This is not an example of the work produced by our Dissertation Writing Service. lies with the organization through its leadership offering . The Guidance for Professional Practice – (UKCC 1996). Section IV then considers judicial interpretations of how best interests should be understood and applied. He did so in part by imputing specific values to the patient, holding that because Ms Y’s family could be said collectively to espouse the sort of values that would support a decision to donate, Ms Y herself could be said to do so. Before the Dementia progressed, she was a very bubbly lady who could be found wherever a group had gathered. NIH Dina has lived at this Nursing facility for nine years where she has slipped into what her doctor agrees is Alzheimer’s disease. Consent may be implied, verbal, or written, but accurate records must be kept by the professional as to the information given and the consent granted by the client. She was transferred to the Intensive Care Unit (ICU), but her condition deteriorated. I shall even assume that the parties do not know their conceptions of the good or their special psychological propensities. Rights Rationing and Resources in the NHS ( 2nd ed OUP 2005) 46, C. Faulder, Medical Ethics, Patient Rights & Informed Consent (1985:32). Nurses face more and more ethical dilemmas during their practice nowadays, especially when nurses have responsibility to take care of patients with terminal diseases such as cancer .The case study demonstrates an ethical dilemma faced by a nursing staff taking care of an end stage aggressive prostate cancer patient Mr Green who confided to the nurse his suicide … It challenges the application of best interests as conceived in Airedale NHS Trust v Bland which responds to concerns that best interests and substituted judgment might wrongfully be elided. Dina has always been a chain smoker. A clinical case study of an ethical dilemma that occurred in a cross-cultural context is examined. TSO (The Stationery Office). V. Tschudin, Ethics In Nursing: The Caring Relationship 1989:339, Williams G, ‘Assisted Suicide, the Code for Crown Prosecutors and the DPP’s Discretion’, (2010), Common Law World Review, Yorke J, The Right to Life and the Value of Life Orientations in Law, Politics and Ethics, Ashgate Publishing Limited, 2010, Page 6. Ethics Case Studies Revived Jan. 2018 1 Ethical Dilemma Case Studies Please select ONE of the following ethical case studies below and respond to each question accompanying your selected dilemma. More than 50 case studies match ethics concepts to real world situations. While in Dworkin’s argument Margo’s previous values should be determinative, and lead to a life-ending decision, at law the weight of argument suggests that her current values should be prioritized. An ethical dilemma arises when the clients and health care providers differ in their understanding of what is right or wrong (Narrigan, 2004). Such relationships include that of a parent and child, that of spouses as well as that of doctors and patients. In a nut shell, the more people we can make happy the better. As a Bachelor of Social Work intern at the New Hanover County Senior Resource Center, ethical dilemmas are easy to come by. Legal rules regarding anticipatory decision-making suggest that a patient’s more recent values should be prioritized if there is a conflict or apparent change over time. Despite such judicial reasoning, in Y, we find a patient who cannot in any concrete sense be said to have previously (or currently) held values that can be drawn on and applied in reaching a decision that accords, as best possible, with what she would have reflectively endorsed as serving her interests. In addition, physicians must not do anything that would purposely harm patients without the action being balanced by proportional benefit. This case raises questions about obstacles to open communication about death and goals of care. In either case, the patient’s values should not themselves be displaced at law. The case studies on ETHICS & BUSINESS It’s been noted lately that Dina has been spending more time in her room, communicating with very few words. This approach focuses on safeguarding the fundamental principles of: • integrity, • objectivity, • professional competence and due care, • confidentiality, and • … As nurses we often deal with ethical dilemmas in our everyday clinical practice; and as professionals we have the responsibility to analyse and examine any ethical problems that may arise. Therefore the moral worth of an act must derive from something intrinsic to the act itself rather than extrinsic to it. Read an article: Being ethical in the face of wrongdoing. The test for establishing capacity level will be further covered under my Mental Capacity section below. Therefore, if