Ethical Issues and Nonmaleficence in Healthcare Report (Assessment)

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Introduction

Medical professionals often deal with unpredictable situations, which they must navigate by following principles of healthcare ethics. A healthcare worker is generally associated with help, safety, alleviation, professionalism, and the common good. The environment nurses and doctors work in is often complex, overwhelmingly stressful, and, therefore, chaotic conditions. To manage this environment, doctors and nurses need to apply concrete ethical principles that help them make choices and decisions in unpredictable situations. Healthcare ethics, or bioethics, includes four basic principles applied across all practices and levels. These principles are autonomy, beneficence, nonmaleficence, and justice.

Overview of the Case Study

E. L. Straight is an experienced healthcare professional known for his thoughtful approach to managing hospital personnel. He is devoted to patients’ well-being as much as to his staff’s satisfaction with the working environment, as he knows that it directly influences the quality of medical services. One day, at the end of the day shift, E. L. Straight is informed by the operating room supervisor that there might have been an accident involving one of his most experienced surgeons, Dr. Cutrite. The supervisor said the doctor forgot a plastic needle protector inside a patient’s stomach after the operation. The operation occurred three days ago, and the patient, Mrs. Jameson, was released from the hospital the day before. Right after the operation, the supervisor was unsure whether the incident occurred. Yet, now that she recalls the situation and her conversation with Dr. Cutrite, she is certain there was a case of unintended retention.

Mr. Straight’s immediate concern is, of course, the patient’s safety. He urgently calls Dr. Cutrite and the scrub nurse, who worked with the surgeon that day, for questioning. Without a patient’s medical examination, it is impossible to confirm that unintended retention has occurred. Still, the surgeon and the nurse confirm it might be the case. Mr. Straight calls in the chief surgeon to examine the possible implications for the patient’s health and decide the hospital’s reaction to the incident. The top surgeon confirms that a foreign object, such as a needle protector, can cause severe damage to a patient’s health and that the situation demands immediate medical intervention. Mrs. Jameson has a right to sue the hospital for the accident.

E. L. Straight faces an ethical dilemma: whether to inform the patient about the accident and call her in for an urgent examination to determine whether there is a foreign object in her body or keep it quiet to avoid the scandal and the consequences lead to. For the hospital’s director, this is not even a question. He urgently calls Mrs. Jameson for a meeting to inform her about the possibility of the accident and for a thorough medical examination.

Analysis of the Ethical Issues in the Case Study

In the case study, E. L. Straight faces a complex ethical situation that deals with crucial ethical principles, justice, benevolence, and nonmaleficence. He acts according to his professional ethics, seeking the best for the patient. E. L. Straight is aware that unintended retention of foreign objects occurs in a very small percentage of surgeries. Still, about a high number of surgeries performed, it remains a relatively common medical malpractice (Banja, 2019). The chief of the hospital understands his responsibilities to the staff. He consults his chief surgeon before acting on the situation. Relying on his high moral standards, E. L. Straight contacts the patient immediately to inform her about the situation and provide essential medical treatment.

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

E. L. Straight is guided by his professional ethics in dealing with this complex situation. It involves the interests and well-being of the patient, above all, but also the perspectives of his employees and the whole hospital. E. L. Straight is well aware of the stressful and chaotic environment of the hospital and its effect on the personnel. He has noted before that Dr. Cutrite might be dealing with professional burnout. E.L. Straight also understands the limits of his authority over his staff when they provide medical treatment. E. L. Straight applies the Four-Box decision-making model to consider all ethical aspects when making his decision. He considers medical indications that deal with the patient’s health as such, the capacity of the patient to act in this situation, and the professional perspective on the situation in social and legal circumstances.

Resolving the Ethical Dilemma by Applying Ethical Principles

Four basic ethical principles of autonomy, beneficence, nonmaleficence, and justice are applied when dealing with complex ethical situations that often occur in healthcare and demand immediate and precise reactions. In the case of unintended retention of foreign objects, unethical behavior may lead to a patient’s severe health problems and even death. The situation E. L. Straight deals with as the hospital’s director involves two fundamental principles of bioethics. He has to consider the patient’s rights and interests, the hospital’s interests, and his own limits of authority. He chooses to inform the patient immediately about the possibility of an accident.

Conclusion

The four basic principles in healthcare are applied to navigate complex, confusing, and sudden situations that sometimes occur in medicine. Healthcare workers’ authority spreads beyond the situations that occur within the hospital, dealing with issues of authority and legal, social, and cultural aspects. In the case study, E. L. Straight deals with the complex ethical situation that involves his professional interests and the patient’s well-being. He relies on moral principles to resolve this, in fact, a relatively common problem.

References

Banja, J. D. (2019). Patient safety ethics: How vigilance, mindfulness, compliance, and humility Can make healthcare safer. Johns Hopkins University Press.

Capella University (2018). NHS-FP4000 Exemplar Sample Ethical Case Study.

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IvyPanda. 2022. "Ethical Issues and Nonmaleficence in Healthcare." November 11, 2022. https://ivypanda.com/essays/ethical-issues-and-nonmaleficence-in-healthcare/.

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