Applying the Moral Model - Essay Example

Applying the Moral Model Essay Introduction Patient came to ER due to motor vehicleaccident. He needed a blood transfusion to live due to hemoglobin 5.4. Patient has belief that transfusions are unacceptable. Patient did not receive the transfusion and died three hours later. There is a clash of values here. The healthcare provider gives much importance to saving or preserving life; the patient gives more importance to his belief against blood transfusion. Aside from this, there is also a moral dilemma. Since the transfusion is not administered and the patient died, the healthcare provider broke the principle of nonmaleficence or harm to the patient (Caplan & Arp, 2013); if the healthcare provider in some way forces the patient to agree to undergo transfusion, s/he has defied the principle of autonomy or the right of the patient to decide for him/herself (Treas & Wilkinson, 2013). Hence the judgment that the healthcare provider should make is whether to agree to the patient’s wishes, look for legal means to administer transfusion without the consent of the patient, or look for the most appropriate middle ground or compromise. This essay will use the MORAL model to generate several options or choices for the resolution of the moral dilemma. MORAL Model First is identifying and describing the aspects of the moral dilemma—(M) massage the dilemma. The values in conflict are respect for physical life and individual autonomy. The healthcare provider gives importance to both principles of nonmaleficence and autonomy. The healthcare provider completely understands the patient’s condition that is triggering the need for blood transfusion. However, s/he does not have sufficient time to decide because the situation was all too sudden. It seems that the patient is not aware of the full situation and does not know that it will be fatal if transfusion is not administered. Still, as stated in the core principles that healthcare professionals must take into consideration when making medical decisions with patients who refuse blood transfusions, a completely competent, fully informed adult patient is authorized to make a decision whether to agree to a medical treatment or not (Corey et al., 2014). The healthcare provider should then outline the options. The healthcare provider has to provide a summary of the emergency condition of the patient and specify some of the medical options available. First are non-blood medical options. The patient may agree to non-blood volume expanders like Dextran, Saline, Haemacel, and so on (Wilkinson & Treas, 2010). Second option is products such as albumin, recombinant products, haemophiliac preparations, immunoglobulins, and others (Wilkinson & Treas, 2010). Third option is surgery, which has to administer an uninterrupted extracorporeal circuit such as haemodilution, haemofiltration, dialysis, and heart-lung by-pass (Treas & Wilkinson, 2013). Fourth is asking the patient to fill up a ‘Refusal of Treatment’ Certificate so as to uphold maximum legal security (Rowe, 2010). However, the most important thing is the healthcare provider specifying whether a single blood transfusion will probably resolve the problem or whether sustained treatment may be needed. The patient should also fully clarify to the healthcare provider the reason for his refusal to consent for the blood transfusion and what he thinks the outcome would be if transfusion were administered. Then the healthcare provider should assess the problem and options, and must exercise fundamental moral principles. First, by refusing to accept transfusion, the patient is using his right to decide for himself or the principle of autonomy. The healthcare provider, on the other hand, describes ‘good’ as the patient getting the required blood. S/he describes ‘harm’ as the consequence for the patient without the needed blood, although s/he administers less effective method (Jindal-Snape & Hannah, 2014). The patient would describe ‘good’ as upholding his belief. Second, the healthcare provider is being faithful to the ethical codes of medicine and established, evidence-based procedure, which require blood transfusion. To the patient, his faithfulness to his belief may be more essential than dying itself. Third, the code of veracity states that the healthcare provider must not overstate the urgency of a blood transfusion, and s/he must be truthful with the patient with regard to the outcomes of the other options (Jindal-Snape & Hannah, 2014). The role of the healthcare provider is to be the patient’s advocate. S/he must communicate with the patient and his family, if possible, about their opinion of their conflicting responsibilities: the duty to protect their beliefs and the duty to safeguard physical life. It is important to guarantee that the opinion of everybody has been valued and taken into consideration. This could be as vital as the ultimate judgment that is made (Piazza, 2012). In such and other problematic situations, it is advisable to find a middle ground or the best compromise. Subsequently, the healthcare provider should act by using the selected option. If an emergency demands a quick decision, the sole legal action is to obey the decision of the competent patient, whether or not the healthcare provider regard it the most appropriate moral choice (Corey et al., 2014). Regardless of what happens, the patient’s family will require emotional guidance. If the patient decides against transfusion, the healthcare provider must stay open-minded in assisting the family, although s/he does not support the patient’s decision. The last stage requires assessment of the whole process, not only the outcome of the chosen action. The healthcare provider must ask his/herself the following questions (Wilkinson & Treas, 2010): was the process successful or did it work the way it is intended to? Was the dilemma thoroughly discussed? Were the expectations of all those involved realistic? Whatever the result the decision is, do all parties feel their opinions or perspectives were valued and taken into consideration? Did established policies and evidence-based practice guide or inform the action of the healthcare provider? Has a greater good been attained? Conclusion The healthcare provider, in evaluating the moral dilemma, decision, and outcome, should always think about his/her duty as an advocate for the patient. A completely informed, competent patient has the authority to decide for himself and choose to uphold his belief. This must be respected by the healthcare provider, especially after explaining to the patient the possible consequences of not getting the needed blood and alternative treatments to blood transfusion. Therefore, in terms of value conflict, the competent patient’s right to autonomy prevails over the healthcare provider’s duty to preserve physical life. References Caplan, A. & Arp, R. (2013). Contemporary Debates in Bioethics. New York: John Wiley & Sons. Corey, G. et al. (2014). Issues and Ethics in the Helping Professions. Mason, OH: Cengage Learning. Jindal-Snape, D. & Hannah, E. (2014). Exploring the Dynamics of Personal, Professional and Interprofessional Ethics. UK: Policy Press. Piazza, J. (2012). “If You Love Me Keep my Commandments”: Religiosity Increases Preference for Rule-Based Moral Arguments. The International Journal for the Psychology of Religion, 22(4), 285-302. Rowe, J. (2010). Information disclosure to family caregivers: Applying Thiroux’s framework. Nursing Ethics, 17(4), 435-444. Treas, L. & Wilkinson, J. (2013). Basic Nursing: Concepts, Skills, & Reasoning. New York: F.A. Davis. Wilkinson, J. & Treas, L. (2010). Fundamentals of Nursing: Theory, Concepts, and Applications. New York: F.A. Davis. Read More