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Applying Ethical Principles

While practicing medicine, healthcare practitioners must adhere to four ethical health principles. These principles are the backbone of medical practice. They are intended to act as guidelines to help workers make decisions under challenging circumstances (Casali & Perano, 2021). The four critical components of health ethics are autonomy, beneficence, non-maleficence, and justice.

Overview of the Case Study

E.L. Straight is the Director of Clinical Services at Hopewell Hospital in Virginia. During his two-year tenure in that position, he is faced with the challenge of having to cut down on the privileges of a colleague that may damage his reputation as a superb surgeon, but he had aged as a consequence of his physical and mental degeneration. One day, the supervisor of the operating room paid him a visit in his office, generating complications for an adult surgeon in the operating room. He was concerned that the plastic needle shield might get lodged in a patient’s stomach. After then, the patient was discharged from the hospital. A week after surgery, they discovered abnormalities in the records indicating that a syringe that shouldn’t have been there had been left in the operating room. After being questioned, the nurse acknowledged to using a syringe but failing to remove the protective shell while doing the final post-procedure count.

Straight requests that the patient be taken to the operating room so that he can locate the sheath, but he is told that he is at home and that the surgeon, Dr. Cutrite, refuses to return her to the hospital. He concludes that there will be no harm done in any way. Straight dialed the chief of surgery’s number and posed a hypothetical query concerning the ramifications of leaving a hat on someone. Although it may be painful, the head of surgery feels it will do no harm; nonetheless, no one knows what the long-term implications will be. Straight is at a loss for what to do since Dr. Cutrite has considerable authority at the hospital as a result of his long service there and Straight is at a loss for what to do (InDarr, et al., 2017).

Analysis of Ethical Issues in the Case Study

Dr. Cutrite’s decision not to take action on the needle cap, despite the fact that he was a politically powerful man in the hospital, was the single most important aspect of this case that aided E.L. Straight’s ethical quandary. When E.L. Straight first met this situation, he requested that the patient be returned to surgery to remove the cap. This quick choice is motivated by the ethical concept of non-maleficence, which states that the provider should not harm the patient. The patient, however, has been discharged, and Dr. Cutrite’s desires have been denied. The ethical concept of justice manifests itself in the contexts in which it finds itself.

Using the Ethical-Decision Making Model to Analyze the Case Study

In the ethical decision-making paradigm, the components of moral awareness, moral judgment, and ethical behavior work together to form a whole (Opsahl et al., 2020). Each of these elements may assist in comprehending the ethical problem presented by this circumstance. When confronted with an ethical dilemma, moral awareness is the recognition of the occasion, and moral judgment is the choice between right and wrong behavior (Opsahl et al., 2020). Ethical behavior is described as an act of doing what is right and expected to solve an ethical dilemma as a result of a combination of moral awareness and moral judgment (Guidolin et al., 2021). E.L Straight’s moral conscience may be shown in his concern and belief that leaving a cap in one’s stomach after surgery might be harmful. This was his first moral judgment, and he used it to send the patient back to the operating room in search of the lid. On the other hand, moral behavior has yet to emerge since it is torn between going against the revered surgeon’s intentions, implementing them, or being immoral despite one’s wants at the moral assessment stage of the decision-making process.

Being aware that it may cause harm to the patient EL Straight must depend on the four core principles of health ethics (autonomy, compassion, innocence, and justice) to guide and enhance his moral judgment in order to make ethical choices or act ethically. He must also be mindful that the satisfaction of his managers will have an impact on the ethical components of his choices. Limited Consciousness allows us to ignore essential facts when defining a problem, therefore restricting the in-depth study of the ethical implications of an issue (Guidolin et al., 2021)

Effectiveness of Communication Approaches in the Case Study

For resolving this ethical dilemma, verbal communication is likely to be the most effective mode of communication. The surgical supervisor communicates the issue to the rest of the healthcare team in a straightforward and effective manner. On the other hand, E.L Straight shields facts from the head of operations by asking “hypothetical” questions throughout their conversation. Despite the fact that the employer saw something was wrong with the investigation, he opted not to sue him. Maintaining an open line of communication with the Chief Surgeon would be the most profitable way in this situation because, as a team, they could concentrate on the safety of their patients rather than pressing E.L Straight to deal with the problem alone. Patients will be protected from possible damage in the future because more individuals will be able to collaborate to establish what is right or incorrect and then take appropriate action if open communication between all parties is common.

Withholding information in this situation is not a brilliant idea since it puts the patient at risk if the foreign body remains in their stomach for an extended period of time. If communication breaks down, other employees will be uninformed of the issue and unable to make a decision since they are unaware of the scope of the problem. An ethical conversation with the chief surgeon, Dr. Cutrite, the operating room director, and everyone involved to argue whether or not to summon the patient into the operating room might be helpful in finding a solution. They should weigh the benefits of surgery against the risks of the cap and then engage in ethical arguments based on medical facts, shared knowledge, and personal beliefs. Sharing everyone’s own point of view and reasoning may be advantageous to the surgeon since it allows them to have a better grasp of the problem from a different angle.

Resolving the Ethical Dilemma by Applying Ethical Principles

In the event of an ethical quandary, medical practitioners should refer to the four ethical principles of autonomy, beneficence, nonmaleficence, and justice and should be used in specific cases to resolve them. From the standpoint of the surgeon, this case does not demonstrate the implementation of the four ethical standards. The fact that EL Straight considers patient justice without inflicting harm means that it has investigated the potential harm that leaving foreign bodies on patients may cause. In order to give the best possible care for patients, E.L Straight must be allowed to interact with surgeons and chief surgeons freely. He knows what is morally proper; he was just unclear how to behave in this particular circumstance. After using the four ethical principles to reach plausible ethical conclusions, he can become even more motivated to speak out and fight for the well-being of future patients.


When faced with an ethical quandary, healthcare practitioners may use the four principles of health ethics to guide them through the decision-making process. In this case, E.L. Straight must decide whether to fight for his patient’s safety by removing the needle guard, despite the surgeon’s argument that it is not required. EL Straight must discover safe solutions for the benefit of patients while abiding by the concepts of autonomy, beneficence, nonmaleficence, and justice in order to achieve results.


Casali, G. L., & Perano, M. (2021). Forty years of research on factors influencing ethical decision making: Establishing a future research agenda. Journal of Business Research132, 614-630.

Guidolin, K., Catton, J., Rubin, B., Bell, J., Marangos, J., Munro-Heesters, A., … & Quereshy, F. (2021). Ethical decision making during a healthcare crisis: a resource allocation framework and tool. Journal of medical ethics.

In Darr, K., In Farnsworth, T. J., & In Myrtle, R. C. (2017). Cases in health services management.

Opsahl, A., Nelson, T., Madeira, J., & Wonder, A. H. (2020). Evidence‐Based, Ethical Decision‐Making: Using Simulation to Teach the Application of Evidence and Ethics in Practice. Worldviews on EvidenceBased Nursing17(6), 412-417.


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