In a healthcare setting, diverse situations demand ethical decision-making principles. The primary ethical principles in healthcare include justice, autonomy, nonmaleficence, and beneficence (Jill Day et al., 2018). Therefore informed consent, sharing accurate and truthful information, and promoting confidentiality are among the key ethics of autonomy. These principles guide health practitioners in ethical decision-making. Healthcare is designed to apply these principles in diverse situations, including guiding a patient in making correct decisions in regard to their health.
Overview of the Case Study
E. L. Straight is the director of Hopewell Hospital, contemplating reducing Dr. Cutrite’s privileges, whose physical and mental status have deteriorated because of age. However, due to his political influence, Straight recommended him and thus continues performing a wide range of procedures within the institution. In a recent incident, the operating room supervisor reported a serious issue: a plastic syringe needle protector was left in a patient’s belly after surgery. She reports this incident without signs of concern. She further recounts that she was unsure of the origin as the protector was noted missing during counting and keeping records. In addition, the scrub nurse during the surgery with Dr. Cutrite had noted the usage but did not think of the protective sheath after the procedure.
This discovery was noted a few days later, even after the patient was discharged. Straight planned to recall the patient instead of telling the truth of the situation, and they would claim it was a checkup of the incision and deep sutures (Capella, 2022). The supervisor also indicated that Dr. Cutrite warned them against taking any actions since the mistake would result in a little discomfort. Even after calling the chief of surgery, who failed to follow up, he acknowledged a likely discomfort. It is evident that this event leads to a rebound in his anxiety behaviors.
Analysis of Ethical Issues
This case presents different situations facing health practitioners that contributed to moral dilemmas. Firstly, the institution’s director, Straight, fails to play his role in reducing the responsibilities of Dr. Cutrite not only because of his age and increased risk of making an error. While the doctor is among the oldest in the hospital, his deteriorated physical and mental condition affects the quality of care. Secondly, how the surgical team, including the doctors, supervisors, and nurses, responded after discovering their mistake was bad. For instance, the doctor had directed the supervisor against taking further action on recalling the patient. Besides, the director’s intentions were also unethical, especially in wanting to hide the mistake from the patient.
The mistake of leaving the protective sheath of a syringe in a patient’s body is significant and the patient’s health. Considering the risk of further deteriorating the patient’s health, the medical practitioner took the matter lightly. It is immoral to brash off these actions. Therefore were wrong in not taking the situation seriously, which is indicated by the late reporting. Lastly, Dr. Cutrite uses his influence to foster immoral behavior, including warning the staff against taking any action on the matter.
Applying the Ethical Decision-Making Model
The ethical decision-making model consists of three components – moral awareness, judgment, ad ethical behavior. According to Capella.edu (2022), this model is designed to understand how an individual makes decisions when faced with an ethical dilemma. Therefore, using this model can help analyze the presented case. The model indicates that moral awareness is an individual’s knowledge of an ethical dilemma. As in the case, Straight identified the unethical nature of the case and therefore wanted to recall the patient and remove it. The other health practitioners, in this case, lacked moral awareness, as indicated by the supervisor’s behavior in reporting the mistake. Further moral judgment promotes a decision of choosing the right action. However, in this case, the health professional chooses the wrong action when faced with the dilemma. It is vital to note awareness and judgment components foster ethical behavior.
Ethical behavior involves taking the right action in resolving an ethical concern. Moral awareness, in this case, is reflected in Straight’s ability to recognize the significant problem revolving around the mistakes his doctor had made of leaving the plastic cover in a patient’s body. His judgment indicated the right action of calling the patient. However, it had the wrong intention of not sharing the details. This outcome led to unethical behavior of failing to take any action based on the directive of the senior doctor Cutrite and the minor discomfort that the patient will experience.
Effectiveness of Communication Approaches
According to Buljac-Samardzic et al. (2020), communication is central in promoting quality health outcomes. In this case, the health practitioners failed to share the mistake with their patients to avoid further adverse outcomes. Besides, the communication between the director and the doctor was in effect since he failed to reprimand his actions. Besides, rather than being concerned about their actions, the supervisor and the nurse failed to report the issue on time, contributing to health risks. It is reported that the operating room supervisor, when reporting to Straight, was nonchalant and portrayed disgust that they had left a plastic protector in the patient’s belly.
Firstly effective communication involves timely and accurate information. Therefore the nurse and supervisor should have conducted the counts and records on time and reported even before the patient was discharged. The missing needle protector would have been identified early, and corrected the error. In addition, since Dr. Cutrite has declined in his clinical role, the director should also play his role by reducing the number of surgical procedures to avoid the poor quality outcome.
Solution
Ethical concerns within healthcare can be solved based on the ethical principles; of justice, autonomy, nonmaleficence, and beneficence. Firstly, beneficence, where health practitioners are required to act in the best interest of their patients. Secondly, Non-maleficence indicates that the practitioner should not cause harm to the patient. Therefore, in this case, the practitioner failed to adhere to these principles, which led to harm. These principles are a guide in avoiding adverse outcomes (Spoljar et al., 2020). The ethical dilemma presented in the case involves three principles, including anatomy, beneficence, and nonmaleficence. The health practitioners, including the director, intended to hide the truth from the patient, and fostering practice by the clinically declined doctor put the patient at risk. In addition, even after discovering the possibility of the plastic cover in the patient’s belly, they failed to take appropriate action to avoid harming the patient.
Conclusion
Patient health is the primary concern when the ethical principle is correctly applied in any healthcare setting. Besides, these principles can help guide health practitioners in making ethical decisions. In the case study, Straight is faced with the decision of recalling the patient and telling them the mistake and demoting Dr. Cutrite, both actions that are ethical behaviors. The solution to these cases is to promote principles of beneficence, nonmaleficence, and autonomy to resolve the ethical dilemma in the case.
References
Buljac-Samardzic, M., Doekhie, K. D., & van Wijngaarden, J. D. (2020). Interventions to improve team effectiveness within health care: a systematic review of the past decade. Human resources for health, 18(1), 1-42.
Capella. (2022). Ethical Case Studies. Retrieved from https://media.capella.edu/CourseMedia/nhs4000element18655/wrapper.asp
Capella.edu. (2022). Ethical Decision-Making Model. Retrieved from https://media.capella.edu/CourseMedia/nhs4000element18816/wrapper.asp
Jill Day, B. G. S., LDA, R., CDA, C., & Sarah Stream, B. A. (2018). Ethics in the Dental Office: Autonomy, beneficence, non-maleficence, and justice should guide your decisions. Dental Assistant, 87(4), 8-9.
Spoljar, D., Curkovic, M., Gastmans, C., Gordijn, B., Vrkic, D., Jozepovic, A., … & Borovecki, A. (2020). Ethical content of expert recommendations for end-of-life decision-making in intensive care units: A systematic review. Journal of critical care, 58, 10-19.
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