Introduction
Every healthcare practitioner is supposed to embrace ethical principles while making decisions. In practice, various ethical problems call for sound judgment as guided by moral values and principles. According to Varkey (2021), four fundamental concepts define healthcare ethics, also known as bioethics. The primary basic principles include justice, autonomy, beneficence, and nonmaleficence. These principles are universally accepted in all contexts of clinical and medical practice.
A physician’s ability to think critically and make decisions in complex situations is essential to provide quality treatment to patients in various clinical settings (Pozgar, 2019). These choices go beyond just picking on an approach or remedy. Clinical practice is inherently and inseparably intertwined with ethical considerations because of the physician’s duty to promote the patient’s welfare, prevent or mitigate harm, and honor the patient’s beliefs and desires. Physicians apply these principles when making rational decisions in complex situations.
Overview of the Case Study
Every physician experiences ethical challenges at any point during medical practice. This has been illustrated in Hopewell Hospital, where E.L. Straight, the head of clinical services in the hospital, experienced some ethical challenges. Straight has been in the position for two years. Dr. Cutrite, on the other hand, is one of the highly regarded doctors and has served for the longest time. Despite Dr. Cutrite being a brilliant general surgeon, his discernment ideal and mental judgment has deprived over the years. Hence, Straight is making an effort to recommend a reduction in the effectiveness of Dr. Cutrite. However, the action is incomplete since Cutrite still performs the full range of processes.
The ethical problem addressed in the case study is that a plastic needle protector was mistakenly left in a patient’s belly. The operating room supervisor reported the issue to the director of clinical services. This illustrates that a counting error after the operational procedure led to an ethical issue (Gunnar et al., 2020). The scrub nurse working with Cutrite confirmed that a syringe was used, and the protective sheath was not accounted for after the surgery. The operating room supervisor reported the case so the clinical service director could follow up with the surgeon to get the proper ethical solution to the whole process. After reporting the case, there was much concern, which resulted in an ethical predicament.
The supervisor was concerned that the needle sheath would be missed if it became lodged in a wound because of its red color. The supervisor found an inconsistency with the needle guard after checking the surgical pack reports after a week, but he could not be sure that the two were related. Straight recommended that the patient return to surgery immediately to check if the sheath had been left in the patient’s belly and, if so, to have it removed. Straight was to handle the situation by telling the patient that they needed to examine her wound and sutures. However, Mrs. Jameson was only discharged from the medical facility a few days ago, so this option seems out of hand.
Evaluation of Ethical Issues in the Case Study
The main ethical issue in the case study is the needle protector left in the patient’s belly after the surgery. The primary factor that resulted in the issue is the negligence of accountability of the medical practitioners who did the surgery on the patient. The incident was realized one week after the operation, whereby the records of the things used for the operation were reconfirmed. However, after the operation, the surgical pack was supposed to be thoroughly checked, and everything was accounted for after the process. This could have assisted in knowing the actual records of the surgical pack used during the surgery. If the practitioner in charge of the surgical pack had adequately checked the pack, the issue would have been dealt with before discharging Mrs. Jameson.
Moral judgment was a concern since the practitioners needed to harmoniously agree on the best approach to provide after the mistake happened. The supervisor was also irresponsible and showed laxity since he checked the surgical pack after the thorough process, and the patient was discharged. The medical practitioners also failed to accept their mistakes by getting to understand that they had messed up and failed to follow the due process of the surgery. The problem could have been avoided if everyone had done their part and taken responsibility for the mistake.
Decision-Making Concept in Analyzing the Case Study
The three aspects of the decision-making model, which include moral judgment, moral awareness, and ethical behavior, would be appropriate for making ethical decisions and analyzing the case study appropriately. Hence, moral awareness is when one develops the capacity to recognize and weigh the ethical implications of a given a choice. The first stage in making moral decisions is to develop moral awareness. The aspect of moral awareness was applied when the operating room supervisor and Straight were aware of the issue at hand, which was seen by their concern once they noticed.
Moral judgment was identified when Straight was identifying the various options to consider so that the situation could be solved. Through moral judgment, Dr. Cutrite and Straight must embrace the best method to help address the situation. Therefore, there is a need to have a better ethical option through moral judgment to help remove the needle protector from the patient.
The practitioners, therefore, did not use moral judgment appropriately. This is because Straight called the chief of surgery to ask the hypothetical question about the severe impact of the needle protector on the patient’s belly. The chief of surgery knew that something was not okay and did not take proper action on the issue. Hence, the chief of surgery stated that the situation would only cause slight discomfort to the patient. Through this, the moral judgment was ineffective since it did not find the proper solution to the patient’s problem. However, practitioners need to solve the issue that the patient faces correctly.