one is to judge morality by examining the nature of one’s actions rather than by the goals that those actions ultimately achieve, the outcome relative to medical professionals should be that they are praised or blamed only for those actions within their immediate control. Connell J found a means of holding that Ms Y’s best interests were served by her submitting to the painful process of being a bone marrow donor, so that she might help save the life of her sister. If teachers and principals have enough practice discussing case studies of morally unclear situations, they might become more prepared to discuss their own. 1785. By Toni Cesta, PhD, RN, FAAN Senior Vice President Lutheran Medical Center Brooklyn, NY. 1 (2009), Mary Donnelly, ‘Best Interests, Patient Participation and the Mental Capacity Act 2005’ (2009) 17(1) Med LR 1, MacIntyre argues that ‘The Ethics shows us what form and style of life are necessary to happiness.’47 Hursthouse’s ‘neo-Aristotelianism’ is illustrated by many other-regarding and self-regarding virtues, and she defines a virtue ‘as a character trait that a human being needs to flourish or live well’.48. Equally, in cases of uncertainty; the dominant rule at law is that decision-making should err on the side of life. The lesson includes a thorough examination of the Heinz and Louise dilemmas from Kohlberg’s classic dilemma research. Even though this action may have taken place at a critical stage, the consultant can prove that his action helped to minimize Dina’s pain. Article 3: Prohibition of torture and inhuman or degrading treatment – is an absolute right and states that, Restraint will generally not be seen as torture unless too much force is used, or it is used to limit your movement in a way other than to protect or prevent further damage. Working out what to do in a case like this can take all the moral thoughtfulness and sensitivity and reasonableness that we can muster. As a normative theory, Utilitarianism is not a theory about what moral terms mean but is a theory which offers a test which we can use to decide whether an action is right or not. Save responses in a word document and upload the document to your certificate record in myKU Portal. An ethical dilemma can be defined as a situation where there is only a decision which is “’more right’ than the alternatives” (Hill, Glaser, & Harden, 2008, p.102). (Kant, Immanuel. The consultant may not be found negligent if he can prove that his actions were in line with common practice. Read an article: Identifying ethical dilemmas in the workplace. In other words, ethical dilemmas are everywhere! For the purpose of this essay, I will only highlight the situation where there is a special relationship between doctors and patients. The human rights contained within this law are based on the articles of the European Convention on Human Rights. It can be seen in Dina’s case that she suffered pain as well as swelling of her arm as a result of the side effects of receiving the IV Fluids. This is not Identify Ethical Dilemma or Issues . She appeared to be initially very happy at this home. As nurses we often deal with ethical dilemmas in our everyday clinical practice; and as professionals we have the responsibility to analyse and examine any ethical problems that may arise. A survey in 2013 by the Institute of Business Ethics found that 38 per cent of the British public believe that business behaviour is in general not ethical.  |  Section 3.2 of the Nursing & Midwifery Council Code of Professional Conduct for instancestates that “you must respect patients’ and clients’ autonomy- their right to decide whether or not to undergo any medical or health care intervention – even where a refusal may result in harm or death to themselves”. Dina could also belong to the group of patients who’s past and present values conflict. To qualify for the discount, you must have paid at least 50% of your order cost by 23:59 on Wednesday 3rd of December 2020 (UTC/GMT). In the health care area, one of the most important obligations of nursing staff is take the positive action to promote health and wellbeing of patients [7]. We've received widespread press coverage since 2003, Your All Answers purchase is secure and we're rated 4.4/5 on The courts took both a utilitarianism approach but also respected Mrs. Purdy’s autonomous, self-determined choice to end her life. He also showed a positive attitude towards the whole medical process to benefit his sister. Beneficence which means the ‘duty to do good’. There is a requirement for emphasis to be made to autonomy within capacity law. Dina was no longer found sitting in her chair smoking when she was in her room; she was spending more time in bed, complaining of being “tired”. Stevenson C. L. (1944): Ethics and Language: New