Healthcare Ethics: Ethical Dilemma

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Healthcare Ethics: Ethical Dilemma

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Healthcare Ethics: Ethical Dilemma

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Discuss about the Healthcare Ethics for Ethical Dilemma.

This essay aims to discuss the ethical dilemma by selecting a case study. The case study that has been selected is case study 4. In this case scenario the stakeholders include, the Registered nurse (RN), Paramedics and the patient. All these individuals have been affected by the ethical dilemma. The essay will differentiate the legal and ethical conflicts and will provide an explanation for them with respect to the rights and dignities of the stakeholders in the given case and the virtues and principles of healthcare ethics, which inform professional practice along with the relevant codes of ethics or professional conduct. In addition, it will propose a legally as well as ethically defensible resolution to the conflicts in the case scenario.
The case scenario highlights the ethical dilemma, which has been faced by the R.N, paramedics and the patient, named Elsie Lee aged 88 years who was moved to the Residential Aged Care Facility as she faced difficulty due to severe rheumatoid arthritis and short-term memory loss along with an impaired vision. The nurse manager in the Residential aged care facility suggested that she should be provided with Advanced Care Directive (ACD). The patient agreed and was pleased that she had been given with this opportunity. She neither wanted an aggressive treatment nor did she want to be resuscitated. She developed severe chest pain on Friday night and she had an irregular pulse rate and a low BP. An ambulance was called by the R.N and the patient pleaded before the paramedics to leave her in that situation but the RN insisted that she must be transferred. In this process, the patient suffered a cardiac failure and was declared dead. The family of the patient claimed that the patient died due to the stress by being shifted to the hospital and demanded that the R.N, the RAC facility and the paramedics must be sued because of the assaulting and battering of the patient.  In this case, scenario, the dignity of patient has been hampered as before shifting her to the hospital, the staff of the hospital did not consented her and the stress of shifting to the hospital is responsible for her death. On the other hand, the hospital staff did right on their part, as their most important responsibility was to save the life of the patient, as the situation was severe. They were bound with their duties.
There are several ethical theories that can be taken into consideration with respect to the case scenario such as Deontology and virtuous theory (Tonti-Filipini, 2011). Deontology highlights that the right defines the good independently. It is a normative moral position, which reviews the ethics of an action founded on the adherence of actions to a rule or a set of rules. It stresses on the fact that an actions are more important in comparison to the consequences. It is also known as duty-based ethics. It teaches that an act is right or wrong depending on the situation and the individuals are obliged to act accordingly, despite of the good or bad consequences at the end.
In deontology, Kantian ethics states that- an action is correct, if it complies with an ethical principle or rule. The moral concrete specification of this theory states- an ethical rule is one, which is necessary for rationality. The stakeholders (R.N and the paramedics) have done right on their part, as they were obliged with their duties and that is why they did not listen to the patient. Even though the patient pleaded, in front of the paramedics but they did not listen to the patient as for them in that situation, their main concern was to save the life of the patient. This theory can be associated with the case scenario as the R.N and the paramedics took a step of shifting the patient to the hospital as they as were more concerned regarding the well-being of the patient. They made this decision irrespective of thinking about the consequences. Therefore, they did not consent the patient or her family before shifting her to the hospital. Another theory, which is relevant to the case scenario, is virtue ethics, which deemphasizes set of laws, consequences and specific acts (Townsend & Luck, 2013). It focuses on the kind individual who acts in a particular situation. Virtue ethicists have carried out a discussion regarding the definition and nature of virtues and other associated problems. According to them, a virtue is usually concurred as a character trait like customary action or developed attitude. In particular, it is a positive characteristic and the individuals who possess it are good human beings (Kerridge, Lowe & Stewart, 2013).
