Ethical Integrity: Brain Death Scenario

944 words | 4 page(s)

Integrity is an important factor in health care service delivery. This is because it serves to guarantee that health care professionals will always act in the best interests of the patients and their loved ones at all times. In this sense, patients and their families can trust that the healthcare facilities they visit and the professionals that treat them will not take advantage of their health care problems and needs for their own benefit (Boylan, 2014). Similarly, health care facilities and professionals must protect patients from any ill intentions that may stem from their families (Hope, Savulesco, & Hendrick, 2008). In this scenario, there is a clear tussle in the patient’s family that has divided the family into two opposing factions.

While one group seeks to end the patient’s life on the grounds that the patient “would not want to live this way” the other is accusing this group of being after the patient’s wealth. From this position, it becomes abundantly clear that the medical care issues to be considered in this scenario are those of good faith, beneficence, and maleficence (Pozgar, 2016). The healthcare facility and professionals involved are required to act in good faith insofar as the patient’s health is involved. Similarly, they are required to uphold the principle of beneficence insofar as the patient’s health and the family’s conditions are concerned. At the same time, they are required to protect the patient from any form of maleficence either from other health care professionals or family members. In essence, this creates a confusing situation in which the healthcare facility and professionals are required to uphold the highest standards of medical ethics.

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The piece of legislation that applies to this scenario is statute 4-1107 of the state of Arizona. This statute essentially declares that a determination of death should be made in accordance with accepted medical standards. From this position, it is quite clear that the patient cannot be classified as dead under any conditions. Hence, it now becomes a matter of determining whether the conditions under which the patient will continue to live under life support are not that much different from death (Pozgar, 2016). Seeing as essentially determining this fact is quite difficult, it becomes vital that medical expertise is applied to develop the alternative outcomes that are in store for the patient (Hope et al., 2008). It becomes critical to examine whether the patient in question is likely to ever recover from their injuries or whether they can lead a normal life with their injuries. Once the facts have been established, it becomes a matter of presenting all the possible outcomes for the family members in the most objective way possible. The best way to ensure that this is maintained is to avoid making any suggestions to the family members on the best way forward (Harris, 2011). Finally, it becomes vital to also understand the power and role of the spouse in this scenario. In the event that the spouse is tasked with making an informed decision on behalf of their incapacitated significant other, then they should be fully informed on all the medical options available for their spouse.

As the administrator, there are a number of ethical issues that stand to arise based on the decision that one takes. The first ethical issue is that of full disclosure (Harris, 2011). As the administrator, it is vital to ensure that the spouse of the patient in this scenario is fully informed of all the options available to the family (Hope et al., 2008). This involves not only the medical and health aspects, but also the financial, social, emotional, and mental aspects. The ethical approach to this scenario would be to navigate all the options available for the patient in their entirety while covering all of the aforementioned aspects (Harris, 2011). In this way, the spouse of the patient and the rest of the family can fully understand the situation in which they are in and what each decision will mean for them and the patient. Similarly, it is also vital that the administrator provides an honest medical assessment of the patient based on the information from the attending physician as well as their personal experience (Fincham, 2009). This will enable the family to understand what they will have to go through. Finally, the issue of euthanasia will also arise insofar as informing the family is concerned (Boylan, 2014). To ensure transparency, the administrator should also provide advice on euthanasia, its eligibility, costs, and legality should the family choose to make that decision.

Ensuring ethical integrity is the hallmark of sound healthcare service delivery. To this end, it is important that all protocols, procedures, and legal mandates are adhered to at all times when dealing with this patient (Harris, 2011). This requires developing an elaborate guideline on the protocols to be followed when handling such cases in the facility. By doing this, attending physicians and other medical staff can have a point of reference from which they can navigate the scenario with relative ease (Pozgar, 2016). This will ensure they provide the soundest medical advice while still observing the full extent of the law and maintaining ethical medical practice. Along the same line, establishing these guidelines as core facility procedures and policies will work well to absolve the facility and its staff of any medical or ethical liability insofar as dealing with such patients is concerned (Fincham, 2009). This is a critical aspect of handling such patients that must be fully implemented in accordance with the law as well as medical and nursing ethical standards. It is only in this way that the facility can best serve the patient and the family in a scenario such as the one presented.

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