Haven, Connecticut. Please enable it to take advantage of the complete set of features! Act Utilitarianism is arguably the more primitive of the two since it takes literally the requirement that we examine the consequences of each possible course of action in any situation when making our moral deliberations. In the Bolam testa patient suffered severe injuries as a result of receiving Electro Convulsant Therapy (EVT) without muscle relaxants. It can be referred as actions which mainly focus on benefiting other people [6]. (Kant, Immanuel. He also notes a reference to a complete listing: Edmund Pincoffs, Quandaries and virtues, University Press of Kansas, 1986. Ultimately, the patient must decide whether the potential benefits outweigh the potential harms. In its simplest terms, consent may be defined as giving permission: “… in current usage consent is defined as a voluntary compliance, or as a permission. Kant, Immanuel. (In reality, there is no quid pro quo: medicines not used on her would have no obvious intended recipient. Was there negligence in the hospital setting? Major health care interventions are based on the principle of autonomy. ETHICAL CASE STUDY OF SARAH 2 issue dealing with confidentiality arises and the counselor must decide whether the golden rule that is the basis for trust in a counseling relationship should be broken in order to protect the client or someone else, General Medical Council, Consent: Patients and Doctors Making Decisions Together (GMC 2008), General Medical Council (UK). Jeremy Bentham famously stated, ‘… nature has placed mankind under the governance of two sovereign masters, pain and pleasure’. From journalism to performing arts to foreign policy to scientific research to social work, these cases explore a range of current and historic ethical dilemmas, their motivating biases, and their consequences. Disclaimer: This work has been submitted by a student. Since higher possible benefit and minimum risk of injury pertain to this scenario, justice is making sure that Dina is given fair access to needed supplies or therapies. They should be able to come and go from the hospital within reason and are able to discharge themselves if they decide to go home. The conflict is between the duty of the medical team to respect the instructions of the patient’s next of kin, who have explicitly given consent to firstly medical intervention and (perhaps) a duty owed to Dina to pay attention to her wishes. Ethical decision making in a bureaucratic context by senior nursing students. She retired ten years ago when she began to suspect that she was suffering from depression. You can view samples of our professional work here. My intension is to present a problematic case that poses a medical-ethical dilemma for patients, families, and healthcare professionals. These resources could be used for other patients who might benefit more. House of Lords House of Commons (2007) Joint Committee on Human Rights: The Human Rights of Older People in Healthcare. Find NCBI SARS-CoV-2 literature, sequence, and clinical content: As a service to its members, the ISMPP Ethics Committee developed the CoE to be used as a touchstone to provide guidance on the most appropriate and ethical practices and conduct. In the case of D. Pretty  v The UK, 2002, the courts exercised a utilitarianism approach and sacrificed Mrs. Pretty’s autonomy interests for the greater good, to protect vulnerable people in society who may be coerced into giving up their life. An ethical dilemma found in a case study. James R. Thobaben, Health-Care Ethics (Downers Grove, Illinois: IVP Academic, 2009). We can increase our sensitivity, sharpen our moral reasoning skills, by thinking hard about such cases, and the moral theories which underlie our responses to them, in a context of academic inquiry and discussion. (Hasman, A., Mcintosh, E. and Hope, T. 2008), Jackson however has argued that doctors do not consciously apply rationing to decisions, in day to day practice; at the most ‘If a patient is suffering from symptoms which are very likely to be caused by a minor illness but there is a remote chance that there is something much more serious wrong with them the doctors will adopt a wait and see approach. Eighteenth Report of Session 2006–07. Gary Slapper and David Kelly, The English Legal System—16th ed (Routledge 2015) 98–101. For Hume, the wrongness lies not in the object but in us. Managing Business - Ethical Dilemmas Case Studies - Free download as Powerpoint Presentation (.ppt), PDF File (.pdf), Text File (.txt) or view presentation slides online. Ethics Case Studies Preamble. This lesson will explore the ethical decision making process through two classic case studies. As part of their normal work duties, publication professionals are frequently required to untangle difficult ethical problems. Managing Business - Ethical Dilemmas Case Studies - Free download as Powerpoint Presentation (.ppt), PDF File (.pdf), Text File (.txt) or view presentation slides online. First, patients who have capacity. There is a vast amount of case law in this field which will be used to illustrate the exceptions to an omission. A clinical case study of an ethical dilemma that occurred in a cross-cultural context is examined. It is for this reason that the adjective ‘informed’ has been used to clarify its meaning. Hazel Biggs and Caroline Jones, ‘Legally Vulnerable: What Is Vulnerability and Who Is Vulnerable?’ in Michael Freeman, Sarah Hawkes and Belinda Bennett (eds), Law and Global Health (OUP 2014). (Brent, N. J., 2000). A clinical case study of an ethical dilemma that occurred in a cross-cultural context is examined. It is best conceived as being about respecting a patient’s determination of her interests by reference to her reflectively endorsed values, rather than non-substantive reverence for bare choice in itself. 16th Dec 2019 It must however be mentioned that within this same code of practice, section 3.8 conflicts the whole autonomy idea and states that “where treatment is necessary to preserve life, care should be provided without the patients’ or clients’ consent”. Case Studies; Case Study of Ethical Dilemma in Nursing. The way ethical dilemmas are handled within an organization is referred to as the ethical climate (Victor and Cullen, 1987) (as cited in Lemmenes, Valentine, Gwizdalski, Vincent, Liao, 2016, p. 725). Another term for the deontological approach is duty ethics. To export a reference to this article please select a referencing stye below: If you are the original writer of this dissertation and no longer wish to have your work published on the website then please: Our academic writing and marking services can help you! The principle of beneficence is often seen as the overriding duty in healthcare. This is where the law will require an individual to act where there is a special relationship. A case study of an ethical dilemma that could happen in your practice arena. Theoretical studies have demonstrated that an ethical dilemma ascends from a situation that necessitates a choice between conflicting sets of principles. Harry Frankfurt, ‘Freedom of the Will and the Concept of a Person’ (1971) 68(1) J Phil 5; Gerald Dworkin, The Theory and Practice of Autonomy (CUP 1988). Confidentiality: Protecting and Providing Information. Analyzing case studies of similar ethical dilemmas may help teachers make the “right decision” when faced with similar situations. Instead Rule Utilitarian believe that we should stick to general rules of conduct such as ‘Don’t lie’ or ‘Always keep your promises’ because these rules in turn tend to produce good consequences overall. The English legal system does not have a ‘good Samaritan rule’ neither is there ‘no duty of easy rescue’. All of the names have been changed. It must be noted that this ultimate decision may not have been in her best interest as in the case of Sidaway vs Bethlem Royal Hospital Governors 1985. These he believed were the twin motivators and goals of all human action. John Stuart Mill was also an advocate of Utilitarianism and his version is: ‘Utility’ or the ‘Greatest Happiness Principle’. (1910-1987), Perception and identify, ed. For the purpose of this essay, I will only be discussing Articles 2, 3 and 8 of the Act: Right to life, Prohibition of torture and inhuman or degrading treatment and the Right to respect for private and family life.  |  Moral approval and disapproval, therefore, is not a fact about the world but is a matter of our emotional response to a given situation. An ethical dilemma arises when the clients and health care providers differ in their understanding of what is right or wrong (Narrigan, 2004). For use in publications such as textbooks and other works, please contact the Media Ethics Initiative. Christopher Newdick, Who should we treat? The language of the client and provider differed, and no interpreter service was available. Brent N. J. : Nurses and the Law: A guide to Principle and Applications, ed: illustrated and published by Elsevier Health Sciences, 2000). He spent his life outlining the implications of Utilitarianism for a variety of social and political institutions. 