A case study of an Ethical Dilemma

Ethical Case Study Paper

Introduction

Typically, ethical dilemmas manifest when patients and health professionals contrast in opinions and understanding of what defines right or wrong nursing practice. Nurses often encounter numerous ethical impasses in their routine ethical practice. Thus, as nurse professionals, we are charged with a vita, obligation to analyze and scrutinize any occurring moral issue. Any ethical decision to be made by nurses should be based on the underlying ethical principles that defend the critical interests of both patients and care practitioners. A significant ethical dilemma case will be analyzed in an instance of clinical experience in ICU and the underlying moral principles that apply to the situation.

A case study of an Ethical Dilemma

I remember vividly the ethical dilemma I faced while treating a 78-year old female at her home. The older woman was suffering from a stroke that had affected her right side of the body. She was admitted under home-based care upon running short of her financial resources and Medicare allowable days at on the skilled nursing facility. She unable to walk on her own, and hence she was assisted with a wheelchair. A month after she was placed under home care services, she was stressed and became more concerned about her situation. Through the help of her family members and friends, she could visit me at the rate of 4 to 6 hours a day. At this point, her husband developed massive myocardial infarction, which tremendously worsened her situation. This made her experience difficulties, particularly maintaining her appointments routine, among other home health provisions with me. This became an ethical concern because it acted against the Medicare guidelines and principles. The Medicare principles assert that for a patient to be subjected to home care services based on the Part-A Insurance Plan, he or she must submit to specific homebound standards. Center for Medicare and Medicaid Services (CMS) outlines homebound norms as the existence of normal incapability to leave home, and thus exiting home would necessitate a considerable as well as taxing determination. There must be a need for homebound, and the absences from home care are irregular, and the period should be concise.

Why the Scenario is an Ethical Dilemma

Offering sound client care and averting harm is a keystone of ethical adherence. Health professionals desire to do the right thing, but the criteria to guide them into adhering to the correct standards of health care practices is unclear. Each situation that physicians and nurses face is unique and ethical impasses are bound to happen in cases when a health facility constitute polices that can handle such extreme circumstances. The case, as mentioned above scenario, provides an unethical dilemma in the sense that the organization’s stipulations about the home care services are clear. However, the 78-year older woman could be placed at homebound care because of her physical incapacitation.

Notwithstanding, her routine absences mismatched the requirements and prerequisites of Medicare coverage. Besides, the ethical dilemma is provided because of the incapability of the coverage strategies to precisely quantify the terms of short-time span and infrequent hence rendering it for additional elucidations. The patient anticipations and what could be projected as her right to receive health intervention at home was influenced by the medical prerequisites which are wholly consolidated within the consumer rights. The moral obligation to offer responses as well as my beliefs and responsibilities toward her welfare conflicted with the facility procedures when regulations that determine processes for services are put into account.

Best Practices

Ethical dilemmas are predominant in the contemporary healthcare environment. However, healthcare organizations are striving much to address such dynamic healthcare impasses. Upon occurrence, the ethical dilemma causes moral distress not only to the care providers but also threatens the life and health of the patient. Best practices need to be adopted to locate solutions for such ethical situations to avert health complications, lawsuit, moral distress, which may adversely affect patient care.

One of the first best practices to address ethical extremes is to support the treatment codes of ethics. As outlined by the ANA codes of ethics, all healthcare providers should be accustomed to the nursing codes of ethics and adopt them in their daily practice. Organizations should, however, describe such codes of ethics in the job description before hiring a health practitioner. This provides an excellent opportunity for the nurses to handle ethical issues to use them as a guide.

Establishing open communication kind in an organization where nurses can openly and confidently engage other critical stakeholders in health matters is vital. This offers a platform for nurses to raise specific enthralling ethical concerns and empowers them to tackle such concerns appropriately and effectively. It is important to note that ethical issues are dynamic and sophisticated, and each party contributes their opinions, values, and experiences to the moral situation. In the current setting, every nurse desire to achieve the best by considering the concerns of the patients since the ethical position is complicated the open engagement with other people to the issue plays a significant role in establishing intelligent solutions to the moral concern.

Options for Making an Ethical Decision to Address the Dilemma

Several fundamental principles are underscoring prolific ethical practices that are key to ethical decision making in addressing ethical situations. In particular, the four principles provide potential moral reasoning to ethical dilemmas above include autonomy, beneficence, justice, and non-maleficence.

In the case of autonomy, the above client has a right to determine based on whether to receive occupational therapy services at home. This is a proper guiding principle to apply to my professional autonomy to make an informed decision on how the patient should receive the services outlined under the organization’s laws.  The nursing education courses us with substantial and robust knowledge on the rules, strategies, policies as well as legal provisions that are pertinent to decision making on where to treat patients based on the available medical variables of the client. Also, the projected and care demands of the client are put into consideration. Among the explicit guidelines, no provision warrants other variables such as financial resources, patient and relatives choices, insurance reimbursement influence such clinical decisions about where the patient should receive appropriate medical interventions.

Beneficence, on the other hand, provides an alternative way of solving ethical dilemmas. It is proper to assert that client required home-based occupational treatment services that could significantly benefit her health situation. In my expertise verdict, the client definitely could help with continuous amenities. Nevertheless, the beneficence appeared to contrast with fundamental ethical and legal provisions of healthcare service delivery. This key moral code of beneficence is crucial in a sense it promotes a healthcare service that is in the best interest of the client.

Justice implies that a patient should be subjected to equal treatment. Besides, this ethical principle provides for equitable utilization of resources. I was guided by the law of justice, where I felt a strong sense of duty to provide adequate care for the patient even though it came to my attention that the client did not certainly fulfill all the Medicare coverage procedures.

The principle of Non-maleficence is another critical approach to an ethical situation that calls for clinicians to avoid cases that would result in ineffective interventions to the client as it provides a peril that could not probably result in any substance. Since numerous medication procedures and treatment alternatives may lead to harm and advantages to the patients, this principle allows the conscience of the health professionals to guide use wisdom in making clinical reasoning and decisions that would otherwise not harm the patients but bring substantial benefit to him or her.

Analysis of the Best Ethical Outcome Based on Evidence

In my analysis, the scenario, as mentioned above, highlights an ethical battle that is regularly faced by majority home-care providers and patients. Many scholars have proposed numerous concepts that guide healthcare choices with universal health coverage to people. The scope that identifies and recognize everyday ethical dilemma among the healthcare arenas is unclear and not entirely established. Through common knowledge, a significant number of health professionals face the same moral difficulties in their practice across the world. However, due to patient enlightenment and education, there is escalated sensitivity and applicability of the patient’s rights and self-sufficiency. Clinicians among nurses should address the clinical needs and demands of their clients based on specific social, cultural, and ethical standards.

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