Nurs FPX 4000 Assessment 3 Applying Ethical Principles
Student name
Capella University
FPX 4000
Professor Name
Submission Date
Applying Ethical Principles
The ethical problems that are normally experienced are when one or more ethical values find themselves facing another or intersect in a situation of healthcare decision-making. The issue of self-governance of the patients with regard to their treatment and the responsibility of the caregivers and family members to act in the best interest of the patient can be difficult to consider. It should focus on interpersonal as well as mass communication and implementation of ethically structured systems to ensure caring and principled solutions. The assessment that follows explores the possibility of ethical principles, communication technology, and ethical decision-making models in resolving a healthcare issue.
Overview of the Case Study
A case of a huge ethical-moral dilemma is presented in the case of Timothy Collins, a 16-year-old boy with an aggressive form of leukemia (Capella University, 2024). He receives chemotherapy and bone marrow transplants for two years, but becomes tired and does not want to be treated further, to go to hospice care. He would prefer to die at home and the rest of the days to be spent with his family without worrying that he will be hospitalized. His parents, who do not agree with their child, are still not hopeless and are willing to keep on with the treatment, and perhaps, in another country. This leaves the oncologist, Dr.Angela Foster Timothy, in a dilemma where she attempts to comply with the independence of Timothy, and at the same time, she cheers the despondent parents of the young boy.
The case introduces the ethical dilemma between the overall need to uphold the autonomy of the mature minor and the desire of the parent to know what is in the best interest of his son (Varkey, 2021). The results of peer-reviewed journal articles, which provide a decent idea of what ethical principles in the workplace are, support the subsequent analysis. To illustrate, the research concerning the doctrine of the mature minor reveals that the legislation is granting adolescents with adequate knowledge to make rational decisions when it comes to medical care (Weithorn, 2020). This covers the right to choose in their treatment programme or not to take one. Such a disposition is in line with the desire of Timothy to discontinue further active chemotherapy and transfer to hospice. Conversely, family-based care literature is concerned with the functions of families in decision-making and ethical considerations that should be undertaken when there is a discrepancy between the insight of the family and the patient (Lin et al., 2021). This would be in accordance with what the parents wanted to do with all the treatment options they had available to them, so that their son could make it through.
The findings are selected because they facilitate the analysis by telling about the three most important ethical principles of autonomy, beneficence, and the approach to the family when considering this problem. The hospice care has been a matter of self-determination and a desire to have a good time in the case of Timothy. His parents are kind when it comes to seeking other treatment, as they desire what is best for their son in their minds. Striking a balance between such types of usually conflicting or competing values and objectives is not an easy undertaking, and healthcare professionals such as Dr. Foster must not only empower the agency of the recipient or patient but also re-prioritize and address the needs of the parents where they feel that the agency of their son is at risk. It makes them of great consideration since they plan their care by giving them a chance to consider ethical issues not just by the patient but also by the family.
Effectiveness of Communication Approaches in the Case Study
The question of ethics in the case of Timothy greatly hinges on the communicative strategy that Dr. Foster must create with the young patient and his parents. Timothy must realize that he is not the only one with an opinion, and as such, he is to show respect when dealing with him; he knows his age and what he can do. Nevertheless, providing his parents with clear and understandable communication of the medical and ethical implications of their actions is also crucial (Noorulhuda et al., 2023). One of them is the encouragement of positive family meetings where both parents and Timothy can listen and speak out. As a mediator, Dr. Foster is able to build rapport with the family members, which will ultimately help the family to resolve this challenging circumstance without overlooking the emotions and morals of the family members.
Evidence-based explanations can provide insight into the choices of the situation, and can be helpful in generating realistic decision-making about the situation. Therefore, Foster can inform all the stakeholders that the chances of good outcomes and adverse side effects can be anticipated with the experimental treatment. The family can be assisted by counsel or the ethics committee at a given institution to work through their feelings, and you make a decision (American Medical Association, 2022). Care should be taken, particularly in identifying the bereavement of the parents and optimism as symptoms of the real disposition that arose out of the situation of their son. As much as Foster should know that their love and desperation put them in a position of vulnerability, he should also make sure that they remain true to the will of Timothy. A collaboration, and an ending that is acceptable both in the principles founded on ethical care and the family’s values.
Preferred and Avoided Approaches
The principle of advocacy and collaboration should be adopted by Dr. Foster by considering the capacity and preferences of Timothy, the beliefs of the parent, and professional knowledge. This will help him to honor the voice of the child, Timothy, and also address the emotional needs of his parents. The avoidance of paternalistic and authoritarian-oriented approaches may lead to making decisions without regard to the wants of Timothy or the value system of Davis, which will destroy confidence and lead to an increase in tension (Yao & Hao, 2023). But when the conversation turnover is encouraged, and all the parties involved in a case are absorbed into the conversation, ethical and emotionally healthy solutions can be achieved.
