A medical error that led to a tragedy always requires a balanced and sober understanding of the situation that has occurred. Announcing this fatal mistake to journalists, the Chief Nursing Officer (CNO) is ready to share the blame with the entire medical community, saying that the error was not the fault of the nurse but the system as a whole. This statement seems to urge the public to re-evaluate the very concept of justice as more complex and ambiguous in medical practice.
The CNO’s decision to make this story public may entail harsh criticism from citizens and opposing healthcare communities. This announcement could even jeopardize his career, as he could be the scapegoat not only for the medical community but also for the media and the general public. However, this is precisely why it seems necessary to explain how even a system that makes such mistakes is more humane and nuanced than other approaches. It is important for the public to realize that the human factor may not be so important in a high-tech system that is capable of making mistakes from time to time.
Being in the constant need to make a momentary vital decision, medical practice is always torn between being guided by the rational skill of the diagnostician and the altruistic desire to help. Value-based healthcare offers possible coordinates for navigating the stressful chaos of medical practice with high personal ethical responsibility (Terrell & Bobbitt, 2019). A doctor proceeding from such a system of values is aware of the boundaries of his own responsibility since his idea of his place in the professional hierarchy is less distorted and closer to reality. The value-based approach is decentralized and does not place the doctor in charge of a particular situation since the situation is perceived as part of a ramified system.
The negative opinion of the regional consortium regarding the decision of the Central Non-Governmental Organization to publish information about the tragedy also seems understandable. Such a statement endangers not only the speaker but the community itself. Secondly, these words can be misunderstood and perceived as a renouncement of a failure of the very concept of a value-based approach. The whole principle of health care advocated by the CNO is based on the needs of the patient. Moreover, ongoing needs require thoughtful and long-term strategies tied to economics, ethics, and medicine (Teisberg et al., 2020). This philosophy, like others, is imperfect, and such a statement risks wholly devaluing their meticulous approach and undeniable professionalism.
The parents of the child, who find themselves in such a monstrous situation, must do everything possible so that this case avoids turning into a scandal. It seems logical that the parents should have wanted the CNO to bring the nurse to justice. The nurse may be considered a professional who was as close as possible to their child, therefore, could influence the outcome of the situation. However, parents might not want to prosecute this person if they knew how deeply moral principles could be instilled in an ordinary nurse. The moral position of nurses is so firmly established that decision-making outside the medical community can operate on their principles (Mallari & Tariman, 2017). To centralize responsibility around one person would emphasize an impulsive response that lacks rational understanding and stems from anger and grief. Therefore, parents should try to understand that it is impossible to find the culprit in this situation, that this is a tragedy that is not subject to legal processing.
Considering all of the above, it must be remembered that justice and ethics in medical practice can often diverge. The public view of the problem that has happened hardly corresponds to the point of view of doctors and is unlikely to be as informed. Thus, the court of the people can commit a systemic error itself, and the punishment will be borne by the person who did not want evil, but on the contrary, wanted only the best for the patient.
References
Mallari, G., & Tariman, J. D. (2017). Ethical frameworks for decision making in nursing practice and research.Journal of Nursing Practice Applications and Reviews of Research, 7(1), 50-57. Web.
Teisberg, E., Wallace, S., & O’Hara, S. (2020). Defining and implementing value-based health care: A strategic framework. Academic Medicine, 95(5), 682-685.
Terrell, G. E., & Bobbitt, J. (2019). Value-based healthcare and payment models: Including frontline strategies for 20 clinical subspecialties. American Association for Physician Leadership.