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Communication applied effectively to health care settings
Communication applied effectively to health care settings
Communication applied effectively to health care settings
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In the increasingly complex world of health care, health care professionals make life-changing decisions for their patients and clients. The decisions can range from life to death and long care term for patients with mental disabilities. Not only do the decisions impact the patients or clients life but it also affects the patient’s family, caregivers and even the person making the decisions. Hence, healthcare professionals are advised to develop a moral reasoning and ethical decision-making process. The model used by most healthcare professionals is the six-step process developed by Purtilo and Doherty.
The Six-Step Process “allows one to take a situation apart and look at it in a more organized, coolheaded way while still acknowledging the intense emotions everyone may be experiencing about the situation and how these feelings factor into addressing the problem” (Purtilo & Doherty, 2011, p. 102). The six-steps are as follows: Gather Relevant
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Patients who are diagnosed with the disease have an 85 percent survival rate if they receive chemotherapy. She does not want to go through with the treatment advised by her physicians. Due to her age, Cassandra cannot legally make that decision and it is left up to her parents to decide course of treatment. Her parents are in agreement with Cassandra but the hospital is in disagreement with their decision and opts to take the case to court. (Macklin, 2015, p.1)
Ethical Dilemma
From a healthcare professionals aspect, respecting Cassandra’s request of no treatment gives rise to an ethical dilemma. She is not of legal age to make such decision about her health. Also by refusing chemotherapy she is potentially causing self-harm. As a healthcare provider one tries to honor the patients wishes but cannot always do so. In order to have a solution that works for both patient and physician, we need to go through the six-step
If Marguerite’s caregiver was the one making the decision, because she is emotionally attached to Marguerite, she would have chosen to treat Marguerite and not Sarah. However, a member of the angiography team could have been opposed to the idea of treating the younger patient because he/she might have thought that they were discriminating against Marguerite because of her age, when in reality, they evaluated the chances of survival of both patients without being emotionally attached to one or
In module four, it is made evident that “any medical treatment that is not essential to the comfort of the dying patient may be withheld or withdrawn” (ELNEC, 2014). In Sybil’s case, her cancer was recurring, meaning she had already received care for her breast cancer. She was in remission. Since her husband stated that her cancer was “not looking good,” we can infer that it has now metastasized. This means that her cancer has returned and now spread. At this point, her chance of re-entering into remission is not likely. Thus, we as the audience understand that she has accepted her mortality and any further chemotherapy or treatment would be considered medically futile. As mentioned prior, the mortality of her breast cancer recurrence was accepted and they were no longer doing anything to treat it. If Sybil and her family had attempted at an aggressive treatment plan for this recurrence, it would be very unlikely that she would have a good outcome. Thus, any possible treatment for her cancer would only promote suffering and not
During week 4, we became familiar with the application of ethics in the nursing practice settings. We learned about ethical theories and principles, which are crucial when practicing in any clinical settings during ethical decision-making and while facing one or multiple ethical dilemmas. Also, we were introduced to the MORAL model used in ethical decision – making progress. The MORAL model is the easiest model to use in the everyday clinical practice, for instance at bedside nursing. This model can be applyed in any clinical settings and its acronyms assist
Sim, J (1997). Ethical Decision Making in Therapy Practice. Oxford: Reed Educational and Professional Publishing Ltd. p.16.
The four major ethical principles in health care are: Autonomy – to honor the patient’s right to make their own decision (the opposite is paternalism - the health care provider knows best for the patient), Beneficence – to help the patient advance his/her own good, Nonmaleficence – to do no harm (many bioethical controversies involves this principle), and Justice – to be fair and treat like cases alike. All 4 principles are considered to be in effect at all times. In theory, each is of equal weight or importance. Ethical responsibilities in a given situation depend in part on the nature of the decision and in part on the roles everyone involved play.
In step six we must, “ Make the decision and document the decision-making process” (p.166). As I did my research and decided what was morally correct to do in this situation, I decided Lori should have the bone marrow transplant done. I do not think she is at the right stage of life to make a life or death decision, when we have the option of saving her life. There are too many parties that feel that this option is the best one and want to at least try to help her. At this point, we can say we tried and if it does not work we never gave up on her.
Since ethical dilemmas are not always easily answered through the use of The Code of Ethics, ethical decision-making models are effective tools that can assist nurses in dealing with ethical issues. Ethical decision-making models provide a framework for working through difficult choices. They seek to define the limits of what is morally acceptable and help clarify the guidelines for making those difficult decisions. Ethical decision making models assist nurses in analyzing situations by focusing on understanding the patient needs, need for responsiveness to circumstantial considerations, and recognizing the uniqueness of each situation.
