Analysis of an ethical dilemma from a clinical

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analysis of an ethical dilemma from a clinical practice

Select an ethical conflict that you experienced in your own clinical practice.
Address all elements listed below in a substantive manner.
Describe the event that has ethical implications.

Use appropriate ethical terminology to define the concern(s).
Analyze the dilemma according to the decision-making model below

 Identify the problem
 State your value and ethical position related to the case
-includes discussion of theory and principles on which your position is based
 Generate alternatives for resolving the problem
 Examine and categorize the alternatives
 Predict the possible consequences for those acceptable alternatives
 Prioritize acceptable alternatives
 Develop a Plan of Action
 Evaluate: Did you do the right thing?

THIS IS THE STORY PLEASE THINK ABOUT OTHER THINGS I MIGHT BE MISSING AND ADD TO THE POSSIBLE DILEMIA THIS STORY IS A COMBINATION OF SEVERAL STORIES FOR THE PURPOSE OF ADDRESSING THE ELEMENTS OF THE ASSIGNMENT. PLEASE USE YOUR CREATATIVITY
TO FURTHER INHANCE THE FLOW OF THE ASSIGNMENT.

Step 1: Identify the problem  :
Who are people involved in the dilemma? Staff doctor, family, patient promenade members of the community and medical community
How are they related or inter-related? staff on oncology floor, Doctors on staff in hospital, family in local community
What is involved in the situation?
The wife of a well liked and prominent Doctor in our hospital is admitted with a diagnosis of endometrial cancer. The patient is 57 years old. The word spread like wildfire. The staff was talking about the fact she was going to die. Many people were looking up lab results and reading her chart. Doctors were debating at the nursing stations what the right course of treatment she should have. There was open discussion that she should not be at our hospital related to limited treatment options. The children of this family were unable to visit at the time of diagnosis because one was getting married in Canada the other was expecting his first child in Oct.. The pregnancy was high risk so it curtailed traveling. The situation started in the month of June. There are many problems that have arisen in the care and privacy of this patient. The patient is still currently a patient at our hospital. Two months have passed since the diagnosis and 5 major surgeries. The patient has now made herself a DNR. The wedding she was trying to stay alive for was yesterday. Neither the patient nor her husband were able to attend. The husband was constantly deciding different treatment plans and convincing the treating doctor to try unproven treatment. The problems are many
1. People having access to the chart
2. Public discussion about her death sentence
3. The patient was given unrealistic expectations that if she continued with grueling treatment she might be alive and able to travel to the wedding 3000miles away. Also she may live to see her grandchild
4. The patient was not being given her options. Her husband was making those decisions
5. Her children were being a water down version of their mother s condition.
After answering the above questions, identify the ethical dilemma and make a concise statement of the problem and state the conflict in values.
6. The husband is trying to be a husband, father and Doctor.
Step 2: State your values and ethical position related to the problem.

My ethical values are I do not read charts supple information discuss future outcomes of any patient with anyone that is not immediately associated with the patient s care and treatment.
I am honest with the patients about what they can expect with their diagnosis and will be honest when they ask questions
” How does this fit with your personal values?
My personal values are the same. There is a reason HIPPA is so important. People will talk, make judgments and second guess what treatment is being done
” Are they congruent or incongruent?
Congruent I THINK


Step 3: Generate alternatives for resolving the dilemma
Stop the behavior Speak up
Report the HIPPA violation to our ethics committee
Speak about concerns to patient advocates
Speak with the family (remember Doctor on staff)
Any other ideas you might have

Step 4: Examine and categorize the alternatives identify those that are consistent and inconsistent with your personal values
Examine the above alternatives or any other you can think of.