Ethical Dilemma In Healthcare Case Study 2

Ethical Dilemma In Healthcare Case Study 2ethical Dilemma In Healthc

The selected case study involves a 57-year-old man diagnosed with motor neuron disease (MND) for two years. The subsequent decision-making process demands comprehensive diagnosis, including electromyogram, muscle biopsy, and MRI, to determine the disease stage (Jaworska, 2017). Additionally, it is crucial to evaluate whether the patient has a concurrent dementia, such as frontotemporal dementia (FTD), that could impair decision-making capacity. Diagnosing dementia is vital because it impacts consent and treatment choices. If FTD is diagnosed, the patient's next of kin, typically his wife, would assume the authority to make healthcare decisions on his behalf, following legal and ethical guidelines.

Central to resolving this dilemma are the principles of beneficence and non-maleficence. These principles emphasize acting in the patient's best interest while avoiding harm (Dharmadasa et al., 2017). An assessment of the patient's home environment should also be conducted to compare the benefits and risks of remaining at home versus transitioning to hospice care, respecting the patient's preferences. This evaluation aims to maximize comfort and quality of life while minimizing potential harm. Engaging the patient and his wife in education about the disease progression and management options is essential. Patients should be informed that symptom management can enhance comfort and could potentially prolong life, fostering informed consent and shared decision-making (Smebye, Kirkevold, & Engedal, 2016).

By discussing the prognosis and treatment options collaboratively, including the possibility of palliative care, the healthcare team can empower both the patient and his wife to make decisions aligned with the patient's values and wishes. It is imperative that such conversations include both parties to encompass all perspectives and ensure ethically appropriate care tailored to the patient's unique situation. Respecting autonomy, recognizing capacity, and incorporating family input are fundamental in ethically complex cases involving neurodegenerative diseases like MND and dementia.

Paper For Above instruction

In the complex landscape of healthcare decision-making for patients with neurodegenerative diseases, ethical dilemmas often arise that challenge healthcare professionals to balance respect for autonomy with beneficence and non-maleficence. The case of a 57-year-old man diagnosed with motor neuron disease (MND) exemplifies such a dilemma, especially when compounded by potential cognitive impairment such as frontotemporal dementia (FTD). Addressing this case requires a nuanced understanding of diagnosis, capacity assessment, ethical principles, and family involvement, all aimed at ensuring that the patient's best interests are prioritized while respecting his rights.

Motor neuron disease, also known as amyotrophic lateral sclerosis (ALS), is a progressive neurodegenerative disorder characterized by the deterioration of motor neurons, leading to muscle weakness, paralysis, and ultimately respiratory failure (Dharmadasa et al., 2017). In the case of this patient, diagnostic procedures such as electromyography, muscle biopsy, and magnetic resonance imaging (MRI) are essential to confirm the diagnosis and stage of the disease (Jaworska, 2017). These tools help clinicians understand the current progression and prognosis, which are critical in planning appropriate care. Additionally, since cognitive impairment, especially FTD, can occur concurrently, a neuropsychological assessment is necessary to determine the patient's decision-making capacity (Smebye, Kirkevold, & Engedal, 2016).

The presence of FTD complicates the situation because it may impair the patient's ability to understand, appreciate, and reason about treatment options, thus affecting autonomy. If diagnosed with FTD or significant cognitive decline, legal provisions typically shift decision-making authority to designated surrogates, often the patient's spouse or legal guardian (Jaworska, 2017). Respecting the patient's autonomy involves only permitting surrogate decision-making when the patient lacks capacity, which underscores the importance of early and thorough assessment. This approach aligns with ethical guidelines emphasizing respect for persons and the importance of informed consent.

While respecting autonomy is crucial, healthcare practitioners also bear the responsibility to act beneficently—promoting the patient's well-being—and to avoid harm (Dharmadasa et al., 2017). This involves evaluating whether interventions or treatments will provide meaningful benefit without undue burden or distress. In this case, decisions about the patient's living environment—such as remaining at home or moving to a hospice—must consider the patient's safety, comfort, and preferences. An environment assessment ensures that the patient's quality of life remains the central focus of care.

Patient and family education is an integral part of the ethical management of neurodegenerative diseases. Patients and their families should understand the nature and progression of the disease, prognosis, and available supportive and palliative options. Such discussions can facilitate shared decision-making, which is ethically preferable, especially when cognitive impairment diminishes decision-making capacity (Smebye et al., 2016). It is essential that the healthcare team communicates compassionately and transparently, allowing the patient and the wife to process information adequately and make informed choices regarding treatment preferences and end-of-life care.

Involving family members, particularly the spouse, in planning and decision-making respects the relational aspect of autonomy—acknowledging that individuals often derive identity and decision-making bonds within family contexts (Jaworska, 2017). The spouse's role becomes especially pivotal in cases where the patient's capacity is compromised. Ethical healthcare provision necessitates balancing respect for patient autonomy with the recognition of familial and social dynamics that influence care decisions.

Furthermore, considering quality of life and the patient's expressed wishes, when known, guides ethical decision-making. If the patient has previously articulated preferences about treatment and care levels, these should direct current decisions. Surrogate decision-makers are advised to act in accordance with known wishes or, if unknown, in the patient's best interests, emphasizing comfort and dignity (Dharmadasa et al., 2017).

The ethical principles in this case advocate for a holistic, patient-centered approach that incorporates thorough diagnosis, capacity assessment, family involvement, and transparent communication. The healthcare team must navigate the tension between respecting autonomy and providing beneficent care, always prioritizing the patient's dignity and comfort. As neurodegenerative diseases continue to challenge clinicians, adherence to ethical frameworks and compassionate engagement remain fundamental to delivering ethically sound care.

References

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