Ethical Decision Making in Arriving at a Caring Response - Research Paper Example

? Ethical Decision Making in Arriving at a Caring Response Ethical Decision Making in Arriving at a Caring Response Introduction Today, restraints and veracity (including pharmacologic and physical measures) are other issues entangled with ethical overtones. Sometimes when money is the subject, ethics becomes the last priority. Therefore, within this ever-changing healthcare environment, clinical healthcare professionals are constantly encountering cases where they must make difficult choices in reference to their patients’ best interests. Some cases make the choices enmeshed in dilemmas tied to ethics. At times when healthcare professionals face value, systems and ethical dilemmas they rely on a tool called ethical decision-making process (Martin et al, 2003). This paper will seek to describe ethical decision-making process upon arriving at a caring response unit. The paper will put into consideration a six-step process of ethical decision making that healthcare professionals use when they arrive at a caring process at the Memorial Medical Center and especially when dealing with veracity issues. Step One: Gather the relevant information Veracity deals with trust issues of medical practitioners. The first thing a healthcare professional does upon arriving at a caring response in the Memorial Medical Center is to collect the relevant information that clarifies the ethical conflict involving the basic principles of ethical dilemma that a patient is facing. At a caring response, a nurse practitioner establishes the specific ethical conflict or question that a patient is experiencing. At Memorial Medical Center, all medical professionals involved in attending a patient at a caring response must succinctly and clearly articulate the ethical issue in question and answer all the questions that arise. Note that, before resulting to disclose any information regarding veracity issues, it is advisable for a medic to consult the family members of the patient. These decisions may be technical such as cost effectiveness analysis and principle related alternatives such as distributive justice. Following the fact that there may be some competing values and goals, ensuring procedural level of fairness becomes the best method of ensuring social acceptance of decisions and moral demonstration of public accountability. In these kinds of situations, a professional health practitioner should not disclose any information regarding the identified ethical problem as doing so is against medical ethics (Kapiriri, et al, 2009). At Memorial Medical Center, after gathering ethical related information, reporting to the relevant parties incorporates two stages. Nevertheless, note that the question at hand must have ethical ramifications just as required by the facility. First, a healthcare professional puts together prescriptive approach information that he or she then goes ahead to report to the relevant bodies. Prescriptive approach is a tool derived from theories of ethics in philosophy and presents health practitioners with an opportunity to use decision-making tools of ethics. In prescriptive approach, healthcare professional at MMC gets to exercise modes of thinking when it comes to ethical choices whereby it helps them make decisions that a “conscientious moral agent” who is a careful and upright thinker about ethical options to make. The second phase of information gathering and reporting involves descriptive approach. In this case, MMC healthcare practitioners incorporates measures included by psychological research in which it defines and describes the actual mode of making decisions ethically as opposed to how they should make a choice (Mitty and Ramsey, 2008). Step Two: Identify the Type of Ethical Problem Even after identifying the possible ethical problem, it is unethical to disclose the information to any other person apart from the required persons. In the example provided by the MMC, identifying the exact problem a patient is experiencing might result to making unethical decisions simply because, given the kind atmosphere a healthcare professional exposes himself during responsive care giving, identifying the type of ethical problem is difficult since ethics and morals are subjects of psychological response. As such, at MMC care respondents identify every affected stakeholder and its values. In this case, the hospital identifies the type of ethical problem then notifies the programs and the individuals affected. With regard to the stages that a healthcare professional undergoes upon arriving at a caring response unit, the truthfulness and confidentiality of the information gathered depends on the ethical level of a the involved medic. This shows that, if a medical practitioner at MMC ends up disclosing details of the ethical problem that a patient is suffering from, the move is deemed unethical. As such, the practitioner stands to lose his or her job-based laws passed by the hospital board. However, a healthcare professional has the will to examine contextual features of both the patient and the identified ethical problem as this assists in creating comfort, which necessitates provision of empowerment (Kapiriri, et al, 2009). A professional in the medical field should always understand that a patient’s problem should remain a secret between the doctor and the patient. This is the first step healthcare professionals at MMC resolve to take upon arriving at a caring unit. This process of making decisions assists care givers solve a number of conflicts and provide basis for effective process of solving the others. The complexity of identifying ethical problems dwells among patients’ characteristics based on complicated factors. According to the Ethical Policy Statement at MMC, identification of ethical problems examines factors like emotions, values, feelings, strengths, among other biases concerning the identical case or issue. As a result, these factors may influence a healthcare professional’s role making it impossible for him or her to respond professionally rather than personally (Mitty and Ramsey, 2008). Step Three: Understanding the Circumstances revolving around ethical conflict At this step, MMC provides extensive fact-findings that involve theories concerning healthcare professionals. These theories include Utilitarianism, Deontology, Natural law, and Multicultural ethical theories among others. Upon defining the ethical problem a patient may be suffering, there comes the need to identify factors surrounding the situation that include ethical dilemma, moral distress, and locus of authority problem. Dr. Ozar who is in charge of Organizational Ethics at MMC says that, such situations calls for imperative systems that involve rules, percepts, and principles forming special theoretical framework that facilitate general strategies a healthcare practitioner should resolve to undertake. Under deontological ethical theories, a healthcare professional deem an action as right or wrong with reference to whether it adheres to the pre-established criterion commonly referred to as imperatives. Doctors at MMC employ the language of healthcare professionals, wherein an imperative is a “must do”, an absolute or a rule which is at times a white and black issue. It is an ethic-based duty linked upon absolute truths set forth by specific philosophical schools of thought (Daniels, and Sabin, 2002). Therefore, for as far as a healthcare professional dictates these principles while on the line of duty, we can say he or she is acting ethically. As stated in the MMC ethical manual followed by practitioners when they arrive at a caring response, other ethical issues that arise during care response include resistance by a medical practitioner to treat a patient mainly due to his or her beliefs. However, code of ethics lay forward by the MMC state that, instead of focusing on an individual rightness or goodness, a medic should follow principles that seek to address the great good for a society or group as a whole. One of the countries that base their social laws under this theory include the United States of America where individual interests come second after the interests aimed at addressing a large group. MMC professional consortium asserts that rule utilitarianism enables medical practitioners to obtain experiences of an individual and how they influence a person to do great good for all while in act utilitarianism what determines whether an individual’s act is right or wrong. In this case, there exist no rules to the game as every situation comes along with different set of cases or circumstances. MMC refer to this situation as situational ethics whereby it states that, if an act or decision brings an individual goodness or happiness, it means that action or decision is ethically right or correct (Daniels, and Sabin, 2002). Step Four: Identification of the perspectives relevant to this conflict At MMC, exploration of ethical problems and ethical thinking involves application of professional codes like those of ACHE’s Code of Ethics. Dependently, the process of coming up with ethical decisions involves challenging steps that requires healthcare professional to consider exploration of practical alternatives. In order to ensure ethical decision-making process, MMC has a set of practical alternatives that incorporate strategies that minimize power differentials and at the same time optimizing on effective opportunities for ethical participation. In this vein, a caregiver must have a practical alternative available for implementation at the outset of the ethical decision making process and incorporated throughout the whole process. Such alternative practices set strategies that reflect the status of “empowerment” in which the situation might require the engagement of a society, encouragement of expression of specific ideas or views, as well as present the need to vote democratically. At the step of practical alternative in ethical decision-making process, MMC provides the aspect of “publicity” (Gibson, Martin and Singer, 2005). In exploring the practical alternatives, ethical decision-making process encourages brainstorming as well as reflecting on a variety of possible and available alternative courses of action. Thus, in any given circumstances, healthcare professionals should at least come up with three different and practical alternatives. Additionally, they should be able to explore both the limitations and strengths of these alternatives and identify options that are consistent and relevant with the policies and laws set out by the respective organization. Moreover, brainstorming and reflection of alternative practices should be in line with the organization’s mission, vision, as well as values. This means that alternative practices should consider conditions that reveal revisions and appeals of the current situation. This entails that, prior acting upon a decision; a healthcare professional should establish a mechanism for appeals and revisions on arriving at the caring response (Gibson, Martin and Singer, 2005). He or she can therefore revisit and revise the decision in light of additional or new evidence making the decision process satisfactory and ethical. Studies show that, for a healthcare professional to determine whether the decision at hand is ethical or not, he should be aware of the relevant ethical principles. There should involve open discussion regarding the dominant principles and values concerning the relevant parties. This step is necessary for further clarification of ethical matters at hand. Just as ethical investigations put across, this step requires healthcare professionals to explore the scope and nature of the identified considerations and principles of ethics relative to weight assigned to every principle. Presence of decision-making criteria paves way for establishment of priority principles that are essential for guiding through the process of making ethical decisions. In this case, nurse practitioners and physician assistants should set practical alternative questions enquiring about values and principles that most considerable to the stakeholders and relevant to the issue at hand (Mitty and Ramsey, 2008). Step