Introduction
In Canada, more than 30,000 older adults encounter a fragility hip fracture. A good number of cases require surgical repair; however, due to the risks of anesthesia and the trauma of the operative procedure, surgery is not always the best option for all situations. Patients in the greatest danger of poor outcomes need the opportunity to explore other available options. Unfortunately, patients and their families face a hurried and challenging decision because they often lack sufficient time to raise their concerns and gather information to guide their choices.
Background Information
In this case, Ms. Jones is a 93-year-old female who lives in a long-term care residence (Haslam & DePaul). She was admitted to a health facility with a fragility hip fracture in the company of her two daughters. She has dementia and cannot decide on her own; she also has restricted mobility and has been using a walker. Furthermore, the daughters report that her health has been deteriorating over the past few weeks.
After examination, medics discovered a pleural effusion, taking up much of her right lung, a heart murmur, and a poor condition with serious valve problems. Additionally, carrying out surgery on her cardiac and pulmonary functions indicates that she may not survive. In this case study, the ethical dilemma is whether doctors should perform surgery on the patient, considering her medical condition and potential complications. Furthermore, all the practitioners involved, as well as her family, agree that surgery is the only viable option available (Haslam & DePaul). The ethical quandaries to be assessed include whether the fracture will be repaired, whether the patient will recover, and whether the patient will go home after the operation or proceed to rehabilitation.
Ethical Theory Applied
This scenario will require the application of utilitarianism and ethical theory. The principle behind it is that the selected intervention is based on whether the option would maximize a positive result for the patient (Tseng & Wang). The foundational moral principles of this theory are autonomy, nonmaleficence, beneficence, justice, fidelity, and veracity (Vearrier & Henderson). For example, Ms. Jones’s interest is overshadowed by her family members’ interests and the maximum net benefit. In terms of anatomy, Ms. Jones has dementia and cannot decide on her own; this limits her participation in the process, thus increasing the risk of her inability to understand the final decision.
Regarding non-malfeasance, the medics involved should be truthful and give the family members all the information about Ms. Jones (Haslam & DePaul). Ms. Jones is in a position and age where communication could be challenging, so her two daughters will receive information on her behalf. Therefore, health practitioners must present the family with as much honest and truthful information as necessary to enable them to make an informed decision.
Assessment of the Response to Utilitarianism Theory
The three normative claims in this case study are consequentialism, which focuses on the outcome of the intervention rather than the process, and deontology, which emphasizes the moral principles underlying the intervention. From a moral perspective, assessing whether to carry out a procedure is determined by its consequences and not any other features (Elements and Types of Utilitarianism). There is welfarism, a view that only the well-being of an individual should dictate the importance of a result, and good outcomes are seen as those that improve the patient’s health. Lastly, impartiality stresses that regardless of the patient’s identity, they must receive equal treatment that meets the standards of a professionally run health facility.
Practically, Ms. Jones is in a critical situation where using the best option among possible interventions, which could give the best outcome, is required, even if it compromises her opinion. This means that the procedure selected considers her welfare at the end of the process above anything else. Ideally, decisions should be made based on the patient’s interests. However, it was made with consideration for the greater interest and benefit of the patient’s family.
Weaknesses of Assessing the Case from a Utilitarian Perspective
One critical flaw in evaluating this case from a utilitarian standpoint is that it failed to intervene in a patient-centered manner. Thus, Ms. Jones’s preferences and personal values were not taken into account (Haslam & DePaul). The decision on her treatment was a collective one taken by the medics and her daughters without seeking her opinion. This demonstrates a blind spot the theory is ill-equipped to handle, and in this case, even the Jones family had to accept the proposal as prescribed by the practitioners.
Conclusion
This case scenario applied utilitarianism and ethical theory because it maximized the patient’s positive outcome. It is based on moral principles such as autonomy, nonmaleficence, beneficence, justice, fidelity, and veracity. The theory was selected because it best suited the patient’s dilemma: surgery was the only viable intervention. Thus, it would maximize the patient’s and family’s pleasure and happiness while reducing pain. However, the theory is ill-equipped to enable patient-centered treatment.
Works Cited
“Elements and types of Utilitarianism.” Utilitarianism, 2022.
Haslam, Lynn, and DePaul, Vincent. “Case Study Application of an Ethical Decision-Making Process for a Fragility Hip Fracture Patient.” Canadian Geriatrics Journal, 2019, vol. 22, no. 1, pp, 7-12.
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.