Ethical Decision-Making Model
The ethics decision-making model below will assist in offering a solution to these dilemmas as an ethics conflict between Timothy and his choice of autonomy and what his parent wants him to be. Moral awareness is the initial step wherein a conflict is identified, and appreciation of the conflict is achieved (Rahmani et al., 2022). Foster is the client advocate in this scenario; he makes sure that he listens to both Timothy and his parents as they want to be provided with a quality life. Timothy is interested in experimental treatments provided by Lazarus, and his parents are interested in the same. Moral judgment means a good, comprehensive judgment of the repercussions of all the possible choices. This involves the expense of the experimental care, the advantages of hospice care, and the right of the patient to make decisions on his behalf, the right of Timothy. The final, ethical action is achieving an ethical resolution, and one that will resolve all the problems.
Here, Dr. Foster might recommend the first option of hospice care as this decision would honor the patient by considering his wishes to live as much quality life as possible or receive a better quality of the remaining life. Meanwhile, since the parents anticipate it, Dr. Foster might say that this choice does not utterly disqualify the possibility of re-evaluation of the experimental treatment in case of new medical discoveries. Hence, relative justice is reinstated by recognizing the freedom of decision-making by the patient in terms of his care. Similarly, theoretically, it considers and addresses the emotional and psychological issues of the parents who appear to be realistically hopeful alongside the wishes of the patient. It is possible to have open communication with the parents of the patient and with the patient himself in the case of Timothy, and that is what Dr. Foster should do in order to make people feel significant. The positive result of the applied ethical decision-making model to this highly sensitive issue is this caring and professional reaction (Haaksman et al., 2024).
Consequences of Effective vs. Ineffective Approaches
Equity and collaboration in decision-making, including the use of a shared decision-making model, promote inclusivity and fairness, making sure that all the stakeholders feel respected and valued (National Library of Medicine, 2021). This approach supports the right to self-determination of Timothy, supports the emotional needs of his parents, and encourages open communication, which enhances trust and the relationship between the care team. The emphasis on equity and open communication reduces possible conflicts and promotes harmony among people, and contributes to the resolution of the problem based on consensus.
On the other hand, the authoritarian decision-making style or not considering the preferences of Timothy may have serious undesirable consequences. This can be a very dangerous strategy as it will instill tension, mistrust, and frustration amongst stakeholders, which may destroy the patient-physician relationship. It can also cause any unresolved ethical and emotional issues that can weaken the provision of care that is both caring and high-quality. Failure to have an effective decision-making process may lead to loss of trust and derailment of the effective working process that results in an acceptable outcome to all involved parties.
Balancing Ethical Principles in Timothy’s Case
The ethical considerations in the resolution of the dilemma in the case of Timothy are a dilemma that concerns the issues of autonomy versus the common good and care that his parents should give him (Centers for Disease Control and Prevention, 2023). Autonomy as a concept safeguards self-determination of the person and especially honors the right of Timothy to make decisions concerning his body and treatment since he is aware of what the condition is all about. Foster can still adhere to this principle and insist on his right to end aggressive treatments and turn to hospice instead of aggressive treatments to have the best quality of life with this disease. But as I make the decision, the right of beneficence will compel me to do what is in the best interest of Timothy, and this will involve a consideration of his physical, emotional, and psychological well-being. In explaining to Timothy and agreeing to his decision, Dr. Foster ensures that he treats him with respect at this most difficult time in his life.
The principle of non-maleficence could be used in order to address the needs of both the parents and the children and concentrate on the specifics of this case. This implies that no harm should be inflicted by giving unnecessary and overly invasive treatments. In this way, she was able to come up with a formula whereby Timothy would be given hospice care, but at the same time, the door would be left open to the experimental treatment in the event that all the parties involved, such as Timothy and his parents, changed their minds. This option also attempts to discover a fair one, where his rights will be safeguarded, and the expectations of his parents will be taken into consideration as well. Such a dissonance prompts arranging facilitated family conferences and attending them together by a holistic care team, including the palliative care team, so that all could work towards the same objective of understanding and empathy (Ndiok et al., 2020). This will ensure that the determination of the cases will not give unjust verdicts, since ethical principles will be used as the primary condition of the profession.
Ethical Justification for Proposed Solution
Relying on the ethical considerations, the identified plan of action has one positive aspect: it assists in making the decision about the life of Timothy. It also pays attention to the reaction to the emotions of parents on equal measure and gives them good consideration towards their emotional responses. All about autonomy is about reflecting the maturity of the subject and respect for their right to decide and, therefore, the right to an adequate quality of life. Timothy is blessed with informed decision-making on his care (Lehman, 2023). The principle of beneficence is fulfilled when an organization has a care plan that involves the removal of physical and unnecessary emotional pain. Besides, there is the principle of non-maleficence, which implies that no more harm will be caused by a cumbersome treatment. In fact, hospice care where there is a chance to resume vigorous therapies implies hope and the choice of comfortable dying, which appears to be fair since it acknowledges the interests of all the subjects involved in the process.
