NURS FPX 4000 Assignment 3 Applying Ethical Principles

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Capella university

NURS-FPX4000 Developing a Nursing Perspective

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Date

Applying Ethical Principles

In the complex healthcare landscape, healthcare professionals often navigate ethically challenging scenarios that demand careful consideration and adherence to moral principles. Ethical dilemmas in healthcare can manifest in various forms, from patient autonomy and confidentiality issues to resource allocation and end-of-life decisions (Almoallem et al., 2020). By applying foundational ethical principles, healthcare personnel can develop an ethically sound framework that prioritizes well-being, individual rights, and ethical aspects of healthcare delivery (Olejarczyk & Young, 2022). In this retrospective, effective communication strategies are essential in addressing ethical dilemmas and fostering stakeholder transparency and trust. 

Overview of the Case Study

The case study is related to genetic testing and raises the dilemma of the autonomy principle. Clara, a 38-year-old woman, is expecting her first child. She came for testing to Dr. Leonard Harper, a seasoned geneticist at Hillside Medical Center. She said that her family history has genetic disorders, and her age factor concerns her, so she would like to know if it is present in her child. The testing results showed high chances of Down syndrome disease. However, Clara’s husband is overseas due to the nature of his job, as he is a naval officer named Lt. Jack Bennett.

Clara requested Dr. Harper withhold the news from her husband in fear of his reaction and to save him from the undue stress of his already demanding and stressful job. Dr. Harper finds himself in a profound ethical dilemma between respecting Clara’s autonomy and the importance of open communication, especially in matters that affect family dynamics and decision-making. He proposes shared decision-making through open, empathetic, and transparent communication, which is necessary for addressing this dilemma. 

Analysis of the Case

The assessment of the ethical dilemma Dr. Harper faced in Clara’s request to withhold information is effectively understood through peer-reviewed journal articles. At one end, Dr. is concerned about the consequences of withholding the information from the husband on their marriage and limitations for decision-making regarding the test outcomes. On the other hand, Clara is concerned about the impact of the news on her husband, who is stationed overseas. Journal articles have highlighted the importance of pre and post-testing counseling (Schwartz et al., 2021). Dr. Harper utilized a counseling strategy for shared decision-making with Clara and was aware of the outcomes of prenatal genetic testing. However, he was not expecting the odd request from her husband to withhold the news.

 Studies show that women taking prenatal genetic testing results and finding abnormalities may choose pregnancy termination because of social, emotional, and psychological pressure (Laabs, 2019). The studies also highlight the importance of the autonomy of an individual to make decisions like abortion involving a couple or relatives. Still, it encourages open communication between the couple and the doctor for informed decision-making about the situation (Di Mattei et al., 2021). Dr. Harper can make Clara understand the impact of handling news alone and delaying informed decision-making, impacting her physical and psychological well-being.

So, hiding from Clara’s husband is not an ethical decision. Decision-making based on ethical considerations, like discussing choices and treatments within ethical and moral considerations involving both parents, is a practical choice for Dr. Harper. The chosen articles also support the importance of the proposed solution of shared decision-making involving both parents despite the outlook on the pregnancy journey by counseling in clinical activity choices, social and informational support, or psychological coping mechanisms (Michie, 2020). This can help Clara and her husband cope with the results’ physical, emotional, and psychological impact without straining their relationship. 

Effectiveness of the Communication Approaches

In the presented case of Dr. Harper and Clara Bennett, the doctor finds himself between respecting Clara’s request to withhold news and his belief in the importance of open communication within families. One practical approach in this scenario is empathetic and patient-centered communication for shared decision-making. Clear and empathetic communication is key for all stakeholders to understand and respect ethical principles  (Turner & Archer, 2020). Dr. Harper should prioritize active listening to acknowledge Clara’s concerns and fears.

Empathy can help  Clara to express her emotions and aid in decision-making. However, withholding information from Lt. Jack Bennett, Clara’s husband, is not ethically appropriate. Transparent and honest communication is important in medical situations, especially those involving life-altering information (Menon et al., 2020). Effective communication between physician and patient is essential for shared decision-making and providing comprehensive knowledge to patients and their partners or families  (Menon et al., 2020). 

Communication Approach to be Avoided 

Dr. Harper must avoid a paternalistic approach to this case, where decisions are made without the patient’s consent or preferences. So, Dr. Harper must encourage shared decision-making involving both husband and wife in discussing genetic results. The paternalistic approach will compromise the autonomy principle despite the goodwill of the healthcare professional. So, open communication among all stakeholders fosters trust and informed decision-making regarding the choices available  (Ballesteros et al., 2019).

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

In analyzing the effectiveness of Dr. Harper’s approach in a case study using the Ethical Decision-Making Model, we can assess the three components: moral awareness, moral judgment, and ethical behavior. Dr. Harper demonstrates moral awareness by recognizing the ethical dilemma at hand. He acknowledges the conflict between respecting Clara’s autonomy and the importance of open communication within families facing genetic diagnosis.

This is a crucial aspect of the proposed decision-making solution because it highlights an understanding of the ethical dimensions involved in the case (Smith, 2023). Dr. Harper faces a moral judgment dilemma. On one hand, he respects Clara’s autonomy by considering withholding information from her husband. On the other hand, keeping information secret on her health and marriage has consequences. This reflects the complex nature of moral judgment demanding balanced ethical principles (Borhany et al., 2021). 

The effectiveness of Dr. Harper’s ethical behavior depends on his actions based on his moral judgment. Choosing to prioritize, transparency, open communication, and shared decision-making align with ethical principles as they uphold principles like honesty and patient-centered care (Ewuoso et al., 2021). However, if he complies solely with Clara’s request, it will compromise ethical behavior, considering long-term implications. 

