Introduction
Ethical dilemmas mainly arise when a choice needs to be made, and the answers are unclear with imperfect options. Such issues may impact the quality of patient care, result in troubled clinical relationships, and even cause moral distress for healthcare providers. The paragraphs below will highlight an example of an ethical dilemma, point out the conflicting ethical principles, and outline an appropriate course of action that prioritizes ethical principles.
Example of an Ethical Dilemma
An example of an ethical dilemma is the moral obligation to provide patients with Limited English Proficiency (LEP) with good quality healthcare. According to Green & Chijioke Nze (2017), LEP patients have been shown to receive lower-quality care compared to patients who can fluently communicate in English based on several metrics – patient satisfaction, knowledge of the treatment procedures and disease processes, and the frequency of medical errors that result in bodily harm. These differences are mainly brought about by communication hurdles, physician biases, and inefficient interpretation processes. However, in most cases, the clinicians are provided with interpreters but fail to utilize them due to time constraints and the inability to work with interpreters jointly. These result in miscommunication, missed diagnosis, and reduced health care quality administered to the LEP patients.
For instance, in the article, the case of Mr. S, a fifty-six-year-old Brazilian construction worker, falls victim to the limitations linguistic inadequacies poses to proper health care administration. Due to the busy hospital schedule, the physicians failed to involve an interpreter, yet his diagnosis of renal failure was complete, with his medical record marked as “poor historian” (Green & Chijioke Nze, 2017). Mr. S’s conversation with several seasoned professionals had not yielded many benefits leaving them frustrated and doubtful that spending more time would be beneficial. However, the careful and systematic talk with the third-year medical student reveals that Mr. S was taxing high doses of pain medicine that resulted in nephritis and a bleeding gastric ulcer. Mr. S almost fell victim to a missed diagnosis due to inadequate communication and failure to use an interpreter.
Conflicting Ethical Principles
The main conflicting ethical principles in a dilemma include justice and equivalence. The principles of justice and equivalence stipulate that patients should not typically be given preferential treatment based on their gender, color, ethnicity, or other personal characteristics. It points out that all individuals should have equal access to health care services such that any disparities are directed towards assisting those facing more adverse conditions. In this dilemma, the clinicians fail to adhere to the principle of justice and equivalence in administering healthcare services to LEP patients. LEP patients experience injustice- they have been seen to receive low-quality healthcare and are mostly viewed as outsiders and should take up the responsibility of learning proficient English. The principle of justice points out that LEP patients should receive equal healthcare as their English proficient patients. Despite the busy schedule of the hospital, for patients with similar cases, the physicians should allocate more time and resources towards interaction with LEP patients to ensure all information is captured and, in turn, prevent miscommunication and missed diagnoses, as in the case of Mr. S. this ensures that all patients regardless of their English fluency receive equivalent and high-quality medical care.
Course of Action
The course of action in providing LEP patients with good-quality health care is the utilization of professional interpreters in the treatment, incentivizing medical interpreters and bilingual clinicians. The strategy will aid in coping with the adverse impacts of communication barriers in the administration of healthcare services. The presence of professional interpreters or bilingual clinicians ensures that the ethical obligations of providing LEP patients with adequate healthcare are effectively satisfied (Espinoza & Derrington, 2021). This benefits the patients and their families in terms of better healthcare outcomes and fewer ethical dilemmas for the staff and physicians.
LEP is a primary cause of health care inequalities and aggravates other social factors that affect health. Inequalities due to LEP are unjust and morally wrong. As a healthcare professional, I am obligated to aid in the elimination of this undue advantage and promote equity in the administration of healthcare services. As a result, I chose to use professional interpreters that help minimize the impacts of language barriers and aid in administering equivalent health care for both LEP and English proficient patients (Providers Don’t Always Meet Ethical Obligations for Patients with Limited English Proficiency, 2014). Incentivization of medical interpreters and bilingual clinicians motivates their language services. Incentivization and utilization of interpreters make better healthcare provision more accessible to LEP patients.
Conclusion
LEP patients and families face language barriers to health care access resulting in adverse health outcomes and low healthcare quality. These healthcare disparities are unjust and differ from the ethical principles of equivalence and justice. Health care professionals are morally obligated to aid in the elimination of this undue advantage and promote equity in the administration of healthcare services. Adopting courses of action, such as using professional interpreters and incentivizing medical interpreters and bilingual clinicians, plays a significant role in minimizing the adverse impacts of communication barriers in the administration of healthcare services.
References
Espinoza, J., & Derrington, S. (2021). How Should Clinicians Respond to Language Barriers That Exacerbate Health Inequity? AMA Journal of Ethics, 23(2), 109–116. https://doi.org/10.1001/amajethics.2021.109.
Green, A. R., & Chijioke Nze. (2017). Language-Based Inequity in Health Care: Who Is the “Poor Historian”?. AMA Journal of Ethics, 19(3), 263–271. https://doi.org/10.1001/journalofethics.2017.19.3.medu1-1703.
Providers don’t always meet ethical obligations for patients with limited English proficiency. (2014). Reliasmedia.com. https://www.reliasmedia.com/articles/21612-providers-don-8217-t-always-meet-ethical-obligations-for-patients-with-limited-english-proficiency
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