15MONDAY2020 can only be used on orders with a 14 day or longer delivery. (Kant, Immanuel. Solving ethical dilemmas; UNODC-UNESCO Partnership for Global Citizenship Education. To reach that conclusion, my analysis will aim for conceptual clarity on whether Dina’s attending doctor offered her rights within case law or that because of her Alzheimer’s condition the medical team denied her rights and took a completely autonomous decision because the law appears to be edging towards giving these groups more recognition. The notion of consent (to be covered below under case law) represents the ethical principle that each person has a right to self-determination and is entitled to have their autonomy respected. These are known as Act Utilitarianism and Rule Utilitarianism. Scrutinizing ethically challenging clinical encounters will result in better understanding of the moral dimensions of practice. Begin Main Content Area Unit 3: Case Studies. A … London, Bolam vs Friern Barnet Management Committee 1957. A replica of Dina’s situation which occured  in Airedale NHS Trust v Bland. A Case-Based Analysis of Ethical Issues with Social Media in Health Care Kayhan Parsi, JD, PhD and Nanette Elster, JD, MPH AMA J Ethics. (Williams G, (2010). She was also eating less, often reluctant to go to the dining room. Your responses should total at least 300 words. Numerous blood tests and scans at the hospital showed that her platelet blood count is abnormally low and her spleen was mal-functioning (scan showed metastasis tumor). Utilitarianism is primarily concerned with providing a mechanism for deciding what to do in given situations. It is established to reflect, or at least be consistent with, the patient’s personal view of her interests: this may be established through gaining consent, or by reference to proven facts about the patient’s values. Fitzjames Stephen gave a classical example of ‘A seeing B drowning and is able to save him by holding out his hand. Ian Kennedy, ‘What is a Medical Decision?’ in Ian Kennedy, Treat Me Right: Ethics in Medical Law and Ethics (Clarendon Press 1988). The Sidaway case makes reference to a patient who was left with paralysis after an operation to relieve a trapped nerve. C. Faulder (1985:32). GMC. Professional duty is therefore placed on Dina’s consultant to act in a morally good way by providing urgent medical interventions as required. Nursing often deals with ethical dilemmas in the clinical arena. As the theory of Utilitarianism was developed and refined over the years, there emerged two distinct branches of Utilitarianism. respect for private and confidential information, particularly the storing and sharing of this information (in the UK this is largely covered by the Data Protection Act 1998: the right to have confidential and unlimited communication with others, the right to control how information about your private life is shared, This approach focuses on safeguarding the fundamental principles of: • integrity, Subsequently, Dina became hypotensive and went into septic shock. All of these ethical dilemmas are quite subtle and there is a thin line between the professionalism of a nurse and well-being of patients or another party involved in the conflict. (Yorke J, 2010). 1814 words (7 pages) Nursing Case Study. Most opinion poll surveys have predicted that … 1785). Ethics Case Studies / Role playing Questions Disobeying an informal order DevAnand is working as a clerk in Collector’s office. Hasman, A., Mcintosh, E. and Hope, T. 2008: Journal of Medical Ethics. Some of the questions raised by this case study include how the issue first arose, including globalization, and why the company and the country would benefit and not benefit from the current position; whether the company and country are acting ethically, with integrity, and consistent with law; the role that consumers in India and elsewhere play in this case study; and the different … In other words the more happiness and the less unhappiness an action produces the more morally praiseworthy it will be. As indicated, the MCA gives little help in adjudicating between the patient’s own inconsistent views. Dina’s later life in the nursing home during which she was unable to get out of bed. Hale, B. Non-maleficence means “not to do harm” is considered to be the positive opposite to beneficence (Rumbold, 2000). For Kant, to deny that lying is wrong is the same as denying that 2+2=4. He is projected to become PM as he is the heir apparent in his party. Company Registration No: 4964706. direction and role modelling and with individuals being . Rawls goes on to describe ‘Justice as Fairness’ suggesting that any state making rules could be justified in doing so on the basis that the coercion was done under conditions of complete freedom, and would therefore appear to be more of a guidance than an oppression, a ‘social contract’. Three organizations have produced ethical guidelines for industrial hygienists: the American Board of Industrial Hygiene, the Joint Industrial Hygiene Ethics Education Committee, and the International Commission on Occupational Health. As my scenario is based on a real case, some details have been changed in the effort to maintain patient confidentiality. This principle