Case Scenario

Case Scenario

CASE SCENARIO 6

Ethical dilemma

The ethical dilemma derives from the contradiction to thephysician’s duties. According to the physician’s code of conduct,it is the physician’s obligation to provide care to the patient.The American Nurses Association (2015) states nurses have anobligation to provide care to patients and lack the freedom toabandon patients. Based on the case scenario, it is apparent that thesituation at hand is an emergency. The patient has a high fever, isvomiting violently in addition to having convulsions. The physicianhas already made a diagnosis that the patient has meningitis. Hence,it is necessary that treatment commence immediately to contain thesituation. Additionally, the physician’s duty involves ensuringthat they contain the situation as soon as possible, and stop furthercomplications. On the other hand, the physician must perform theirduties by adhering to the professional code of ethics. The codestipulates that prior to providing care the physician must seekconsent from the patient (Hobden, 2008). In this case, the patient isa minor, which means that the parents are responsible for givingpermission to the physician to treat the child.

After making the diagnosis, the physician is aware of their dutiesthat they need to begin treatment immediately, as well as the factthat they must seek permission from the parents. Unfortunately, thepatient’s mother restricts the physician from treating the childowing to her religious beliefs as a Christian scientist. The father,who is in a different state, consents to the commencement oftreatment though he seeks consultation from a different physician.Any decision made should benefit both, the parents and patient. Theethical dilemma presents itself in the fact that the physician cannotcommence with the primary obligation to provide care, without firstseeking consent from both parents. This is because both parents donot agree on what action to take.

Decision-making model

The chosen model is the “6-step process of ethical decisionmaking” by Purtilo and Doherty (2013). It refers to actions to takeduring decision-making. Step one – Involves defining the problem inthe context of the health concern. Decision-making is a procedure ofsolving problems, which intends to eradicate impediments to attainingpersonal or organizational objectives. By determining the problem, itbecomes possible to implement applicable steps to do away withbarriers to finding a solution. In order to define a problem clearly,one must be concerned with three fundamental questions. These areasking what the problem is, what to do and what may be taking place.Step two –determines the criteria for a particular health caremeasure. After defining a problem, the subsequent step involvesascertaining the criteria. Criteria refer to measures employed inarriving at the most suitable solution.

Step three – stands for the consideration to all the choices tomake in a health care situation. When dealing with a decision-makingissue, there are numerous solutions to the problem. At this point,the physician refers to their code of conduct, consults with otherphysicians and seniors. It is important to brainstorm prior to takingany action. Step four – involves determining the most suitablealternative. When deciding on the most appropriate alternative, it isimportant to note that the ultimate alternative must be the one thatis the best. Step five– Create and execute a plan of action.Planning on what to do provides direction and makes it possible toplan for any uncertainty. Step six – Observe and analyze thesolution. As a final step in decision-making, it is necessary toobserve and analyze the solution arrived at. After making a decision,follow up is done to access how well the decision solves the problem.This makes it possible to avert, reduce as well as overcome allprobable adverse aftermaths. It is after observation and analysisthat an individual can conclude the decision was the mostappropriate.

Resolving the dilemma

It is possible to resolve the dilemma using the 6-step model. Stepone – The patient’s problem has already been established, whichis a high fever, convulsions and is vomiting violently. Step two –Many illnesses present with the similar signs hence, the physicianmust identify the criteria most suitable to the patient. Notably, thephysician has diagnosed meningitis as the cause for the signs, whichnecessitates the need for immediate treatment. Step three – Thereare two solutions to the problem. Bearing in mind that the parentshave given differing opinions on the course of action to take, thephysician can decide not to commence with treatment until the parentsagree on what to do. At the same time, the physician is well aware ofthe consequences of delaying treatment on the patient. Besides, thephysician has a commitment to make a decision that is in the bestinterest of the patient.

Step four – the best decision in the case scenario is to begin atreatment plan. Step five – beginning the treatment plan willensure that the vomiting, high fever and convulsions are contained.This aligns to the nurturing trait inherent in all nurses. Itinvolves taking care for others to relieve pain (Wilson &ampWoodhouse, 2008). After that, it is important to wait for the child’sfather to report in the hospital. Step six – Involves assessing ifthe treatment plan has been effective. Once the father arrives, bothparents need to be briefed on their child’s condition, and advisedon what action is in the best interest of the patient. The 6-stepmodel makes it possible to resolve the dilemma by ensuring that thephysician makes the most suitable decision to solve the problem athand.

Dialog

It is crucial that the parents comprehend the criticality of thesituation. Hence, the need to explain to them what actions thephysician intends to take and why.

Physician: The patient has arrived in the hospital in a criticalcondition. Based on my knowledge, experience and the signs present, Ihave concluded that the patient has meningitis. This is a seriousillness. It is crucial to commence treatment immediately, which willsave the child’s life, alleviate pain and at the same timestabilize the fever, stop the convulsions and vomiting. So far, thechild has not received any medical intervention. Having been broughtto the hospital, straight from school, a lot of time has already beenwasted. There may not be ample time to save the patient if treatmentdoes not commence immediately. Prior to administering care, it isnecessary for the parents to consent, which aligns to the physician’scode of conduct. In this case, treatment is the only viable solutiondespite any religious beliefs. As parents, you should take actionthat is in the best interest of the child. I have resolved to begintreatment on the child immediately, with the objective of alleviatingpain and saving life.

References

American Nurses Association. (2015). Risk and responsibilityin providing nursing care. http://www.nursingworld.org/MainMenuCategories/EthicsStandards/Ethics-Position- Statements/Risk-and-Responsibility-in-Providing-Nursing-Care.html

Hobden, A. (2008). Ethics in E.Mason-Whitehead, A. Mcintosh, A. Bryan, &amp T. Mason (Eds.), Keyconcepts in nursing.(pp. 147-152). London: SAGE Publications Ltd.

Purtilo, R. B., &amp Doherty, R.F. (2011).&nbspEthicaldimensions in the health professions.St. Louis, Mo:Elsevier/Saunders.

Wilson, F &amp Woodhouse, J.(2008). Nurturing in E. Mason-Whitehead, A. Mcintosh, A. Bryan, &ampT. Mason (Eds.), Keyconcepts in nursing.London: SAGE Publications Ltd.