Conclusion
In order to resolve the case of Timothy, the principles of autonomy, benevolence, and nonmaleficence need to be balanced to come up with a solution that is fair and compassionate. When presenting the action plan, it is congruent with the maturity of Timothy and his wish to be independent, and would take into consideration the emotional needs of parents of Timothy. It also maintains the lines of communication open; this is a viable course of action that has hope in it, but with quality of life as the key point of concern. The next strategy portrays the aspect of professionalism, humanity, and ethical conduct as all the involved parties feel significant in such a sensitive time in life.
References
American Medical Association. (2022). Ethics committees in health care institutions | AMA-COE. Code-Medical-Ethics.ama-Assn.org. https://code-medical-ethics.ama-assn.org/ethics-opinions/ethics-committees-health-care-institutions
Capella University. (2024). Capella University: Online accredited degree programs. Capella.edu. https://www.capella.edu/
Centers for Disease Control and Prevention. (2023). Ethical Principles. Www.cdc.gov. https://www.cdc.gov/niosh/learning/safetyculturehc/module-5/11.html
Haaksman, M., Ham, L., Brom, L., Baars, A., Basten, J.-P. van, Ben, Hendriks, M. P., Jong, Laarhoven, van, Anne, Caroline, van, Smilde, T. J., Lia, Vliet, van, & Raijmakers, N. J. H. (2024). Open communication between patients and relatives about illness & death in advanced cancer—results of the eQuiPe Study. Supportive Care in Cancer, 32(4). https://doi.org/10.1007/s00520-024-08379-5
Lehman, D. (2023, June 9). Respecting Autonomy – Center for Practical Bioethics. Center for Practical Bioethics. https://www.practicalbioethics.org/whats-new/respecting-autonomy/
Lin, J. L., Lipstein, E. A., Wittenberg, E., Tay, D., Lundstrom, R., Lundstrom, G. L., Sediqzadah, S., & Wright, D. R. (2021). Intergenerational decision making: The role of family relationships in medical decision making. Master Data Management (MDM) Policy & Practice, 6(2). https://doi.org/10.1177/23814683211039468
Ndiok, A. E., Oyira, E., & Ncama, B. (2020). Holistic/Palliative management of patients’ health care and home situation in a depressed economy. In www.intechopen.com. IntechOpen. https://www.intechopen.com/chapters/72585
National Library of Medicine. (2021). Shared decision-making. In PubMed. National Institute for Health and Care Excellence (NICE). https://www.ncbi.nlm.nih.gov/books/NBK572428/
Noorulhuda, M., Grady, C., Wakim, P., Bernhard, T., Hae Lin Cho, & Danis, M. (2023). Communication of patients’ and family members’ ethical concerns to their healthcare providers. BioMed Central (BMC) Medical Ethics, 24(1). https://doi.org/10.1186/s12910-023-00932-x
Rahmani, P., Behshid, M., Farshad, M. S., Mousavi, S., & Tavani, F. M. (2022). Moral awareness and its relationship with moral sensitivity among Iranian nursing students: A basis for nursing ethics education. Nursing Open, 10(2). https://doi.org/10.1002/nop2.1344
Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119
Weithorn, L. A. (2020). When does a minor’s legal competence to make health care decisions matter? Pediatrics, 146 (1), 25–32. https://doi.org/10.1542/peds.2020-0818g
Yao, M., & Hao, M. (2023). Influence of paternalistic leadership on employee innovation behavior and new venture performance: The moderating role of leader humility. Sustainability, 15(7), 5897. https://doi.org/10.3390/su15075897
FAQs
1. What are ethical principles in nursing?
These include basic principles that will help one make the right decision. The ethical principles include being patient-oriented, non-maleficence, beneficence, autonomy, and justice.
2. How are ethical principles used in real situations?
Nurses utilize ethical principles during decision making. Initially, the nurses analyze the situation and comprehend what the patient wants, following which they come to a conclusion.
3. Why is it important to respect a patient’s decision?
This is important since it will create trust and highlight the significance of patients’ values. Furthermore, this ensures that the patient attains self-autonomy.
4. What problems can happen when applying ethical principles?
This problem may occur due to conflicts between the patient and the medical professional or the family members regarding treatment options.
5. How can nurses get better at making ethical decisions?
One should have more experience, guidelines, and ask questions. Discussion of certain situations is equally helpful.