Effectiveness of Communication Approach in the Case Study
Increased efficiency and better health outcomes for patients depend on healthcare practitioners’ ability to communicate effectively with one another. The case study illustrates how Straight demonstrated exceptional verbal and interpersonal skills when the message was relayed to him by the supervisor. For instance, E.L. Straight is a keen listener since he listens carefully throughout the conversation. By listening, he understood the seriousness of the situation. Proper communication and listening skills result in a mature and proper response (Foronda et al., 2016). Straight also indicated compassion since he was so concerned about the issue by being worried about the patient’s well-being. He was shocked that a needle sheath had been left in the patient’s belly after the operation.
Communication resulted in Straight considering potential solutions by asking Cutrite for a better solution to the problem. Healthcare practitioners must embrace more effort when communicating effectively by actively listening, having better communication skills, and being polite during the communication process. Strategies for improved communication lead to enhanced conversation and shared understanding. When people cannot communicate effectively, it becomes more difficult to find common ground and solutions to difficulties (Morley, 2017). Hence for the solution concerning the left needle protector to be found, there is a need to have proper communication skills to find an amicable solution.
Applying Ethical Principles to Resolve the Ethical Dilemma
Given the current state of affairs, a well-thought-out strategy must be developed to improve the organization’s ethical culture. Several moral rules for protecting and defending the rights of others, preventing harm, removing conditions that will pose a risk, aiding persons with disabilities, and rescuing individuals in danger are all supported by the principle of beneficence. It embraces the responsibility of the health care professional to operate for the benefit of the patient. Hence while making the decision, the supervisor, Dr. Cutrite and Straight should make a decision that would not harm the patient. As opposed to nonmaleficence, the discourse here is one of the favorable conditions, and this contrast should be emphasized. Avoiding harm is only part of the principle; it also requires prioritizing the health and happiness of patients (Hawk et al., 2017). The duty of nonmaleficence imposes upon doctors the duty to avoid causing harm to their patients. Surgeons have a moral and legal obligation to deliver competent surgical care. Surgeons are legally responsible for taking reasonable precautions and ensuring that all instruments have been extracted from the patient’s body. Therefore, Dr. Cutrite and Straight have a duty of nonmaleficence to contact the patient and advise her of the situation so that the patient can be aware of the situation. Through this, they will advocate for removing the needle protector to protect the patient from more discomfort. The patient must be readmitted immediately for further medical evaluation and, if necessary, additional surgical intervention. The hospital can reduce the risk of patient harm and legal action by doing so.
In clinical ethics, for the patient’s sake, the hospital should protect her right to know about her health. The disagreement should be resolved amicably in the interest of the greatest good for the most significant number of people. The hospital risks losing credibility if this does not happen. Furthermore, the monetary expenditures of a second medical evaluation, operation, and hospital stay must be considered. The medical personnel can never be certain that the patient will not take the matter to court, even if the issue has been resolved. Even then, the patient’s health is irreplaceable, and no amount of damage or financial loss can compensate for it. Following the procedure, the patient and the supervisor should have been informed. It is unacceptable that this was prioritized over the physician’s patients’ welfare just because Dr. Cutrite is old and well-connected.
Conclusion
While making a decision, the healthcare professional should use the four ethical principles and the decision-making concepts which provide a proper solution to the ethical dilemma. Therefore, Hopewell Hospital staff need to make a sound decision to avoid harming the patient since the patient’s welfare should be the priority. There is a need to have proper accountability after carrying out a critical process, such as surgery in the hospital. Also, effective communication is essential when handling patients and communicating with other healthcare personnel. This provides proper and efficient communication and better opportunities for medical practitioners to make ethical decisions as a team. The hospital has to start working on a complete policy that would mandate the safe storage of surgical tools after use by both the practitioner and the medical assistant. Physicians and other doctors would have to tell their patients whatever they need to know about their health. Through these means, the hospital can promote and sustain an environment that encourages ethical conduct in all patient care and management areas.
References
Foronda, C., MacWilliams, B., & McArthur, E. (2016). Interprofessional communication in healthcare: An integrative review. Nurse Education in Practice, pp.19, 36–40. https://doi.org/10.1016/j.nepr.2016.04.005
Gunnar, W., Soncrant, C., Lynn, M. M., Neily, J., Tesema, Y., & Nylander, W. (2020). The impact of surgical count technology on retained surgical items rates in the veterans’ health administration. Journal of Patient Safety, 16(4), 255–258. https://doi.org/10.1097/pts.0000000000000656
Hawk, M., Coulter, R. W. S., Egan, J. E., Fisk, S., Reuel Friedman, M., Tula, M., & Kinsky, S. (2017). Harm reduction principles for healthcare settings. Harm Reduction Journal, 14(1), 70. https://doi.org/10.1186/s12954-017-0196-4
Morley, L., & Cashell, A. (2017). Collaboration in health care. Journal of Medical Imaging and Radiation Sciences, 48(2), 207–216. https://doi.org/10.1016/j.jmir.2017.02.071
Pozgar, G. D. (2019). Legal and Ethical Issues for Health Professionals. Jones & Bartlett Learning.
Varkey B. (2021). Principles of Clinical Ethics and Their Application to Practice. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7923912/
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