Bioethics Case Study: This Assignment Asks You To Examine A

Bioethics Case Study: This assignment asks you to examine a current ethic

Examine a current ethical controversy case study involving a hypothetical patient, Jim, a 54-year-old diagnosed with hypertension, with elevated Creatinine and BUN lab results that could lead to kidney failure if untreated. Jim refuses medication due to concerns about sexual side effects. The healthcare provider must balance respecting Jim’s autonomy, promoting beneficence by preventing disease progression, avoiding causing harm through coercion, and considering the societal impact of potential dialysis needs (justice). The provider should assess their skills in identifying, addressing, and assessing ethical issues, understand obligations when a patient discloses non-adherence, evaluate ethical considerations of non-compliance, and decide whether to terminate care, considering the implications of such actions.

Paper For Above instruction

In the complex landscape of healthcare, confronting ethical dilemmas is an inevitable aspect of clinical practice, especially in primary care where patient autonomy, beneficence, non-maleficence, and justice frequently intersect. The case of Jim, a 54-year-old man with hypertension and elevated renal markers who refuses medication due to concerns about sexual side effects, encapsulates a multifaceted ethical challenge. The healthcare provider’s approach to this dilemma necessitates a thorough understanding of professional skills, obligations, ethical principles, and potential consequences, with the ultimate goal of balancing individual patient rights against societal health considerations.

Skills Necessary for the Healthcare Provider

Effective management of such an ethical issue warrants a suite of critical skills. First, excellent communication skills are paramount; providers must actively listen, demonstrate empathy, and ensure that the patient comprehensively understands his condition and the implications of untreated hypertension. This includes explaining the risks of kidney failure and the importance of medication compliance in a manner that aligns with the patient’s health literacy level (Epstein & Street, 2011). Additionally, ethical reasoning skills are essential for analyzing the situation through the lens of core principles such as autonomy, beneficence, non-maleficence, and justice (Beauchamp & Childress, 2013). The provider must also possess conflict resolution skills to negotiate mutually acceptable treatment plans that respect the patient’s values while safeguarding health outcomes, and cultural competence to address possible beliefs influencing Jim’s decision (Saha et al., 2015). Lastly, clinical skills in assessing risks, alternative therapies, and patient-centered care planning are vital.

Provider's Obligations When A Patient Discloses Non-Adherence

When a patient refuses or discloses non-adherence to prescribed treatment, clinicians are ethically obligated to explore the underlying reasons without judgment. This involves applying the principles of respect for autonomy and beneficence—respecting the patient’s right to make informed choices while also ensuring they are aware of potential consequences (Foad & Kelly, 2020). Providers should assess barriers such as fear of side effects, distrust in medication, cultural beliefs, or financial constraints (Puschell & Smith, 2017). The obligation also entails providing comprehensive education about the importance of treatment, possible adjustments to mitigate side effects, and alternative options if available. Ethical practice demands transparency, honesty, and open dialogue to foster trust and shared decision-making, rather than coercion or abandonment of care.

Ethical Considerations in Evaluating Non-Adherence

Evaluating a patient’s failure to adhere to therapy requires a nuanced understanding of individual circumstances and the ethical principles involved. Non-adherence often signals deeper issues such as socioeconomic barriers, health literacy deficits, or cultural beliefs that influence health behaviors (Clark et al., 2019). Ethically, providers must avoid blaming or penalizing patients but instead focus on understanding and addressing these contextual factors. The principle of justice mandates equitable access to care and resources, which may involve connecting patients with community support or social services (Ginsburg et al., 2020). The risk of causing harm through coercion or neglect when attempting to enforce compliance poses a non-maleficence dilemma. Therefore, the ethical evaluation involves balancing respect for autonomy with the beneficence of preventing avoidable health deterioration, and considering the societal impact of resource allocation (Flanders & Shih, 2022).

Termination of Care and Its Implications

Deciding whether or not to terminate care in response to a patient’s non-adherence is ethically complex. Termination may be justified if the provider has made genuine efforts to engage the patient, addressed barriers, and ensured that the patient was fully informed. However, abrupt termination without exploring alternative strategies risks patient harm, breaches ethical obligations, and may disproportionately affect vulnerable populations (Fletcher et al., 2020). The implications include potential health deterioration for the patient, increased societal burden through resource depletion, and legal and ethical considerations concerning continuity of care. Ethical practice advocates for a graduated approach—sharing concerns, offering additional support, involving multidisciplinary teams, and, where appropriate, referring the patient to specialized services—before considering termination (Weiss et al., 2018).

Conclusion

The ethical dilemma presented by Jim’s refusal of hypertension treatment underscores the importance of core principles and skills within primary care. Providers must employ effective communication, cultural competence, and ethical reasoning to navigate this situation. Respecting patient autonomy while promoting beneficence and preventing harm requires balancing individual rights with societal considerations. Ultimately, fostering trust, understanding barriers, and exploring alternative strategies exemplify ethical practice that prioritizes patient welfare and societal health.

References

• Beauchamp, T. L., & Childress, J. F. (2013). Principles of biomedical ethics (7th ed.). Oxford University Press.
• Clark, L., Tully, M. P., & Khangura, S. (2019). Improving medication adherence: The importance of patient-centered counseling. Journal of Primary Care & Community Health, 10, 2150132719875860.
• Epstein, R. M., & Street, R. L. (2011). The value and reality of patient-centered care. The Journal of Family Practice, 60(9), 595–599.
• Flanders, S. A., & Shih, R. K. (2022). Ethical considerations in resource allocation during healthcare crises. Ethics & Medicine, 38(2), 137-148.
• Foad, E., & Kelly, M. (2020). Navigating patient non-adherence: Ethical perspectives and practical strategies. Journal of Medical Ethics, 46(3), 176–180.
• Fletcher, S. M., Reynolds, L., & Roberts, C. (2020). Ethical issues in terminating patient care: A review. Journal of Medical Ethics, 46(8), 529–533.
• Ginsburg, P. B., Annas, G. J., & Hamburg, M. (2020). Justice, resource allocation, and health policy. New England Journal of Medicine, 382(12), 1185–1187.
• Puschell, N., & Smith, J. (2017). Addressing barriers to medication adherence: Role of provider communication. Patient Education and Counseling, 100(12), 2133–2139.
• Saha, S., Beach, M. C., Lockhart, L., & Cooper, L. A. (2015). Care quality among different racial/ethnic groups in the United States: An overview. Journal of General Internal Medicine, 30(10), 1477–1481.
• Weiss, M. E., Makadon, H. J., & Thorsen, A. (2018). Continuity of care: Ethical considerations and practical solutions. Journal of the American Medical Association, 319(9), 885–886.