Five: Completing the action After exploring the practical alternatives, a healthcare professional should focus on the most justifiable alternative that is ethical; hence resolve to implement the recommendation. This shows that, healthcare givers should document and communicate the processes and decisions employed in reaching the overall decision to the relevant groups or parties. Cognitively, physician assistants, nurse practitioners, and the overall healthcare professionals should henceforth articulate implementation of the plan. At the stage of completing the action, a healthcare practitioner determines the process followed while evaluating the attained ethical decision. Conditions involved in the process of completing an action in ethical decision-making process concerns compliance. In order to ensure satisfaction of the condition of enforcement or compliance in ethical decision-making process, there should be a means of reviewing the decision with view of ensuring that it undergoes all conditions that deems it satisfactory (Mitty and Ramsey, 2008). In spite of the fact that the directly involved parties can carry out the review of decision-making process, it is advisable to involve a party that has no direct links with the process in order to ensure validation and less biasness. In completing the action, healthcare practitioners should consider the overarching questions involved upon arriving at caring response. Doctoral research implies that a healthcare practitioner should ask him or her self whether he or she is comfortable with the decision made. This is because, some arrived at decisions may not be preferable to everyone. Nevertheless, the involved groups or individual in the process of decision-making should feel comfortable with the process and decision employed while reaching the overall decision. This indicates that, if the reached decision does not satisfy the involved individuals or groups, the decision subject to further exploration since dissatisfaction warrants discomfort prior implementation. In other words, a healthcare practitioner should ensure there is defense for a decision in case of any questions asked regarding its morality (Registered Nurses Association of Ontario, 2006). Completion of the action incorporates all the processes of ethical decision-making and sorts out the most relevant and preferable action decision for implementation. As such, crucial aspects of the decision making process such as naming the dilemma become far much congruent. Nurse practitioners are in this case subject to principles, values, and theories that outline ethical behavior. They include nonmaleficence, which entails healthcare practitioner’s duty to do no harm; beneficence that requires responsibility to act for goodness; and veracity, which is the duty to be truthful. Ethical process of making decisions considers and recommends respect for individuals making it a duty to honor responsibilities of a healthcare professional position and duty to care for patients without biasness (Mitty and Ramsey, 2008). Completion of the action is otherwise sorting the issue. It can resolve to follow a set framework that comprises of comments and rationale used for identifying the relevant and ethical decision making processes in arriving at caring response. Step Six: Evaluate the Process and Outcome There are some cases where an ethical issue such a moral distress that make professional medics fall victims of veracity issues. Such cases are but applied ethical dilemmas since medics must as well exercise their will to be truthful and stay secretive. Every decision a healthcare practitioner at Memorial Medical Center makes must have consequences, which may be either good or bad. As a result, nurses and other caregivers are always ready for risks involved in medical treatment. Making an ethical decision that has rationale and commendable outcome focuses on consequentiality philosophies that sometimes fall under teleological theories. The right decisions a healthcare practitioner should make upon arriving at a caring response focus on ethics a clinic sets up for its healthcare practitioners. This should influence typical specifications of patients and staff members thus correlate with the organization’s values and missions. After completing evaluation of the process and outcome, MMC ethical guidelines generally incorporate views and ideas set forth by patient’s friends, family, systems, staff members, and the organization as a whole, which in turn addresses circumstances where the decision might require a healthcare professional to discontinue the life of a patient (Registered Nurses Association of Ontario, 2006). All medical practitioners at MMC appeal and employ the Hippocratic Oath while making decisions upon arriving at a caring response. In simple terms, this oath is a meaningful framework that healthcare professionals pledge to uphold while treating patients at all times but relies heavily on ethical related issues (Jonsen, Seigler, and Winslade, 2002). In conclusion, application of ethical practices and theories is challenging and complicated. A huge number of healthcare professionals, particularly nurse practitioners, portray that mastering plenty of information requires more skills and technologies. However, the nature of their job forces them to encounter ethical dilemmas. With that respect, without a concrete background of understanding and knowledge, a healthcare professional might be unable to make sound decisions regarding the established ethical decisions that patients and their families require in the process of making decisions that are ethical in nature. In addition, noting that ethical dilemmas are serious and important is worthwhile. This indicates that numerous decisions concerning physiological dilemmas that nurse practitioners encounter might result to be the underlying factor in a number of physiological problems the world is experiencing today. References Daniels, N., and Sabin, J. (2002). Setting limits fairly: Can we learn to share scarce resources? Oxford: Oxford University Press. 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