582). Ethical decision making is defined as “The process of choosing between actions based on a system of beliefs and values” (Black, 2014, p. 347). The nurse handling the ethical problem must first identify that there is in fact a problem. The second step is to acquire all of the required information related to the current situation. The third step is to come up with multiple choices and options to solve the ethical problem. The fourth step is to actually pick one of the choices utilizing sound ethical judgement. The fifth step would be to enact the made decision. The final step in the process is to reassess your decision and look for effectiveness and
In “ Sounding Board Death and Dignity, A Case of Individualized Decision Making” by Timothy E. Quill talks about a patient of his named Diane. An ordinary person but has struggled with alcoholism and depression. Quill then, with vigorous testes, finds out she has acute leukemia. Now knowing this, Quill and other doctors advised Diane about undergoing treatment as soon as possible. But she refused and just wanted to go home and be with her family. Though at this time she was not experiencing any suffering as ...
Christina Robbins awakens screaming as she clinches the railing of her hospital bed while excruciating pain radiates through her weakened body. Christina’s husband and two teenage daughters sit on the couch in the corner of her dimmed hospital room. In just three months, Christina went from a completely healthy lawyer to lying in her deathbed needing 24 hour care. The cancer has now spread from her lungs throughout her body and within days would reach her brain. The doctors have tried to keep Christina’s pain under control, but with all the medicine the slightest touch feels like razor blades scraping her skin. Being a terminal patient is rather difficult to come to terms with, leaving unpaid bills behind, losing bodily control, and having family watch them die a slow painful death. Incidentally Christiana does not live in one of the four states that offer Physician Assisted Suicide. Physician Assisted Suicide should be legalized in all states because it is a freedom of choice, ceases one’s pain and suffering and decreases traditional suicide rates.
Representing the importance of emotional support, Susie comforts Bearing in the final days of her life by simply talking to her and listening to Bearing’s fears about death and pain. Susie explains to Bearing that her cancer is not and will not be cured and she must decide on how she wants to die, which is information Dr. Kelekian never clearly explained to Bearing. Providing Bearing with the information about how she may choose how she wants to die, Susie returns control back to Bearing that Dr. Kelekian and Dr. Woodward had denied her. This sense of compassion and respect for the patient is crucial in patients making the best decisions for themselves. Without the thorough communication between Bearing and Susie, Dr. Kelekian and Dr. Woodward would have extended Bearing’s suffering to benefit their research. Susie’s compassion for Bearing puts the patient first and allows Bearing to accept death on her own terms as a do not rusticate
This is a fascinating case because it presents the distinction between a patient’s right to refuse treatment and a physician’s assistance with suicide. Legally, Diane possessed the right to refuse treatment, but she would have faced a debilitating, painful death, so the issue of treatment would be a moot point. It would be moot in the sense that Diane seemed to refuse treatment because the odds were low, even if she survived she would spend significant periods of time in the hospital and in pain, and if she didn’t survive she would spend her last days in the hospital. If Diane were to merely refuse treatment and nothing else (as the law prescribes) than she would not have been able to avoid the death which she so dearly wanted to avoid.
The delivery of healthcare mandates a lot of difficult decision making for healthcare providers as well as patients. For patients, much of the responsibility is left to them especially when serious health problems occur. This responsibility deals with what treatments could be accepted, what treatments could be continued, and what treatments could be stopped. Overall, it considers what route should be taken in regards to the health interests of the patient. However, there are circumstances in which patients cannot decide for themselves or communicate what they want in terms of their healthcare. This is where the ethical issue concerning who should be responsible for making these important healthcare decisions occur if a patient was to be in this sort of situation. Healthcare providers can play a role in the healthcare decision making as their duty is to act in the best interest of the patient.
The Ethical Decision Making Model is an ethical guideline that is useful in ethical dilemmas and what course of action to take. It’s a framework that allows professionals to analyze and make ethical decisions to the best of their ability. It gives counselors a protocol to determine the appropriate course of action when faced difficult challenge. These decisions are taking into account; reflect a concern for the interests and the well-being of all clients concerns. Counselors should keep in mind the Golden Rule: “Do onto others as you would want onto you”.
First, let’s consider the reasoning behind the patients choosing to forego extraordinary treatment for their cancer. They have decided, as Beauchamp would put it, that refusing to prolong their lives in the face of pain and suffering “neither harms nor wrongs [them] and may provide a benefit” (Beauchamp, 76). They “intend to quit life because of its bleak possibilities” (Beauchamp, 77). The doctor readily complies with their wishes out of moral, legal, and professional obligation. A choice has been made to let both patients die, as a response to their “competent and authoritative refusal of treatment” (Beauchamp 74).