Consequences of Using Effective and Non-Effective Approaches

The consequences of these practical approaches will foster trust and empowerment to make decisions based on the values and preferences of the couple and contribute to long-term positive outcomes for patients and healthcare professionals. On the other hand, the consequences of ineffective approaches will lead to the erosion of trust, adverse outcomes due to uninformed decision-making, and ethical violation of honesty and autonomy (Varkey, 2021). 

Resolving the Ethical Dilemma by Applying Ethical Principles

Four ethical principles are essential in considering the possible solution in Dr. Harper and Clara’s case. The four ethical principles necessary are autonomy, beneficence, non-maleficence, and justice (Varkey, 2021). Dr. Harper must respect Clara’s fundamental autonomy so that he can inform and empower her about the choices and importance of shared making. The solution ensures the autonomy principle by making her an active participant in healthcare decisions. 

The ethical principle of beneficence that promotes the well-being of Clara and her unborn child demands comprehensive knowledge about the implications of prenatal genetic testing results. Beneficence can maximize positive outcomes. In this context, truthful and complete information allows Clara to be informed about the disclosure of information and further steps regarding results. On the other hand, non-maleficence emphasizes the obligation not to harm  (Hemberg & Hemberg, 2020). Withholding information from Jack Bennett can lead to unintended consequences like strained family dynamics or potential harm to their marital relationship. The proposed solution of shared decision-making, which encourages truthfulness and open communication, aligns with the ethical principle of minimizing harm associated with withholding information (Hemberg & Hemberg, 2020). 

Justice involves fair and equitable distribution of resources and information. Involving both Clara and Jack in the decision-making process ensures equal access to pertinent information. The proposed solution by Dr. Harper aligns with ethical principles to maintain professional integrity and respect Clara’s autonomy, maximize benefit, and minimize harm to her well-being. It also ensured fair and equitable access to resources and information for Clara and Jack Bennett. 

Conclusion

In conclusion, the ethical dilemma faced by Dr. Harper underscores the balance between autonomy and promoting open communication. Through the application of ethical principles, transparent communication and shared decision-making emerge.

References

Almoallem, A. M., Almudayfir, M. A., Al-Jahdail, Y. H., Ahmed, A. E., Al-Shaikh, A., Baharoon, S., AlHarbi, A., & Al-Jahdali, H. (2020). Top ethical issues concerning healthcare providers working in Saudi Arabia. Journal of Epidemiology and Global Health, 10(2), 143–152. https://doi.org/10.2991/jegh.k.191211.001 

Ballesteros, R. F., Izquierdo, M. S., Olmos, R., Huici, C., Ribera Casado, J. M., & Cruz Jentoft, A. (2019). Paternalism vs. autonomy: Are they alternative types of formal care? Frontiers in Psychology, 10. https://doi.org/10.3389/fpsyg.2019.01460 

NURS FPX 4000 Assignment 3 Applying Ethical Principles

Borhany, H., Golbabaei, S., Jameie, M., & Borhani, K. (2021). Moral decision-making in healthcare and medical professions during the COVID-19 pandemic. Trends in Psychology. https://doi.org/10.1007/s43076-021-00118-7 

Di Mattei, V., Ferrari, F., Perego, G., Tobia, V., Mauro, F., & Candiani, M. (2021). Decision-making factors in prenatal testing: A systematic review. Health Psychology Open, 8(1), 205510292098745. https://doi.org/10.1177/2055102920987455 

Ewuoso, C., Hall, S., & Dierickx, K. (2021). How do healthcare professionals respond to ethical challenges regarding information management? A review of empirical studies. Global Bioethics, 32(1), 67–84. https://doi.org/10.1080/11287462.2021.1909820 

Hemberg, J., & Hemberg, H. (2020). Ethical competence in a profession: Healthcare professionals’ views. Nursing Open, 7(4), 1249–1259. https://doi.org/10.1002/nop2.501 

Laabs, C. A. (2019). Prenatal genetic screening and potential complicity in abortion: considerations for catholic health care. The Linacre Quarterly, 87(2), 206–217. https://doi.org/10.1177/0024363919886515 

Menon, S., Entwistle, V. A., Campbell, A. V., & van Delden, J. J. M. (2020). Some unresolved ethical challenges in healthcare decision-making: Navigating family involvement. Asian Bioethics Review, 12(1), 27–36. https://doi.org/10.1007/s41649-020-00111-9 

Michie, M. (2020). Is preparation a good reason for prenatal genetic testing? Ethical and critical questions. Birth Defects Research, 112(4), 332–338. https://doi.org/10.1002/bdr2.1651 

Olejarczyk, J. P., & Young, M. (2022b). Patient rights and ethics. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538279/#:~:text=Proper%20awareness%20of%20the%20ethical 

NURS FPX 4000 Assignment 3 Applying Ethical Principles

Schwartz, M. L. B., Buchanan, A. H., Hallquist, M. L. G., Haggerty, C. M., & Sturm, A. C. (2021). Genetic counseling for patients with positive genomic screening results: Considerations for when the genetic test comes first. Journal of Genetic Counseling. https://doi.org/10.1002/jgc4.1386 

Smith, C. S. (2023). Applying a systems oriented ethical decision making framework to mitigating social and structural determinants of health. Frontiers in Oral Health, 4. https://doi.org/10.3389/froh.2023.1031574 

Turner, R. E., & Archer, E. (2020). Patient-centred care: The patients’ perspective – A mixed-methods pilot study. African Journal of Primary Health Care & Family Medicine, 12(1). https://doi.org/10.4102/phcfm.v12i1.2390 

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119