Utilizing An Ethical Decision-Making Process In Health Care Management Essay.

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1 -Comprehensively utilizes a formal ethical decision-making process to gather and evaluate relevant facts pertaining to a case study in health care management.

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2- Comprehensively describes and applies ethical theories and principles to a case study related to health care management practice.

Comprehensively utilizes a formal ethical decision-making process to gather and evaluate relevant facts pertaining to a case study in health care management

Ethics and ethical practices are essential in the management of healthcare. Several ethical issues surround the nursing profession. These issues are common in healthcare management, patient care, and the considerations of end-of-life as indicated in the provided case study. It is the ethical duty if the health practitioner to respect the patient’s decisions in consultation with the family of the patient (Shanks, 2016). In this paper, we discuss how a nurse can apply good communication skills, critical thinking and good decision-making to assess and immediately address a situation. The paper additionally discusses the investigation and evaluation of the claims related to the clinical procedures in addition to staff’s ethical behaviors. Finally, we discuss how the nurse can ensure that the Brookside Hospital provides Nichol’s family with the required discharge and end-of-life support.

The problem faced by Ms. Abrams when she arrives at her office is trying to understand the main cause of the scuffle that was experienced between Mary and John regarding their father’s medical condition. The decision regarding the best approach to solving the problem she has at the office. This is simply because the problem is about a misunderstanding between Mr. Nichols’ family. The situation and how it can be handled is the sole responsibility the management of Brookside Hospital. The manager in cooperation with the hospital’s security must ensure that the misunderstanding is solved promptly to prevent any physical confrontations.

The decision made by Ms. Abrams as the administrator at Brookside Hospital may affect the family. This impact may happen in such a way that both Mary and John may not be allowed within the facility or the patient’s room at the same time. This is due to their differences regarding the clinical procedure that is best for their father. The difference in opinions may result in another confrontation if the two are allowed access at the same time. As an administrator, Ms. Abrams should be the decision maker in this situation. The ethical principles of conflict resolution strategies could be helpful in this situation (Finkelman, 2012). Some of the possible options that can be used to solve this problem may include calling John and Mary into the office and having a discussion with them about the importance of being peaceful and reasonable for the sake of their ailing father. Additionally, they could be prevented from visiting the patient at the same time if they cannot agree to work together in harmony.

Comprehensively describes and applies ethical theories and principles to a case study related to health care management practice

Challenge 2

When Ms. Abrams arrives in her office, she is faced with the challenge of assessing and dealing with the situation that initially involved a scuffle between the family members of a patient admitted in the ICU. There is an ethical conflict in the decision made by both Ms. Abrams and the Brookside Hospital. Mr. Nichols had an advanced directive that included DNR and DNI orders in addition to a preference for no life-support device. The hospital, however, decided to place Mr. Nichols in extensive life support. This is thus an indication that the wishes of Mr. Nichols were not granted and Mary his daughter is furious that the Hospital failed to do thorough research on her father’s medical history to ascertain his preferences and directives (Shanks, 2016).

From the provided case, we are informed that Mr. Nichols had made an advanced directive regarding the types of treatment and designated Mary to speak on his behalf and make the decisions. However, Mary was not available at the time of admission, and the physicians, therefore, deemed that the benefits of the life support outweighed the risks and thus acted to prevent more harm.

The situation is thus as much the facility as the manager’s responsibility. The management of the hospital provides the leadership that should guide the operations within the organization. Any conflicts in the ethical issues experienced in Mr. Nichols scenario stems from the failure of the manger in creating an environment that ensures good and ethical practice (Finkelman, 2012). The individuals who will most likely be affected by the decisions in this scenario are the attending nurses and Mr. Nichols’ family. Mary who is Nichols’ daughter should be the appropriate decision maker because she had been picked by Mr. Nichol as a surrogate responsible for any decision making in the event Mr. Nichol becomes unresponsive due to his condition.

It is important to know Mr. Nichols’ medical history and the available paperwork to ascertain the advanced directive he had initially made. This information helps the medical team in knowing the wishes of the patient before an informed decision on the course of action can be made (Runciman, Merry & Walton, 2017). The key principles of medical ethics include autonomy, beneficence, non-maleficence, and justice. Autonomy requires that the nurse respects the decision of the patient as they can act voluntarily with a full understanding of the consequences of their decision (Elwyn et al., 2012). This principle was however not respected as Nichols was placed on a life support machine. Non-maleficence requires that the patient is not put in a situation that would cause more harm, beneficence ensures that the proposed care benefits the patient, while justice demands fair treatment of the patient without any discrimination.

Understanding the provided case study and the ethical issues surrounding patient care in healthcare management

As an administrator, it would be appropriate if Ms. Abrams ensures that the wishes of Mr. Nichols are respected. The life support should, therefore, be withdrawn as per the request of the patient through his daughter Mary. This course of action is appropriate as it suites everyone especially the patient’s family who would love to Nichols to experience a dignified death according to his wishes. According to the laws by most accrediting bodies, a patient who has made a living will express their desires concerning any life-prolonging procedures should have their wishes respected especially if the patient has a terminal condition as is the case with Mr. Nichols.

The final problem in the case study is the provision of an appropriate discharge and the end-of-life support that suits the family. An ethical dilemma compounds this problem. Mr. Nichols is currently on minimal life support and wants to be taken home even though being withdrawn from the support would end his life within one week. His daughter agrees that he should be taken home so he can experience death with dignity. His son John, on the other hand, is adamant that Mr. Nichols should be taken to a hospice facility. It is, therefore, a conflict between the wishes of the patient and the ethical principles of care.

The situation in this challenge is owned by Mr. Nichols himself as he is the one who can make decisions regarding his life and the course of action he deems appropriate for him. Additionally, as Mr. Nichols has gained consciousness, he is the one responsible for making the decision on the action to be taken (Elwyn et al., 2012). This decision should thus be implemented by the management, and it may affect the patient’s family especially John who feels that Mr. Nichols’ life should still be prolonged. The ethical principles associated with this problem include autonomy, non-maleficence, beneficence, and justice (Elwyn et al., 2012)S. There could be several ways of addressing this situation that may include talking with the patient and his family about the benefits of proceeding with the treatment and how these benefits outweigh the risks. If the patient cannot be convinced, then it would be advisable to grant him his wish and provide appropriate end-of-life support.

Conclusion

Patient care is one of the most critical aspects of the healthcare setting. Hospitals must aim to provide quality care based on the ethical principles of care. These principles include autonomy that requires that the patient’s consent and decisions are respected, non-maleficence that demands that no harm is caused to the patient during care, beneficence that ensures that the benefits of a particular course of action outweigh the risks, and justice which ensures that care is provided to all patients equally and fairly. The above principles should, therefore, be considered in care.

References

Elwyn, G., Frosch, D., Thomson, R., Joseph-Williams, N., Lloyd, A., Kinnersley, P., ... & Edwards, A. (2012). Shared decision making: a model for clinical practice. Journal of general internal medicine, 27(10), 1361-1367.

Finkelman, A. W., & Finkelman, A. W. (2012). Leadership and management for nurses: Core competencies for quality care. Pearson.

Runciman, B., Merry, A., & Walton, M. (2017). Safety and ethics in healthcare: a guide to getting it right. CRC Press.

Shanks, N. H. (2016). Introduction to health care management. Jones & Bartlett Publishers.