Question

In healthcare, issues involving patient care can be complex and the 'right' answer to a problem may either be difficult to discern or may simply be the 'least bad' choice of possible alternatives. For this assignment, you will identify and present an ethical dilemma. You will conduct research and present both sides of the issue in a point/counterpoint format to demonstrate that both sides of some ethical issues can be defended based on ethical theories or principles.

1. Identify an area in healthcare management that presents an ethical dilemmas.

2. Research perspectives on the dilemma identified that is informed consent(explain research)

3. Provide a counter-point argument; explain the conflicting perspectives on the identified dilemmas.According to patient perspective and healtcare worker perspective with different headings.

4. Once you have completed the point/counter-point, determine which ethical theory or principle is the best ethical choice for the dilemma. Defend your answer with supporting evidence, relevance of understanding your personal values framework, and sound logic.

Answer 1

Healthcare based on ethical standards is a necessity for quality healthcare delivery. Medical ethics is the field of ethics that deals with moral decision making in healthcare. Medical ethics is based on the four basic principles of autonomy, justice, beneficence, and non-maleficence. Healthcare providers depend on these principles for the identification of the ethical dilemmas and resolve them. One of the areas in healthcare management that presents an ethical dilemma is a DNR order (Do-Not-Resuscitate). This is written by a physician and is an instruction to healthcare providers that they should not do cardiopulmonary resuscitation if the patient’s breathing stops or if the patient’s heartbeat stops. It doesn’t include instructions for other treatments and it can be allowed only after a physician discusses with the patient and gets informed consent.

There are many research perspectives about this ethical dilemma. Studies have been conducted regarding the validity of this statement if the patient doesn’t want the DNR order to be executed at the last moment and is incapacitated to inform the doctor. Ethical concerns can pop up when the status of the patient while choosing DNR is not known. How far a DNR order is acceptable in a patient-centered care still needs an answer. This is a counter-point argument against those supporting execution of a DNR order for an incapacitated patient. There are several conflicting perspectives on this ethical dilemma from the patient’s perspective and the healthcare worker’s perspective.

DNR order dilemma from the healthcare worker’s perspective: Many healthcare workers consider that they need to honor and execute the DNR order whether the patient is incapacitated or not as it is against the principle of beneficence. Others consider it as a threat to the principle of non-maleficence as it could sometimes be against the best interest of an incapacitated patient.

DNR order dilemma from the patient’s perspective: While opting for a DNR order, the only thing the patient is concerned about is autonomy, i.e., he has the right to choose what is good for him. Often this response has resulted in confusion for both the family members as well as the physician whether to execute it or not when the patient is incapacitated. There are others who don’t want to opt for a DNR order, as they think it wouldn’t be wise to foresee the conditions under which it will be executed.

Non-maleficence or ‘do no harm’ is the ethical theory or principle that is the best ethical choice for this dilemma. The physician’s guiding maxim, ‘first, do no harm’ gives peace of mind to the physician as it promotes acting in the best interest of the patient. The physician can be free without any guilty feeling of doing something against the best interest of the patient of an incapacitated patient. Since it is in the best interest of the patient and the physician, the theory of non-maleficence is the best choice in this ethical dilemma.