requires that a patient’s right to make their own decisions about their care and treatment is respected. Journal of Mental Health Law, May, 7–18. With the explanation and case examples above, it can be noted that Dina’s consultant acted in her best interest even though she suffered harm and finally death as a result. This law is called the Human Rights Act 1998 and fully came into force in 2000. Ngaire Naffine: Law’s Meaning of Life (Hart 2009), Nursing & Midwifery Council Code of Professional Conduct, 2006, P. Jones, Human Rights, Macmillan 1994: pg 237, Philip Bielby, ‘The Conflation of Competence and Capacity in English Medical Law: A Philosophical Critique’ (2005) 8(3) Med Health Care Philos 357, Principles of Morals and Legislation, 1789, Rawl J.: ‘A Theory of Justice’, (Belknap Press of Harvard University, 1971), Re Y (Mental Patient: Bone Marrow Donation) [1997] 2 WLR 556. Many of these virtue traits can also be seen in the character of Dina’s brother as he was very cooperative with the hospital consultants’ views to provide medical interventions on his sister. The solution to the ethical dilemmas in these case studies . Registered office: Venture House, Cross Street, Arnold, Nottingham, Nottinghamshire, NG5 7PJ. lies with the organization through its leadership offering . This lesson will explore the ethical decision making process through two classic case studies. There however remain some debate of what constitutes “common” or “serious”. Analyzing case studies of similar ethical dilemmas may help teachers make the “right decision” when faced with similar situations. It must be noted that virtues exist to show one’s caring nature for the well-being of others and an unwillingness to cause harm. It is judged by reference to professional opinion to be in the patient’s best interests: this will be established by reference to the doctor(s) agreeing that the intervention is indicated as a worthwhile intervention because of the benefits—whether therapeutic or otherwise—that it will provide. Girija, a smart and extremely talented young IAS officer, is posted as SDM of a Sub-Division in a Southern State, under whose jurisdiction the constituency belonging to a young MP falls. Published by, 1834, vol 1, J. Bentham, Principles of Morals and Legislation in 1789. To This could be treated in law as a form of degrading treatment as Dina may have become very distressed at the refusal. Article 8: Right to a private and family life – is a qualified right, which includes: respect for your sexuality, the right to make choices for yourself, and the right to have your body and mind respected. They illustrate how the ethical … “When the consent of the patient is not sought for any treatment or intervention, that person’s life is devalued. Physicians should not provide ineffective treatments to patients as these offer risk with no possibility of benefit. The assessment was then presented to the physician; concern was expressed that the child may have been injured. Eventually, Levinson envisions the discussion of ethical dilemmas as common professional development in schools. Constructing the ‘Vulnerable Adult’ in English Law and Public Policy’ (2008) 28(2) LS 234. Health care providers have the professional responsibility to analyze these dilemmas. Free resources to assist you with your university studies! John Coggon, ‘Varied and Principled Understandings of Autonomy in English Law: Justifiable Inconsistency or Blinkered Moralism?’ (2007) 15(3) Health Care Anal 235. (The ethics of Aristotle: 1976). Department of Health Review: Winterbourne View Hospital: Interim Report: (June 2012). This principle will result in the denial of the patient’s autonomy and right to play full part in decisions about their treatment but will be justified by the belief that patients cannot possibly be as well informed as their doctors and can therefore make no useful contribution to decision making. Case Study – 5: Ethical Dilemma Girija, a smart and extremely talented young IAS officer, is posted as SDM of a Sub-Division in a Southern State, under whose jurisdiction the constituency belonging to a young MP falls. A. MacIntyre, A short history of ethics, London, Routledge, Kegan Paul, 1967, Ibid, Ayer; A. J. When you face an ethical dilemma, CIMA’s ethics checklist can be a useful resource to help you consider the best course of action. On the contrary, one could argue that an appeal to justice would compel cessation of further intervention so that expensive resources would not be used on Dina who was later seen to be benefiting less from the treatment. The principles of justice are chosen behind a veil of ignorance”. For instance, when Dina was admitted into hospital, she was immediately given the appropriate treatment because she was owed the duty ‘to do no harm’.