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Question 1: Write a 1-2 page essay addressing the discussion questions posed for the one you selected. Be sure to clearly identify the news clipping you selected. (News clippings and transcript of story provided in PDF attachment)
Adhere to current APA Style and cite all sources. Review the rubric for further information on how your assignment will be graded.
—Assignment Discussion Questions
Discuss the issues of integrity in this case.
Should criminal charges be considered in this case, if accurately reported? Discuss your answer.
Why did you choose to respond to this story?
How is integrity displayed in your clinical setting
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Question 2: Use the model provided below. Apply this model to a challenging situation in your nursing career that required you to consider the ethical dimensions of the patient case and the role you played in providing care. Specifically apply and address the questions within each topic area as they pertain to your situation.
Situation questions should be pertaining to: Patient Suffering from an Ischemic stroke in the emergency room, staff suggest the use of the medication known as TPA (Tissue Plasminogen Activator) Brand name medication is known as Alteplase. Patient is alert and oriented x4 with facial droop and slurred speech, it has been one hour since the onset of symptoms.
In your conclusion, discuss the impact of the Four Topics process. Did applying these principles shape your decision making in any way? Does this seem like a valid process for you to apply in your practice?
Your paper should be 1-2 pages. Adhere to APA formatting throughout, and cite any outside sources you may use.
Review the rubric for further information on how your assignment will be graded.
TABLE 2-1 Four Topics Method for Analysis of Clinical Ethics Cases
Medical Indications: The Principles of Beneficence and Nonmaleficence
1. What is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal?
2. What are the goals of treatment?
3. In what circumstances are medical treatments not indicated?
4. What are the probabilities of success of various treatment options?
5. In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided?
Patient Preferences: The Principle of Respect for Autonomy
1. Has the patient been informed of benefits and risks, understood this information, and given consent?
2. Is the patient mentally capable and legally competent, and is there evidence of incapacity?
3. If mentally capable, what preferences about treatment is the patient stating?
4. If incapacitated, has the patient expressed prior preferences?
5. Who is the appropriate surrogate to make decisions for the incapacitated patient?
6. Is the patient unwilling or unable to cooperate with medical treatment? If so, why?
Quality of Life: The Principles of Beneficence and Nonmaleficence and Respect for Autonomy
1. What are the prospects, with or without treatment, for a return to normal life, and what physical, mental, and social deficits might the patient experience even if treatment succeeds?
2. On what grounds can anyone judge that some quality of life would be undesirable for a patient who cannot make or express such a judgment?
3. Are there biases that might prejudice the provider’s evaluation of the patient’s quality of life?
4. What ethical issues arise concerning improving or enhancing a patient’s quality of life?
5. Do quality-of-life assessments raise any questions regarding changes in treatment plans, such as forgoing life-sustaining treatment?
6. What are plans and rationale to forgo life-sustaining treatment?
7. What is the legal and ethical status of suicide?
Contextual Features: The Principles of Justice and Fairness
1. Are there professional, interprofessional, or business interests that might create conflicts of interest in the clinical treatment of patients?
2. Are there parties other than clinicians and patients, such as family members, who have an interest in clinical decisions?
3. What are the limits imposed on patient confidentiality by the legitimate interests of third parties?
4. Are there financial factors that create conflicts of interest in clinical decisions?
5. Are there problems of allocation of scarce health resources that might affect clinical decisions?
6. Are there religious issues that might influence clinical decisions?
7. What are the legal issues that might affect clinical decisions?
8. Are there considerations of clinical research and education that might affect clinical decisions?
9. Are there issues of public health and safety that affect clinical decisions?
10. Are there conflicts of interest within institutions and organizations (e.g., hospitals) that may affect clinical decisions and patient welfare?
Source: Jonsen et al., 2010
Unformatted Attachment Preview
#1 Wrong Operation Doctor (ethics and integrity)
Hospitals find it hard to protect patients from wrong-site surgery.
Last year a jury returned a $20 million negligence verdict against Arkansas
Children’s Hospital for surgery performed on the wrong side of the brain of
a 15-year-old boy who was left psychotic and severely brain damaged.
Testimony showed that the error was not disclosed to his parents for more
than a year. The hospital issued a statement saying it deeply regretted the
error and had “redoubled our efforts to prevent” a recurrence.
So, what happened? “Health care has far too little accountability for results
… . All the pressures are on the side of production; that’s how you get
paid,” said Peter Pronovost, a prominent safety expert and medical director
of the Johns Hopkins Center for Innovation in Quality Patient Care. He
added that increased pressure to quickly turn over operating rooms has
trumped patient safety, increasing the chance of error.
Kenneth W. Kizer, who coined the term “never event” nearly a decade
ago when he headed the National Quality Forum, a leading patient safety
organization, said he believes reducing the number of errors will require
tougher reporting rules and increased transparency.
Source: Boodman, S.G. (2011). Kaiser Health News,The Washington Post. Pozgar, 4th ed., p. 43
Links to help:
https://www.washingtonpost.com/national/the-pain-of-wrong-site-surgery/2011/06/07/AGK3uLdH
_story.html
https://www.insurancejournal.com/news/southcentral/2012/12/17/274239.htm
https://www.qualityforum.org/Home.aspx%20
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