Introduction
In today’s world, advances in technology have made data more accessible than ever. Access to information has revolutionized businesses, healthcare, education, and politics. With the abundance of data available, many people believe that if they relied on the facts and cut through the noise using logic and reason, they could always make better decisions.
However, unclear or unprofessional communication often reflects poorly on the hospital and can negatively impact employees’ relationships with patients and families. The hospital also needs to consider other aspects when dealing with patient confidentiality issues, depending on the situation of the evaluated case. Intuition becomes especially important when you have little time to process information before making a decision.
This paper’s decision-making process is based on a case study of a staff nurse working in a geriatric rehabilitation ward at one of Ontario’s public hospitals. The nurse faced an elderly hip fracture patient suffering from nursing home syndrome (Haslam and DePaul 8). It leads to secondary complications and results in adverse outcomes such as more extended hospital stays, returning to the hospital due to pain, and unwanted medicines being taken incorrectly.
The article by Haslam and DePaul is almost entirely concerned with what the doctor should have done and lacks any discussion of what happened when the time came to make a choice. (9). The authors will not avoid saying that the doctors involved did something wrong (Haslam and DePaul 9). The implication is clear, but they do not explain why they believe that and have no examples of any wrongdoing. This case study was performed on an actual situation with a hypothetical patient to illustrate how a decision-making process can be used to determine an ethical course of action. The case illustrates how the joint application of the different elements of this process proved superior to each component used separately.
Background Information
In a world where the healthcare industry is becoming increasingly competitive, medical professionals must prioritize their patients’ needs above all else. It is especially true when the patient is elderly and has a fragility hip fracture. In this case study, Haslam and DePaul offer excellent insights into applying ethical theory in practice (10). They also provide a great example of resolving ethical issues in cases like this.
The authors begin by providing an excellent review of the theory underlying their approach: Utilitarianism. They define Utilitarianism as “the greatest good for the greatest number” (Haslam and DePaul 10). They explain how they would apply this concept in practice by considering all available options before deciding between treatment options that would benefit their patient and society (Haslam and DePaul 11). They also provide some background information on the fragility of hip fractures by explaining what they are and why they occur so frequently among older adults.
However, the original case study lacks a clear definition of “ethical.” While it is true that people cannot define ethics in such a way that there is no room for interpretation, it does not mean there is no room for interpretation. The authors should have provided a more robust account of what they meant by ethical, especially since this is essential to understanding how Utilitarianism fits into the case study.
Another shortcoming of the original case study was its failure to incorporate any theoretical approaches beyond Utilitarianism (MacAskill n.d.). Utilitarianism was presented as being the only possible approach when there is no clear moral imperative from society (Haslam and DePaul 11). However, this is not always true; for example, if a patient makes it clear that they do not want to be revived if they are deemed too frail, because it would be too painful for them. Then, people would be required to respect their wishes, regardless of whether this may be considered unethical according to Utilitarianism. If they did not do this, then they would be violating their right to self-determination.
Ethical Theory Applied
One of the most prominent ethical theories in modern healthcare is the concept of autonomy. This theory posits that individual patients have the right to make their own decisions regarding medical interventions and treatments, and that doctors should respect those decisions. In this case study, the patient’s autonomy was compromised by her daughter, who made decisions based on what she thought was best for her mother’s quality of life. The daughter believed that her mother would not want to live with the consequences of a hip fracture, but the authors argue that this may not have been true.
One other ethical theory that could be discussed in this case study is virtue ethics. Its emphasis is on the person rather than their deeds. Virtue ethics emphasizes doing what is suitable for others and treating them with respect (Tseng and Wang n.d.). Virtue ethics could be used to help explain why the authors chose to treat this patient in the manner they did. One reason may have been that they felt it was essential to show respect for their patient by being honest about what had happened and why she needed surgery (Haslam and DePaul 12).
They also showed respect by listening carefully to her concerns about surgery and considering those concerns when deciding whether or not it was safe for her to undergo surgery. The authors also showed respect for their patient by allowing her time away from stressors, such as family members, so she could focus on healing without additional stress in her life at that time.
Assessment of the Ethical Approaches
One of the most important ways to understand ethical theory is to see how it is applied to real-life situations. It enables a comprehensive understanding of the key factors in a given situation. This case study by Haslam and DePaul presents a clear-cut example of an ethical dilemma, which is then analyzed using three different ethical frameworks: virtue ethics, Utilitarianism, and Kantianism (MacAskill n.d.).
In this case, the patient’s medical history is presented. She has had multiple hip surgeries and now has a fragility fracture, which means that her bones are weak and prone to breaking. She has been given morphine for pain management after surgery, but she also suffers from anxiety and depression due to these previous surgeries.
The authors discuss how all three frameworks would approach this situation differently. Virtue ethics focuses on helping patients become more virtuous or good. Utilitarianism focuses on maximizing happiness or minimizing suffering (Vearrie and Henderson 47). Kantianism focuses on treating people as ends in themselves. However, the Kantian approach does not consider what might happen in future situations if people make decisions based on their values instead of following principles like utility or autonomy.
The ethical approach that best fits this case study is the virtue ethics approach, as it enables a deeper understanding of the conflict between these ethical theories. The virtue ethics approach can provide a more substantive and comprehensive reading of this case study because it focuses on the strengths and limitations of all three ethical theories, rather than just one. This approach allows people to better understand the conflict between ethical theories by examining their reciprocal influence. It recognizes that ethical decisions are driven by multiple interconnected factors, such as the decision-makers’ personal values, intentions, desires, and objectives. By considering these factors and using them as tools for judgments about right or wrong actions, one can better understand how each ethical approach works.
Conclusion
This case illustrates multiple conflicts of interest in the field of elder care, a growing area of concern today. The family that hires and employs the participants in this situation can increase their profits by allowing the patient to die rather than treating him with the necessary care. The elderly services staff will follow these decisions because they feel it is not in their professional capacity to criticize “family” decisions.
The result of this rash decision is not only the potentially damaged reputation of the facility but also the potential death of a vulnerable patient that could have been helped. Overall, healthcare for older people ultimately becomes a delicate balancing act between risks and benefits. If a decision cannot be made based on the best available medical information, a person’s family must be consulted, and active input must be sought. Communication between the hospital, the patient, and their family is paramount in end-of-life decisions.
Works Cited
Haslam Lynn, and DePaul Vincent. “Case Study Application of an Ethical Decision-Making Process for a Fragility Hip Fracture Patient.” Canadian Geriatrics Journal, March 2019, vol. 22, no. 1, pp, 7-12.
MacAskill William. “Principles and Types of Utilitarianism.” Utilitarianism, 2022.
Tseng Po-En, and Wang Ya-Huei, “Deontological or Utilitarian? An Eternal Ethical Dilemma in Outbreak.” MPDI, 2021, vol. 18, no. 16.
Vearrier Laura, and Henderson Carrie, M. “Utilitarian Principlism as a Framework for Crisis Healthcare Ethics. Springer Link, 2021, vol. 33, no. 1-2, pp. 45-60.