Case Study: Identify An Actual Ethical Case At A Hospital

Case Study: Identify An Actual Ethical Case At A Hospital Which Inclu

Case study a. Identify an actual ethical case at a hospital which includes ethical considerations. The case may involve nurses, doctors, medical technicians, CEOs etc. Try to choose an issue you're already interested in, or something based on a personal experience. It will make this project more fun to do.

The choice must NOT be something we already used for a class case study in class. b. Identify the ethical issue posed by the case, and collect background information on this issue from library sources and interviews with experts. You'll need to explain: (THREE PAGES) · how the issue has been handled by philosophers in the past; · legal considerations; · professional considerations; · opinions of experts in the field. Basically, tell me everything the world knows about the ethical issue raised by your sample case. c. Complete the ethics worksheet, decide how you would, or would have, handled the case. (One page) Length: Using the ethics worksheet as an outline, description of the case should be at least one page. Research on the case should total at least three pages, and a good 4 sources, books and articles included--not only web sites! Your paper should be set up using the ethics worksheet questions, with each question number indicated. Objectives: To recognize an ethical issue based on an actual situation; to understand how ethics philosophers and writers have considered your chosen issue; to critically analyze a case, acknowleding ambiguities. At the end of your work, you'll be the expert on this issue, so I expect to read in your work a lot that I don't know already.

Paper For Above instruction

Introduction

Ethical decision-making within hospital settings often involves complex dilemmas that require careful analysis of multiple factors. This paper explores an actual ethical case involving a life-and-death decision at a hospital, focusing on the ethical considerations, legal and professional contexts, and expert opinions. The chosen case revolves around a terminally ill patient whose family wishes to pursue aggressive treatment despite medical advice to prioritize comfort care. This scenario exemplifies the tension between respecting patient autonomy and adhering to medical beneficence, and highlights the importance of ethical discretion in healthcare practice.

Ethical Issue Identification

The core ethical issue in this case concerns the patient's right to autonomy versus the healthcare team’s duty of beneficence. Specifically, the family’s desire to continue aggressive interventions conflicts with medical assessments that such measures may only prolong suffering without meaningful benefit. This situation also raises questions about informed consent, the allocation of hospital resources, and cultural values surrounding end-of-life care.

Background and Historical Ethical Perspectives

Throughout history, philosophers such as Immanuel Kant and John Stuart Mill have offered grounded perspectives on autonomy and beneficence. Kantian ethics emphasize respecting persons as ends in themselves, implying that patient autonomy should be paramount (Kant, 1785). Conversely, Mill’s utilitarianism advocates for actions that maximize overall well-being, which may justify limiting treatment when harm outweighs benefit (Mill, 1861). These contrasting views inform current debates in medical ethics.

Legal Considerations

Legally, patient autonomy is protected under the principle of informed consent, codified in various laws and regulations such as the Patient Self-Determination Act (1990). Hospitals are obligated to honor advance directives and respect patient wishes, provided they are informed and competent. Courts have upheld patients’ rights to refuse life-sustaining treatment in landmark cases like Cruzan v. Missouri (1990). However, dilemmas arise when family members insist on treatment that conflicts with medical advice, challenging healthcare providers' legal duties.

Professional Considerations

Professional guidelines from organizations such as the American Medical Association (AMA) and the American Nurses Association (ANA) emphasize respecting patient autonomy, providing truthful information, and practicing cultural sensitivity. Physicians and nurses are expected to balance ethical principles with legal standards, prioritizing beneficence and non-maleficence while maintaining transparency with families. The ANA Code of Ethics explicitly states the obligation to advocate for the patient's wishes and well-being.

Expert Opinions

Experts in palliative care and bioethics advocate for open dialogue among healthcare teams, patients, and families to navigate conflicts. Dr. Susan Block (2016), a renowned bioethicist, emphasizes the importance of respecting cultural and spiritual values while providing honest information to facilitate informed decision-making. Some scholars argue that advance care planning and early ethical consultations can reduce conflicts at critical junctures (Detering et al., 2010).

Analysis Using the Ethics Worksheet

1. Ethical issue/problem: Should the healthcare team honor the family’s desire to pursue aggressive treatment for a terminal patient against medical advice emphasizing comfort care?

2. Most impactful facts: The patient’s prognosis, the family’s wishes, previous directives, and the medical assessment of benefits versus harms.

3. External/internal factors: Cultural values, religious beliefs, legal mandates, hospital policies, economic considerations regarding resource allocation.

4. Claimants: The patient, family members, healthcare providers, and the hospital administration. Obligations include respecting the patient’s rights, honest communication, and adherence to professional standards.

5. Potential harm: Prolonging suffering, diminishing quality of life, potential legal conflicts, resource misuse, emotional distress for family members.

6. Rules, principles, codes: Legal statutes protecting autonomy (e.g., advance directives), hospital policies on end-of-life care, professional ethical codes emphasizing beneficence and truth-telling.

7. Ethical principles: Respect for autonomy, beneficence, non-maleficence, justice.

8. Ethical theories: Utilitarianism may support withholding aggressive treatment if it results in less suffering; Kantian ethics would emphasize respecting the patient’s autonomous choices; virtue ethics would highlight compassion and moral integrity.

9. Course of action: Facilitate multidisciplinary ethical consultation, respect the legally documented wishes of the patient if available, and endeavor to mediate differences through open communication.

10. Defense of decision: Prioritizing the patient’s previously expressed wishes and the medical team’s professional judgment aligns with ethical principles and legal standards, minimizing harm and respecting autonomy while promoting beneficence.

Conclusion

In complex hospital ethical cases, integrating philosophical principles, legal frameworks, and expert opinions is essential for balanced decision-making. This case underscores the importance of early advance care planning and ethical consultation to navigate conflicts effectively, honoring patient autonomy while ensuring compassionate care. As healthcare evolves, continued emphasis on ethical education and shared decision-making remains crucial to ethically sound practice.

References

• Detering, Kemp, et al. (2010). "The impact of advance care planning on end of life care in elderly patients: Randomized controlled trial." BMJ, 340, c1345.
• Kant, I. (1785). Grounding for the Metaphysics of Morals.
• Mill, J. S. (1861). Utilitarianism.
• Patient Self-Determination Act (1990). Public Law 101-508.
• American Medical Association. (2020). "Code of Medical Ethics." AMA.
• American Nurses Association. (2015). "Code of Ethics for Nurses with Interpretive Statements." ANA.
• Block, S. (2016). "Ethical Dilemmas in End-of-Life Care." Journal of Palliative Medicine, 19(2), 97-99.
• Cruzan v. Missouri, 497 U.S. 261 (1990).
• Beauchamp, T. L., & Childress, J. F. (2013). Principles of Biomedical Ethics. Oxford University Press.
• Sulmasy, D. P., & Sugarman, J. (2010). "The Many Quests for Peace in End-of-Life Decision-Making." Annals of Internal Medicine, 152(4), 274-280.