This section of the essay will discuss the rights and dignity of the stakeholders in the case scenario. Looking to the other side of the case scenario, the R.N and paramedics did not thought regarding the dignity of the patient, as in spite of pleading in front of the paramedics, they did not listen to her. This act hampered the dignity of the patient, which is not at all acceptable. Every healthcare professional should think regarding the dignity of the patient (Berglund, 2012). The philosophy of libertarianism establishes the right of an individual to liberty, to attain, to maintain, and exchange their assets, and think about safeguarding the individual rights. For every patient, dignity is important and is a fundamental right (Fisher, 2011). The Australian Charter of Healthcare rights illustrate the rights of patients and other individuals who use the Australian healthcare system. For making sure, that whenever and wherever healthcare is offered that it safe and is of a high quality, these rights are crucial (Grace, 2013).   
It has been recognized by the charter that the individuals receiving care and the individuals who provide care have a significant role in attaining the rights of healthcare (Catholic Health Australia, 2001). This charter allows the patients, families, care providers, consumers together with the services offering healthcare for sharing an understanding concerning the rights of individuals who receive healthcare. It assists all for working mutually towards a healthcare system, which is of a high quality and is safe. On the other hand, the nurses and the healthcare professionals possess the right for practicing in a manner, which fulfills their responsibility with respect to the society and the individuals receiving care. The healthcare professionals possess the rights of working in an environment, which permits them to act with respect to the professional standards and range of practices, which are legally authorized (Freegard, 2012).
This section of the essay will discuss regarding the virtues and principles of healthcare ethics, which inform professional practice. Beauchamp and Childress principles of healthcare ethics apply to the healthcare professionals. It includes beneficence, non-maleficence and autonomy (Gastmans, C. (2013). For the R.N, beneficence and non-meleficence can be taken in to consideration.  Beneficence is a core principle which is concerned with patient advocacy and doing good to the patients. It addresses the thought that the actions of the nurses must promote good. They should always think regarding the wellness of the patient and should do what is best for the patients. Beneficence should never be with confused with nonmaleficence (Beauchamp & Childress, 2012). However, both are closely related to each other. Non-maleficence refers to not causing harm. The healthcare professionals have to be skilled in their field for avoiding causing any injury or suffering to the patients in the healthcare settings (Grace, 2013). According to this principle, the healthcare professionals need to have compassion and they should be capable of taking positive actions for helping the patients and should have a desire of doing good. In addition, they must focus to ensure that their patients receive the quality treatment for achieving the optimal results (Kerridge, Lowe & Stewart, 2013).
In this case scenario, the R.N and the paramedics should have thought regarding the principle of beneficence and non-maleficence. In addition, they must have respected the autonomy of the patient (Grace, 2013). In clinical ethics, respect for autonomy of the patient is a fundamental guideline. It is not merely to allow the patients for making their own decisions. The healthcare professionals are obliged for creating the conditions essential for autonomous preference in other individuals. For the nurse and physicians, it is necessary to respect for the autonomy of the patients. In this case scenario, the R.N and the paramedics did not respect the autonomy of the patient and due to the stress of getting shifted to the hospital, she died.
This section of the essay will discuss the relevant code of ethics for R.N and paramedics and will describe the rights and responsibilities of the patients receiving care. The practicing nurses in the healthcare settings must practice in a skilled manner and must ensure the safety of the patients. They must practice according to the standards of the nursing profession. Their practice must be in accordance with the laws of their country in which they practice (Freegard, 2012).The must respect the self-respect, beliefs, values, ethnicity and culture of the patients receiving treatment as well as care. They must not provide the personal details of the patients to the unknown persons and must keep the information confidential. They must always provide accurate, honest and fair information with respect to the nursing care and products of healthcare (Grace, 2013).  
The must always think regarding the health and wellbeing of the patients and should always consent them before carrying out any treatment (Grace, 2013). They should always think of promoting and preserving the faith and benefit inherent in the association between the nurses and the patients receiving treatment and care. On the other hand, the members of the paramedics while performing their professional duties must be reliable, sincere and honest. They must always ensure that their actions and care exhibit respect for the patient as an individual and should take care of the patient appropriately. They must be responsible and liable for their individual decision with respect to their profession (Kerridge, Lowe & Stewart, 2013).
