Bioethics Case Study: Examine A Current Ethical Controversy

Bioethics Case Study: Examine a current ethical controversy case study

This assignment asks you to examine a current ethical controversy case study. The paper is informal, but should be in APA style, and does not need an abstract or cover page. With a minimum of two pages and a maximum of four pages, a reference page is needed. In-text citations should be in APA format.

The case study involves a hypothetical scenario in primary care: Jim, a 54-year-old patient diagnosed with hypertension, has elevated Creatinine and BUN levels indicating potential kidney failure if left untreated. Jim refuses medication, citing concerns that it will affect his sex life. The nurse practitioner (NP) must respect Jim’s autonomy while also ensuring beneficence by preventing disease progression. Forcing treatment may breach non-maleficence if it causes harm or violates trust, potentially leading Jim to leave care. Considering justice involves recognizing that Jim’s potential kidney failure requiring dialysis can impact resource allocation and other patients.

Paper For Above instruction

In addressing this bioethics case, it is crucial to understand the skills necessary for healthcare providers to navigate ethical dilemmas effectively. Ethical competence encompasses clinical judgment, cultural sensitivity, and clear communication skills. First, providers must have a comprehensive understanding of bioethical principles—autonomy, beneficence, non-maleficence, and justice—and the ability to apply these principles contextually. Effective listening and empathy are also vital, enabling providers to comprehend patients' values and concerns thoroughly. Ethical reasoning involves weighing conflicting principles, especially when respecting patient autonomy clashes with beneficence and non-maleficence, as seen in Jim’s refusal of medication (Beauchamp & Childress, 2013).

When a patient discloses an intent not to follow prescribed treatment, providers have multiple obligations. First, they must ensure the patient understands the medical implications of non-adherence, fostering informed decision-making. This involves providing clear, honest information about the risks and potential consequences. Providers should explore the underlying reasons for refusal—such as fears about side effects affecting sex life—and address these concerns compassionately. Additionally, the provider’s obligation includes respecting patient autonomy while attempting to mutually negotiate acceptable management strategies. It is also essential to assess whether the patient’s decision-making capacity is intact and to consider cultural, social, and psychological factors influencing the refusal (Epstein & Leong, 2018).

Evaluating a patient's failure to adhere to therapy involves detailed ethical considerations. Non-adherence may indicate misunderstandings, side effects, socioeconomic barriers, or mistrust. Ethically, providers must balance respect for autonomy with the duty to promote health and prevent harm. Respecting autonomy does not mean ignoring non-adherence; instead, providers should engage in shared decision-making to find acceptable alternatives or compromises. Ethical evaluation also involves considering distributive justice, ensuring that the patient’s choice does not unfairly burden the healthcare system or other patients who require ongoing treatment. Finally, consider that punitive or terminating care may conflict with professional ethical standards and could undermine patient trust (Simmons & colleagues, 2017).

Deciding whether to terminate care in this scenario requires careful ethical and practical consideration. Termination of care should generally be a last resort, reserved for situations where the patient’s actions threaten the health of others or significantly impair the therapeutic relationship. Ethically, discontinuing care without exploring all possible avenues could violate the principles of beneficence and justice. However, if a patient consistently refuses critical treatment despite understanding the risks, providers may need to consider ending the professional relationship to prevent harm and allocate resources fairly. Such decisions must be made with transparency, documentation, and adherence to institutional policies, always prioritizing patient safety and dignity (Roberts & colleagues, 2019).

In conclusion, handling this ethical dilemma involves a mastery of ethical principles, effective communication, cultural competence, and shared decision-making. Providers must carefully evaluate each component—respecting autonomy while promoting beneficence, non-maleficence, and justice—to arrive at a course of action that considers both individual and societal health imperatives. Engaging patients in open, empathetic dialogue and exploring their values are essential strategies for ethical healthcare delivery in complex cases like Jim’s.

References

• Beauchamp, T. L., & Childress, J. F. (2013). Principles of Biomedical Ethics (7th ed.). Oxford University Press.
• Epstein, R. M., & Leong, S. (2018). Ethical challenges in clinical practice. Journal of Medical Ethics, 44(4), 243-250.
• Roberts, L. W., et al. (2019). Clinical decision-making in biomedical ethics. Cambridge University Press.
• Simmons, L. A., et al. (2017). The ethics of non-adherence: balancing autonomy and beneficence. Ethics & Medicine, 33(2), 112-119.
• Jonsen, A. R., Siegler, M., & Winslade, W. J. (2015). Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine (8th ed.). McGraw-Hill Education.
• Gillon, R. (2015). Ethics in clinical practice. British Medical Journal, 330(7484), 539-542.
• Childress, J. F., & Faden, R. R. (2002). Phases of the ethical review process: balancing respect for persons, beneficence, and justice. Journal of Medicine and Philosophy, 27(2), 122-135.
• Nelson, C. (2019). Ethical considerations in patient adherence. Nursing Ethics, 26(3), 852-860.
• Gert, B., et al. (2020). The Definition of Ethics. Routledge.
• Andrews, L. B., et al. (2018). Facing the Ethical Challenges of Dialysis: Principles, Practicalities and Personalities. Oxford University Press.