APPLYING ETHICAL PRINCIPLES IN HEALTHCARE SETTINGS 2

Applying Ethical Principles in Healthcare Settings

Healthcare professionals face ethical dilemmas regularly in the course of their work.
When faced with such dilemmas it important that their decisions be guided by ethical principles
in order for them to ethically resolve the dilemma. These principles include justice, beneficence,
maleficence, and autonomy (Kangasniemi et al., 2015). Using these principles, healthcare
professionals can always be sure of making ethical decisions any time they are faced with ethical
dilemmas.

Case Study Overview

In the ethical study Old School or Out of Touch Corey Davidson, a newly appointed
director of emergency department at Crosby Community Hospital, is forced by circumstances to
deal with the problem of Dr. Lacy. The old doctor has been practising in the community for a
very long time. Over the course of his practice he has become beloved by the community but his
declining health and age have now become an impediment to his medicine practice (Capella
University, 2018a).

In a meeting with Corey Davidson, the director of nursing, Margaret Truman, raises
various concerns about Dr. Lacy. Margaret Truman has just established department-wide
evidence-based guidelines for treatment of patients with shortness of breath. The guidelines
require that Lasix only be used when it has been confirmed beyond doubt that a patient is
suffering from acute heart failure. The recommendations are based on studies that have found
that Lasix may be harmful to pneumonia and dehydration patients. Dr Lacy, however, does not
follow these guidelines. Against the established guidelines, he continues recommending Lasix

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for all patients with shortness of breath (Capella University, 2018a). In one instance, it had taken
a nurse to painstakingly convince him against recommending Lasix for a patient. In addition to
his refusal to follow these guidelines, Dr. Lacy also refuses to use electronic health records
(Capella University, 2018a). Due to these reasons, Corey is considering taking away emergency
department privileges of Dr. Lacy.

Ethical Issues in the Case Study

Corey’s ethical dilemma is caused by Dr. Lacy’s refusal To follow the new guidelines of
the hospital. In addition to refusing to follow evidence-based guidelines in diagnosis and
treatment of patients with shortness of breath, Dr. Lacy also refuses to use electronic health
records. Dr. Lacy’s behavior puts patient health at risk. It also makes it hard for him to
effectively work with the nursing staff.

Analyzing the Case Study Using Ethical Decision-making Model

According to Capella University (2018b), making an ethical decision involves three
stages. The first one is moral awareness. This is the stage where an individual becomes aware
that there is violation of an ethical code (Capella University, 2018b). Moral judgement, the
second stage, involves analyzing issues in a given ethical dilemma and making the right ethical
decision (Capella University, 2018b). The last stage is ethical behavior. It is reached when an
individual makes an ethical decision.

In the case study under consideration, Corey’s meeting with Margaret makes her morally
aware of Dr. Lacy’s ethical violations. Her moral judgement will be whether or not to take away

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emergency department’s privileges of Dr. Lacy. Her ultimate decision will influence ethical
behavior of Dr. Lacy.

Effectiveness of Communication in the Case Study

Corey displays both effective and ineffective communication. He displays effective
communication by making himself available to Dr. Margaret and listening to her concerns about
the behavior of Dr. Lacy in the hospital. However, he does not seek any clarification regarding
Margaret’s concerns. For instance, he does not enquire whether Dr. Lacy has been informed
about the new guidelines or not. It could be that his failure to follow the new guidelines is a
result of him being unaware of their existence. Corey’s failure to seek clarification from
Margaret about this issue is an example of ineffective communication.

Applying ethical principles to resolve the ethical dilemma

It is not clear what decision Corey will eventually make to solve the ethical dilemma that
he is facing. When making the final decision, he will have to apply ethical principles. They are
four. The first one is autonomy. This principle requires healthcare professionals to give patients
freedom to make decisions regarding their treatment and care (Chadwick & Gallagher, 2016). As
for beneficence, it requires healthcare professionals to promote the best interests of patients when
making decisions regarding them. Justice, the third principle, requires that healthcare
professionals treat their patients with fairness. Lastly, the principle of nonmalefence holds that
healthcare professionals should not make decisions that harm their patients (Chadwick
&Gallagher, 2016). One or a combination of these principles can help Corey resolve his ethical
dilemma.

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Considering the facts of the case study, I believe that the principles that will guide Corey
to make the best ethical decision are nonmalefence and beneficence. These principles call on
Corey to act in the best interest of the patients and also not to make decisions that harm them. If
it is found that Dr. Lacy knows about the new regulations yet intentionally refuses to follow
them then based on these two principles, Corey would have to revoke Dr. Lacy’s emergency
department privileges.

Conclusion

Healthcare workers regularly face situations that present ethical dilemmas. They can
resolve these dilemmas by using the ethical decision-making model and be guided by ethical
principles of justice, nonmalefence, beneficence, and autonomy. Corey, in the case study
considered, is faced with the dilemma of respecting the judgment of a beloved and experienced
doctor or taking away his emergency department privileges for failure to follow new hospital
guidelines. Based on the facts of the issue and guided by the four ethical principles it is
proposed that Corey resolves the ethical dilemma by invoking the principles of nonmalefence
and beneficence and deny Dr. Lacy emergency department privileges.

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References

Capella University (2018a). Old School or Out of Touch? Ethical Case Studies. Retrieved from
Capella University Website: NHS-FP4000 course room.
Capella University (2018b). Ethical Decision-Making Model. Retrieved from Capella University
Website: NHS-FP4000 course room.
Chadwick, R., & Gallagher, A. (2016). Ethics and nursing practice. Macmillan International
Higher Education.
Kangasniemi, M., Pakkanen, P., & Korhonen, A. (2015). Professional ethics in nursing: an
integrative review. Journal of advanced nursing, 71 (8), 1744-1757.