In the given scenario, the ethical dilemma arises when the position of the attending physician gets in contradiction with his own duties. On one hand, the code of conduct for doctors provides that he should attend to his patients in case of health issues. On the other hand, it is also imperative under the Codes of Professional Ethics under the Nursing and Midwifery Board of Australia that the health practitioner should take the permission of the patient whom he intends to treat. In the given situation, the patient is a child and hence, the permission of his guardians has to be taken by the doctor ('Ethical Dilemmas in Nursing', 1986). Since the child’s mother objects to the treatment of the child and his father is not with him at the moment, hence the doctor cannot initiate a treatment that is essential. Thus, the professional dilemma that arises here is that there arises a conflict between the primary responsibility of the health practitioner to give medical assistance to the child on one hand and the responsibility to seek for the permission to initiate the treatment on the other hand. If the health practitioner fails to meet with either of the two requirements, he shall be making a breach of his duty and thus is stuck in an ethical dilemma (Gair, 2013).
The decision making model that can be selected in this matter is the DECIDE model as prescribed by the NCBI (KL, 2015). The DECIDE model is the ellipsis of six meticulous activities required in the decision making process. The steps as provided in the model are enlisted as follows:
- D = Defining the problem under the Health Issue
- E = Establishing the criteria for the selected health care measure
- C = Considering all the alternatives that are available in the situation
- I = Identification of the best alternative out of the given ones
- D = Developing a proper executable plan of action under the scenario
- E = Evaluating the solution and monitoring the health issue under the selected alternative.
Application of the Model:
Using this model, the dilemma can be resolved effectively. The health issue here is that of meningitis which requires immediate attention. The victim here is a kid who has acute symptoms of vomiting and convulsions. He is going through a lot of suffering and if the treatment is not started immediately, his condition is likely to worsen. The alternatives available here are either to treat the child or allow him to suffer and of these two, it shall be wise to start the treatment of the child which if ignored may result in complications. In order to achieve the requirement, what can be done is, initially, to relieve the child of his vomiting tendencies, he can be given certain medications to ensure that his condition does not deteriorate and he remains stable (Stahl, 2014). Then, a wait for the appearance of his father can be made who can be explained the actual health situation of the child and further treatment can be carried on in this regard (Campbell, 1997).
This model if adhered to can help in solving the ethical dilemma that has arisen in the situation to a certain extent and can also ensure that none of the responsibilities of the health practitioner are violated in the matter.
Being the parents of the child, it is very important that they should understand the critical condition through which the child was going. He was in a complete state of acute health problem. Hence it was very necessary looking at the deteriorating condition of the child that he should receive immediate medical help. If the help would not have been extended, the child could have died of meningitis or even if we would have waited to seek for another independent medical advice, the child would have gone through acute suffering to a greater extent. Thus, it was necessary that the child should have been given immediate medical attention. Moreover, no medical assistance was provided for treating meningitis in the given case. Rather, the convulsions and the vomiting was tried to be treated so that some amount of relief could have been given to the child. Being doctors, it is our foremost important duty to make sure that no patients undergo suffering which is under our control. If the treatment was not give, at time, then, the condition could also have worsened to such an extent that treatment would not have been possible and nothing would have remained under control. Whatever was done only intended to provide help to the child under his chronic condition.
Campbell, A. (1997). Medical ethics. Auckland: Oxford University Press.
Ethical Dilemmas in Nursing. (1986). Journal Of Medical Ethics, 12.
Gair, J. (2013). At the Ethical Crossroads. Gastroenterology Nursing, 36(1), 30-35. doi:10.1097/sga.0b013e31827da049
KL, G. (2015). DECIDE: a decision-making model for more effective decision making by health care managers. - PubMed - NCBI. Ncbi.nlm.nih.gov. Retrieved 29 May 2015, from https://www.ncbi.nlm.nih.gov/pubmed/18475113
Stahl, J. (2014). Trust and Recognition: Coming to Terms with Models. Medical Decision Making. doi:10.1177/0272989x14563080