Question

A. Present and discuss a case-study illustrating an ethical dilemma in healthcare that you have encountered in your own experience or one of current relevance. What are the ethical theories best suited to address the case. How would you solve it? Explain.

Answer 1

A situation of ethical dilemma in Health care

Dilemma is a circumstance in which a choice is made between two or more alternatives that seem equally undesirable. Ethical dilemma is a decision making problem arising out of a situational conflict that deals with ethical principles.

An example of an Ethical dilemma:

Mr. J.J 25 years old is presented to the Emergency department with an open wounds on the left leg and hand due to a motor vehicle accident, after the emergency dressing procedure he is shifted to the trauma ward . His HIV status is positive and he got the infection from his ga*y friend , but he didn't reveal to his family , which consists of his younger sister and the father. As he is uninsured , he requested the discharge and told that his sister will do the necessary wound dressing changes .

I was caring for him and responsibile for the discharge teaching and he requested that not to reveal his HIV positive status to his family, as they are Orthodox Christian family and the father will be in great sorrow. As a nurse I was caught in an Ethical dilemma, whether to tell his family about HIV status as his sister is going to do wound care for him in his home. If I didn't tell his sister is in risk of HIV infection as she is going to handle  the wounds with bear hand.  if I tell I may break the Ethical principle ' Confidentiality' .

Ethical theories involved:

Ethical theory best suited to this scenario is Ethical principles of health care / medical / nursing. The Ethical principle 'Non maleficence ' recommends the health professional , do ' No harm ' to the patient or family members. Another principle ' Beneficience' ask for ' Do good' . As a responsible nurse I was not supposed to break the ethical principle of ' Confidentiality ' .

I solved the situation after consulting with senior in - charge . I explained Mr. JJ about the risk that his sister is going to involve when she do the wound dressing , as he is an HIV positive. If she knows it she can take appropriate precautions to prevent the contact with the Blood and body fluids. Her age is 22 and she is a major person. At last he agreed to tell his sister, with his permission, the physician revealed his HIV status to his sister and the counselling provided for her, and she agreed to take the necessary precautions like wearing gloves etc to prevent the direct contact with blood and body fluids. She was a mature woman , she comforted her brother and told that she is not going to reveal to father about his HIV status. Mr. JJ was happy that he got an understanding sister.