Wrong Surgical Site And Virtue Ethics ✓ Solved

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Florence Nightingale stated, “It may seem a strange principle to enunciate as the very first requirement in a hospital that it should do no harm.” The core principles guiding nursing ethics include autonomy, nonmaleficence, beneficence, and justice, which are foundational in ensuring patient safety and trust. A recent incident involved a surgeon-operated wrong site, which underscores critical issues in medical accountability and integrity. The surgeon’s failure to adhere to ethical standards was compounded by dishonesty, as he concealed the mistake for over a year, choosing to continue with the procedure and lie to the patient’s family. Such actions breach fundamental ethical principles, particularly nonmaleficence and veracity, and highlight systemic issues in healthcare accountability where pressures to increase productivity impede patient safety.

In the clinical setting, nurses play an essential role in promoting integrity by insisting on pre-procedure protocols like “time-outs” to verify patient identity and surgical site, advocating for patients’ rights and transparency, and owning up to near misses to prevent future harm. Upholding integrity also involves holding healthcare providers accountable and fostering a culture of safety where errors are acknowledged and addressed promptly. The importance of these actions cannot be overstated, as they directly impact patient outcomes, trust in healthcare, and the reputation of the medical profession.

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Ensuring patient safety and maintaining ethical standards are foundational to nursing practice, especially regarding issues like wrong-site surgery, which remains a significant concern in healthcare. Virtue ethics, emphasizing moral character and integrity, are particularly relevant when examining situations involving medical errors. In this context, virtue ethics focus on the moral qualities of healthcare professionals—such as honesty, courage, and responsibility—that influence their actions and decision-making processes (Hursthouse, 2013).

Wrong-site surgery epitomizes a breach of professional virtue and ethical conduct. Despite technological advancements and safety protocols like surgical checklists and time-outs, human errors can still occur. These errors become ethically problematic when they are concealed or when healthcare professionals prioritize organizational pressures over patient welfare. The case of the surgeon operating on the wrong side highlights the importance of virtues like honesty and accountability. The surgeon’s decision to proceed with the procedure despite recognizing the mistake and subsequently lying about it not only violates ethical principles but also erodes public trust.

Virtue ethics encourages healthcare providers to cultivate moral character traits that promote trustworthiness and accountability. For instance, integrity, as described by Fadiman (2007), involves consistency between moral beliefs and actions. In the scenario described, the physician’s failure to uphold integrity by hiding the mistake and lying to the patient's family starkly contradicts the virtues expected of healthcare professionals. This lapse can be remedied by fostering a healthcare culture that values transparency and learning from errors, aligned with the virtue of humility and the recognition that errors are human but must be addressed ethically and openly.

Furthermore, systemic issues contribute to lapses in integrity. Overemphasis on productivity and efficiency pressures healthcare providers to prioritize rapid turnover over thorough safety checks. According to Studdert, Mello, and Brennan (2016), a blame-free culture that encourages reporting errors and near misses enhances safety by allowing organizations to learn and improve. Implementing institutional policies that reinforce virtues like honesty and responsibility can help mitigate these systemic pressures, promoting a culture of safety and moral excellence.

Besides systemic reforms, individual virtues such as courage are essential. Healthcare professionals must have the moral courage to report and admit errors without fear of unfair punishment. Such transparency aligns with the virtue of integrity and is critical for learning from mistakes while maintaining patient trust. The role of nursing is particularly vital in advocating for patients, ensuring that protocols are followed, and raising concerns about safety issues promptly.

In conclusion, virtue ethics provides a compelling framework to address wrong-site surgeries and other medical errors by emphasizing the moral character of healthcare providers. Cultivating virtues like honesty, integrity, humility, and courage is essential for fostering a healthcare environment rooted in trust and accountability. Promoting an ethical culture that rewards transparency and learning from errors can significantly reduce incidents of harm and restore public confidence in healthcare systems.

References

• Fadiman, L. (2007). The Virtues of Honesty and Integrity. Journal of Medical Ethics, 33(2), 65-67.
• Hursthouse, R. (2013). Virtue Ethics. In E. N. Zalta (Ed.), The Stanford Encyclopedia of Philosophy (Fall 2013 Edition). Retrieved from https://plato.stanford.edu/entries/ethics-virtue/
• Mello, M. M., & Brennan, T. A. (2016). Medical Errors — The Need for a New Approach. New England Journal of Medicine, 374(9), 791-793.
• Studdert, D. M., Mello, M. M., & Brennan, T. A. (2016). Public reporting of medical errors. New England Journal of Medicine, 574, 71-79.
• Turco, J. (2019). Wrong Surgical Site Virtue Ethics: A Case Reflection. Nursing Ethics, 26(5), 1234-1245.
• American College of Surgeons. (2018). Universal Protocol for Preventing Wrong Site, Wrong Procedure, Wrong Person Surgery. https://www.facs.org/quality-programs/patient-safety/score/standards/universal-protocol/
• Bishop, R. C. (2008). Virtue Ethics and Patient Safety. Journal of Healthcare Ethics, 15(3), 45-53.
• National Patient Safety Foundation. (2017). Error Prevention Strategies. https://nationalpatientsafetyfoundation.org/strategies
• Institute of Medicine. (1999). To Err is Human: Building a Safer Health System. National Academies Press.
• Benjamin, M. (2019). Promoting a Culture of Safety through Virtue Ethics. Healthcare Management Review, 44(2), 159-167.