what is right and what is wrong.
They rely on rat ional and logical crit eria for a decision t o be made given t hat it is a
cognit ive process (Dolgoff, Loewenberg & Harringt on, 2009). Values are t he t hings or
ideas an individual value, and t hese values are associat ed wit h feelings (Allen &
Friedman, 2010). Morals are t he codes of conduct of behavior ascribed by an individual,
used t o st rengt hen relat ionships (Dolgoff, Loewenberg & Harringt on, 2009). Laws and
agency policies are most ly used in complex cases, and t he healt h care at t endant s are
obligat ed by law t o t ake a part icular course of act ion. There is a difference bet ween
personal et hics and professional et hics and values. Values are personal and involve
feelings, and cannot be used in solving an et hical dilemma. Aft er joining a profession,
in t his case as a medical care provider, a person agrees t o follow t he st andards of
t hat profession, t oget her wit h t he code of et hics and values. In t he case of a pat ient
wit h t he DNR t at t oo, et hics and professional values have t o be given a priorit y.
There is an import ant et hical principle t hat emergency physicians have t o consider in a
dilemma such as t his. This principle st at es t hat wit hdrawing and wit hholding t he
t reat ment s t o sust ain life are seen as equivalent in t erms of et hics. Therefore, when
faced wit h a dilemma regarding t he wishes of t he pat ient , t he physicians should go
ahead wit h t he int ervent ions t o save lives. Aft er obt aining more informat ion, t he care
of t he pat ient can t hen be de-escalat ed appropriat ely according t o t heir preferences.
Also, in t he field of medicine, a physician should review ACP (advance care planning),
which has t wo primary forms (Vearrier, 2018). These forms are; Advance Direct ives
(AD) and Physician Orders For Life-Sust aining Treat ment (POLST). ADs can be
complet ed at any t ime during a person’s life t o appoint a surrogat e decider or t o
guide fut ure care. This legal document (AD) has t o be filled by t he person himself or
herself in t he presence of a wit ness. POLST forms, on t he ot her hand, are orders from
a physician for t he care of end of life t hat can be t aken t o ot her healt h care
inst it ut ions. The document s are only for t hose who are seriously ill, or people who are
nearing deat h and could assist in t he surrogat e.
The t at t oo saying “Do Not Resuscit at e” is t herefore neit her legal nor et hical enough
because of t he following reasons. First , t at t oos are not legal POLST or ADs, and it has
neit her a wit ness nor not ary. Therefore, it cannot be used as a wearable AD or t o
finish legal document at ion. The second reason is t hat t he medical providers cannot
presume informed decision making, as t here is no evidence t hat t he t at t oo shows a
clear DNR st at us underst anding of t he pat ient (Vearrier, 2018). Also, t he t at t oo has
no sufficient guiding informat ion t o decide an int ervent ion. Last ly, a lot of people,
more t han 50%, who have t at t oos regret having t hem. The above informat ion does
not , however, mean t hat t he dat a should be ignored. The AD and POLST document s
could not be available when t he healt h care at t endant s are deciding on crucial issues.
A way of communicat ing should be included in t he process of crucial decision making
(Vearrier, 2018).
In t he evaluat ion of t he merit s and challenges of a medical procedure, bioet hicist s
refer t o t he healt hcare et hics’ basic principles. For any pract ice t o be referred t o as
et hical, it has t o conform t o t he four principles including just ice, aut onomy, non-
maleficence, and aut onomy. The first principle is aut onomy; where a pat ient is
required t o make informed and un-manipulat ed act ion and int ent ion when deciding
about t heir healt hcare. A pat ient should be aware of all t he benefit s and risk of a
medical procedure and t he success likelihood. In t his case, t he pat ient was
unconscious. The pat ient did not have a relat ive and he never spoke his mind apart
from t he t at t oo. The second is just ice, where t reat ment is dist ribut ed t o all groups
equally. Healt h care provider should dist ribut e scarce resources fairly. Following t his
on the other hand (...: On the other hand But
Spelling mistake: Dolgoff Logoff
Spelling mistake: Loewenberg Rosenberg
Spelling mistake: Dolgoff Logoff
Spelling mistake: Loewenberg Rosenberg
Passive voice: attendants are obligated b...
in the case of (abou...: In the case of About
in terms of (in, for): in terms of in
Web Content: https://www.acepnow.com/article/do-not…
obtain (get): obtaining get
Spelling mistake: de-escalated deescalat ed
Spelling mistake: Vearrier Earlier
Web Content: https://www.acepnow.com/article/do-not…
Spelling mistake: ADs Ads
on the other hand (...: on the other hand but
assist, assistance (help): assist help
Spelling mistake: ADs Ads
Hyphenation p...: decision maki... decision-maki...
Spelling mistake: Vearrier Earlier
sufficient (enough): sufficient enough
in the process of: in the process of
Hyphenation p...: decision maki... decision-maki...
Spelling mistake: Vearrier Earlier
Web Content: https://web.stanford.edu/class/siw198q/w…
Spelling mistake: bioethicists bioet hics
Spelling mista...: un-manipulated manipulat ed
comma between ...: relative and relat ive, and
met hod, t he t at t oo pat ient could be revived in t he same manner as ot her emergency
cases handled in t he facilit y. The t hird concept is beneficence; it demands t he
provision of medical procedure wit h t he int ent ion of benefit t ing t he pat ient . It
demands maint enance and development of skills and knowledge, st riving for net
benefit . The last principle is non-maleficence. This et hical concept requires t hat a
procedure should not harm t he involved pat ient or ot hers. The physicians ought t o
use t he aforement ioned procedures t o guide in making a decision regarding what is
best for t he pat ient . Aut onomy st at es t hat a pat ient has t he right t o have cont rol of
his body, but since t here is no accompanying relat ives, t he pat ient could not express
himself. I would also do everyt hing possible t o keep t he pat ient alive. I would also
employ non-maleficence t o guide t he t reat ment process; t his makes t he pat ient ’s
recovery process more effect ive.
References
Allen, K. N., & Friedman, B. (2010). Affect ive learning: A t axonomy for t eaching social
work values. Journal of Social Work Values and Et hics, 7 (2). Ret rieved from
ht t p://www.socialworker.com/jswve.
Dolgoff, R., Lowenberg, F. M., & Harringt on, D. (2009). Et hical decisions for social work
pract ice (8t h Ed.). Belmont , CA: Brooks/Cole.
Holt G. E, Sarment o B., Ket t D., & Goodman K. W. (2018). An unconscious pat ient wit h
a DNR t at t oo. N Eng J Med. 2017;377:2192-2193.
Social Worker (2014) What is an et hical dilemma? Ret rieved from
ht t ps://www.socialworker.com/feat ure-art icles/et hics-
art icles/What _Is_an_Et hical_Dilemma%3F/
Vearrier L. (2018) Do Not Resuscit at e t at t oos: Are t hey valid? ACEONow. Ret rieved
from ht t ps://www.acepnow.com/art icle/do-not -resuscit at e-t at t oos-are-t hey-valid/
Spelling mistake: benefitting benefit ing
Legal jargon referri...: aforementioned t hese
accompany: accompanying go wit h