They should be proficient and should enhance their knowledge as well as skills in regard to their practice. They must always maintain the confidentiality of the patients and should not disclose the information to anyone except in few exceptional cases (Ozolins & Grainger, 2015). They should support, promote and participate in the activities of research involving the practices of pre-hospital care, services of technical support systems (Morrison et al., 2014).  The rights as well as responsibilities of patients include right to confidentiality, access to care, right to information, right to know the identity of the care providers, right to receive efficient communication and right to informed consent and denial. The patients should provide the complete information regarding their health and the changes in their health conditions to the healthcare professionals. They should follow the hospital rules and should be considerate regarding the rights and possessions of the other patients. The patients should follow their treatment plan and tell their concerns to the doctors or nurses (Ozolins & Grainger, 2015).
The case scenario is ethically defendable as the R.N and the Paramedics did what was required to be done in that situation. They were ethically bound with their duties and that is why, they did not consent the patient as she was not in a state of giving consent. Hence, they only thought regarding the well being of the patient. However, if one sees the other side, the R.N and paramedics went against the wish of the patient due to stress of shifting, the patient died. In future, the resolution to these conflicts concerns a proper understanding between the patient and the nursing staff. If such kind of situations arises, in which the patient cannot be consented then, in that case, the family members of the patient should be consulted first so that the nursing staff and the patients along with their families do not face ethical dilemma (Johnstone, 2016).
To conclude, the case scenario is a lesson for the nursing professionals, patients and their families. All of them should not blame each other for the ineffective care or sometimes accidental deaths of the patients receiving treatment and care. The nursing professionals should follow the code of professional conduct in their practices and the patients should always think of their roles and responsibilities while receiving care and treatment. The nursing professionals and the patients should always respect each other’s dignity and should ensure that such kind of ethical dilemmas are not faced by them in future. 
Australian Nursing and Midwifery Council (2008). Code of ethics for nurses and midwives in Australia. ACT: Australian Nursing and Midwifery Council.
Banks, S., & Gallagher, A. (2009). Ethics in professional life: Virtues for health and social care. Basingstoke: Palgrave Macmillan.
Beauchamp, T. L., & Childress, J. F. (2012). Principles of Biomedical Ethics (7th ed.). New York: Oxford University Press
Berglund, C. (2012). Ethics for health care. (4th ed.). South Melbourne: Oxford
Catholic Health Australia. (2001). Code of ethical standards for Catholic health and aged care. Retrieved from https://www.cha.org.au.
Fisher, A. (2011). Catholic bioethics for a new millennium. Cambridge: CUP.
Freegard, H. (2012). Ethical practice for health professionals. (2nd ed.). Melbourne: Cengage
Gastmans, C. (2013). Dignity-enhancing nursing care A foundational ethical framework. Nursing Ethics, 20(2), 142-149.
Grace, P. J. (2013). Nursing ethics and professional responsibility in advanced practice. Jones & Bartlett Publishers.
Johnstone, M. (2016). Bioethics : A Nursing Perspective. (6th Ed.). Chatswood, NSW: Elsevier
Kerridge, I., Lowe, M., & Stewart, C. (2013). Ethics and Law for the Health Professions (4th ed.). Sydney: The Federation Press.
Morrison, Eileen E, & Furlong, Elizabeth. (2014). Health Care Ethics: Critical Issues for the 21st Century. (3rd Ed.). Sudbury. MA: Jones and Bartlett
Occupational Therapy Australia. (2014). Code of ethics. Retrieved from Occupational Therapy Australia: https://www.otaus.com.au/sitebuilder/about/knowledge/asset/files/76/codeofethics%282014 %29.pdf
Ozolins,J.T. & Grainger, J. (Eds.). (2015). Foundation of healthcare ethics: theory to practice. Port Melbourne: Cambridge University Press
Speech Pathology Australia. (2010). Code of ethics. Retrieved from Speech Pathology Australia: https://www.speechpathologyaustralia.org.au/SPAweb/Document_Management/Public/Ethic s.aspx
Tonti-Filipini, N. (2011). About bioethics: Philosophical and theological approaches. Ballan: Connor Court Publishing.
Townsend, R., & Luck, M. (2013). Applied Paramedic Law and Ethics: Australia and New Zealand. Chatswood: Churchill Livingstone. https://www.acu.eblib.com.ezproxy1.acu.edu.au/patron/FullRecord.aspx?p=1724010

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