Question:
What is the ethical dilemma here? Describe the decision-making model you selected from your readings. How would you resolve this dilemma using the model?
Answer:
Ethical Dilemma
Ethical dilemma is defined as a complex situation involving a mental conflict occurring between the moral imperatives where obeying one would make to transgress the other. Ethical dilemmas are involved for refuting the moral code or ethical systems for improving or resolving the ethical paradoxes (Shapiro & Stefkovich, 2016). In the present case study, the ethical dilemma involved is faced by the attending physician, who was requesting permission to initiate the treatment of meningitis from the parents of the child. The mother of the child did not want any medical treatment for religious reasons whereas the father insisted that immediate treatment has to be given and requested an independent consultation with another physician. This was a moment of ethical dilemma for the physician as to answer to whom, the father or the mother. The child was in a condition of degrading physical and mental health and required immediate medical treatment and under such conditions, the physician could not receive proper permission for the initiation of the treatment. Refusal of treatment by the mother of the child posed a professional dilemma on the attending physician and had a negative impact on the care provided by the clinical team to the pediatric patient. Therefore, the ethical dilemma eventually contributed to the degrading health of the child.
Decision Making Model
The process of ethical decision-making should be a collaborative process between the physician and the parents of the pediatric patient for deriving their informed consent for the treatment. The physician should not be making decisions for the child and should develop a model for thinking through the ethical dilemma for making the decision in the best interest of the child (Oshima & Emanuel, 2013). The following decision making model may be followed for getting through the ethical dilemma regarding the treatment of the child, crossing the barriers of religious reasons and independent consultation for obtaining the informed consent from the parents.
Resolving the Dilemma
The ethical dilemma in the present case can be resolved using the decision making a model where the different steps of the model can eventually lead to a decision that will be in the best interest of the child. The first step of the model involves the identification of the dilemma where the physician is in a state of professional dilemma regarding the procurement of the informed consent of treatment from the parents of the child (Foye et al., 2015). Both the parents have their individual viewpoint regarding the treatment and it is eventually hampering the health of the child. Therefore, this ethical and professional dilemma can only be addressed by consulting with the parents and it should begin with keeping the health of the child as the center point.
The second step involves the identification of the potential issues involved in the process of decision-making. This step will involve the evaluation of the welfare, rights and responsibilities of the people involved in the treatment, including the parents and the physician. The actions that can cause least harm to the health of the child have to be identified and the decision taken should safeguard the welfare of the child (Hunink et al., 2014). The potential hazards involved in the treatment process should be discussed with the parents and should be encouraged to participate them in determining and identifying the potential ethical issues.
The third step is the reviewing the relevant ethical codes of treatment and therapy obtaining the guidance on the present ethical dilemma regarding the treatment of the child, after consulting the professional codes. The physician should evaluate his values in accordance with the specific ethical codes and should determine that the codes should be in consistent with the applicable laws of the state (Oshima Lee & Emanuel, 2013).
The fourth step is understanding of the applicable laws and regulations regarding the present situation of treatment of meningitis and the related informed consent for treatment. The specific federal and state laws have to be identified along with the policies of the hospital regarding the claims of the biological and custodial parents.
Fifth step involves obtaining consultation from the peers who have the knowledge regarding the ethical issues of treatment (McLennon et al., 2013). Consulting with a supervisor or colleague can give a broader idea of the situation from various perspectives.
Sixth step will involve the brainstorming for the probable and possible courses of action and analyze the ethical obligations. Discussion with the parents has to be documented for following a systematic method (Larcher et al., 2015)
The seventh step will thoroughly evaluate the potential consequences of the action plans before implementing one. Ethical principles have to be included in the framework of the plan.
The eighth step will involve the finalizing the decision regarding the course of action from the gathered information. Feedback can be taken from a supervisor or colleague regarding the formulation of the plan and the input of the parents can be solicited (Doherty & Purtilo, 2015).
Final Decision
Dear Ms. and Mr. X,
I have been in an ethical dilemma regarding the treatment of your child and your decision regarding the initiation of the treatment. However, to get over this dilemma, I had followed a model for decision making where I have thoroughly examined each step of the model that have helped me taking the final decision regarding the initiation of the treatment. I consulted with you wherever required during the decision making process and discussed with you the involved issues. You had your own individual viewpoints and reasons to either start or stop the treatment of your child. I referred to the relevant codes of ethics and reviewed if they are in consistence with my values and the applicable laws of the state. The policies of the hospital were also referred along with the applicable state and federal laws related to the situation. I consulted with the peers and experts of ethical issues along with my supervisors and colleagues, who provided me with different perspectives to the problem. Finally, I developed a course of action, estimated the consequences of my action and arrived at a decision that I am going to initiate the treatment of your child, as he is in a state of degrading health that requires immediate medical attendance. I seek your kind co-operation in this regard for the best interest of the health of your child.
References
Doherty, R. F., & Purtilo, R. B. (2015). Ethical dimensions in the health professions. Elsevier Health Sciences.
Foye, S. J., Kirschner, K. L., Wagner, L. C. B., Stocking, C., & Siegler, M. (2015). Ethical issues in rehabilitation: A qualitative analysis of dilemmas identified by occupational therapists. Topics in stroke rehabilitation.
Hunink, M. M., Weinstein, M. C., Wittenberg, E., Drummond, M. F., Pliskin, J. S., Wong, J. B., & Glasziou, P. P. (2014). Decision making in health and medicine: integrating evidence and values. Cambridge University Press.
Larcher, V., Craig, F., Bhogal, K., Wilkinson, D., & Brierley, J. (2015). Making decisions to limit treatment in life-limiting and life-threatening conditions in children: a framework for practice. Archives of disease in childhood,100(Suppl 2), s1-s23.
McLennon, S. M., Uhrich, M., Lasiter, S., Chamness, A. R., & Helft, P. R. (2013). Oncology nurses’ narratives about ethical dilemmas and prognosis-related communication in advanced cancer patients. Cancer nursing, 36(2), 114-121.
Oshima Lee, E., & Emanuel, E. J. (2013). Shared decision making to improve care and reduce costs. New England Journal of Medicine, 368(1), 6-8.
Oshima Lee, E., & Emanuel, E. J. (2013). Shared decision making to improve care and reduce costs. New England Journal of Medicine, 368(1), 6-8.
Shapiro, J. P., & Stefkovich, J. A. (2016). Ethical leadership and decision making in education: Applying theoretical perspectives to complex dilemmas. Routledge.
