Medical prescription forms a critical component in the application of medical ethical decision making. According to Adams (2006), “the authority to prescribe medication inevitably creates a situation of inequality between the prescriber and the patient” (p.1). This justifies the need for an ethics framework, which will be used to safeguard the ethical practices among medical personnel. In this case, there are three parties involved in the ethical dilemma. First, we have the 96 year old patient who has been admitted with symptoms resembling the presence of a liver disorder. Second, we have the medical personnel who are attending the patient who has been admitted. Third, we have the patient’s daughter, who is a practicing naturopathic.
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The ethical dilemma in this case emerges from the conflict experienced between interests of the naturopathic and the professional medical team. According to the principle of consequentialism, the medical team should essentially consider the consequences of the actions undertaken by the naturopathic. Indeed, the patient has been admitted at the hospital. Hence, it is up to the medical team to ensure that the health institution’s policies are upheld regarding treatment of patients. They are unaware of the potential consequences of allowing the naturopathic to administer the strange concoction given to the patient.
According to the principle of patient centered deontology, the medical team needs to ascertain, if indeed, the alternative medicine provided. However, in this case we are aware that the medical team is yet to establish whether the treatment regimen provided in the first instance was effective in providing cure. Hence, the decision to allow the naturopathic to administer a substance that essentially smelt like feces undermines the principle of deontology. Additionally, the medical has undermined the principle of care because they are bound to provide the best level of care to the patient regardless of the circumstance being faced. In satisfying the principle of care, the medical team needs to establish all the causal relationships and address them conclusively.
Looking further into the created ethical dilemma, a concern emerges there regarding the practice of ethical principles stipulating biomedical ethics. First, the principle of non-maleficence has not been upheld given the fact that this principle focuses on avoiding harm occurring to the patient. Indeed, even after conducting proper diagnosis that the patient could be suffering from a liver disorder, they still subject the patient to harm by allowing him being administered with the concoction prepared by the naturopathic, which essentially results in more pain on the patient. Any medication administered to a patient may cause serious health effects. Hence, it is important to consider reliable approaches that could be used to safeguard this from happening. The principle of respect for autonomy was also not acknowledged given the fact that the patient was not consented before the drug/concoction was administered. In fact, what the naturopathic did was simply a consultation with the medical team, but the patient was left out of this consultation. It makes it appear as if the daughter is merely trying to prove the potency of the drug in curing certain ailments.
The principle of beneficence has also been undermined. The principle demands that any action should always result in doing well for the sake of the patient. In this case, the naturopathic talked to the medical team, but the members of the medical team had their own reservations regarding the appropriateness of the actions. Hence, when the patient was administered with the drug, this resulted in breach of the system. The principle of fidelity has also been undermined. The principle demands that medical personnel should at all times maintain the duty of care regardless of the situation. In this case, the extent of harm was determined. Hence, there was no need to subject the patient to more harm by administering drugs, which are not approved in the specific medical institution. Through duty of care, the welfare of patients can be maintained even when they are unable to make decisions on their own.
Plan of Action
First, there is a need for the medical team to be sensitized on the need to promote fidelity in the healthcare setting at all times. While doing this, the employees need to revise of the components entailed in accomplishing duty of care as a perspective of ensuring that healthcare meets its desired objectives.
Second, the health team needs to be sensitized on the need to promote non-maleficence in the domain of healthcare. Indeed, it is not morally appropriate to consider using alternative medicine in a modern medical centre where treatment regimens and procedures rely on approved drug regimens and treatment processes for specific illnesses. This safeguards the patient from undergoing serious harm, especially considering the fact that the training process that the medical team was subjected did not probably entail aspects of alternative medicine. Hence, their understanding is only based on mere suspicion that it could work.
Thirdly, the medical team needs to consider the beneficence of any medical procedure administered to any patient. In doing so, members of the medical team need to consider final results of using a particular drug regime used to conduct treatment to the affected patient. In this case, the decision to allow the patient to be administered with what the naturopathic recommended did not take into account the positive aspects it would bring on the patient.
There will be need to implement an ethics training program, which will incorporate the entire medical team as participants. The training program will focus on ethical decision making parameters that need to be considered when administering treatment. The hospital staff will need to understand the chain entailed in referral of patients in the event the hospital personnel are uncertain of the treatment regimen that will be effective. Thus, the program will also focus on the components of the alternative medicine (considering the naturopathic’s approach that her concoction would provide a positive outcome). Role games will be used as a tool in the training program to simulate scenarios in which ethical decision making principles such as beneficence, mal-maleficence, autonomy, deontology, and consequentialism. Additionally, there will be need for the medical personnel to design new policies that will be used to protect the autonomy of patients given the fact that in the present circumstance it appears as if there is no clear framework to guide the medical team in making morally correct decisions. Focus will also be given on the application of professional practice that takes into account the patient’s needs.
An accountability procedure will be designed, which will be implemented by members of the medical team. In this procedure, colleagues will record ethical decision making principles that they used in particular instances. A review will be conducted after every fortnight during which members will critically analyze what they did, where they went wrong, and improvements that can be made to improve their practice. Corrective measures will be identified and incorporated into the current ethics program that members of the medical team will be required to consider. Finally, specific members will be appointed to make follow up on the ethical practices of their fellow colleagues.
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